HUMAN ANATOMY

FOR ARTISTS

THE ELEMENTS OF FORM

 ELIOT GOLDFINGER

HUMAN
ANATOMY
FOR ARTISTS
The Elements of Form

Oxford University Press 1991

 The Skefeton * SKULL

SUPERIOR, TEMPORAL LinE

GLABELLA frontal eminence:
7*w TEMPORAL
PARIETAL EMINENCE < V' FOSSA

BREW RIDGE BROW

'RlDOC

ORBIT f NASAL
ysoNE
NASAL 30 N£
T ANT
ZYGOMATIC ARC hi NA5AL
SPINE
7 r jcternal octip;tal
\ PROTUBERANCE
MASTOID PROCESS--'
■ MASAL APERTURE

ANGLE Of JAW ZYG OMATI C ARCH7

RAMUSLA SIDE
-V-mandible angles ^ VIEW
♦ BODY—■
pMWiENTAL PROTUBERANCE OF MANDIBLE
■MENTAL TUBERCLE MENTAL
FRONT VIEW PROTUBERANCE
ANCLE OF JAW
■zygomatic arch

mandible
mental
OCCIPITAL CONDYLE TUBE RCLE
FORAMEN magnum-

V PARIETAL
X EMINENCE

EXTERNAL 1
"HARD
OCCIPITAL 1 PALATE
PROTUBERANCE

SUPERIOR / BOTTOM VIEW

NUCHAL LINE
POST-—♦ANT,
CONDYLAR PROCESS

PARIETAL EMINENCE SUPERIOR TEMPORAL LINE

MASTOID PROCESS

■ANGLE OF JAW

MANDIBLE NASAL
I BONE

'■BROW
RIDGE

TO P VIEW
POST-A NT

6
 The Skeleton - VERTEBRAL COLUMN

CERVICAL VERTEBRAE
■
f t ' ® y L
_ -_, ATLAS (Cl)

/ t- AXIS (cl)

THORACIC VERIESRAG
LUMBAR VERTEBRAE

Til,
SACRUM

L • V ■ i

V
\v.
"v
COCCYX

f05T ~-*-ANT

BACK VIEW RICrHT SIDE VIEW FRONT VIEW

 The Skeleton * RIB CAGE

]«t thoracic vertebra

r > .1 w- ^
hAKUBRIUM

ANGLE OF RIB

S> >**^bddy
^
i 0F sternum

C05TAL
CAFVTlLA&E

XIPHOID
PROCESS

V£ RTF RRA L
LOLUM,JM

3FIN0U5
PROCESS

FRONT VIEW TWELFTH PUB

SPINOUS PROCESS-^
1»t THOTACiC VERTEBRA
/■ 1 V ANGLE OF ftlbTj
'tU I' ^
1 ^
nr A C\ ARTICULAR SURFACE FOR CLAVICLE

MANU&RlLHt

STERNAL ANGLE

-BODVOF STERNUM

TOP VIEW
,7™ COSTAL CARTILAGE

FlANUBRlUtt

12™
THORACIC
VERTEBRA

RIGHT SIDE VIEW

PQ5T.-*-^ANT.

12™ THORACIC VERTEBRA BOTTOJA VIEW

 The Skeleton * RIGHT HAND

TRAPEZOID CAPITATE lunate capitate

SCAPHOID, LUNATE TRIQUETRAL CAPHOID
(TUBERCLES)^-^ PISIFORM P1SIF0RH„V> . TRAPEZOID
TRAPEZIUM ^ A N / -'TRAPEZIUM

HA HATE HAMATE
METACARPAL JMP
HAMULUS
OF THE
HAHATE
SHAFT
PROXIMAL
PHALANX

HEAD
BASE
DISTAL PROXIMAL
phalanx shaft PHALANX

*»4-head
FRONT (PALM) VIEW ^ MIDDLE BACK (dorsal) View
^ PHALANX ULNAR*—4 RADIAL
RADIAL «—» ULNAR

DISTAL _
PHALANX

J
SCAPHOID ■LUNATE
St AFHQlO
TRIQUETRAL
LUNATE
SCAPHOID ..
CAPITATE
IsTRAPEZIUM " ' •TRIQUETRAL
(TUBERCLE DORSAL "\~-H
CAPITATE
TRAPEZOID TRAPEZIUM RADIAL *-J-MJLNAR T
*■ HAMATE
\ PALMAR
\ END VIEW OF CARPUS

fDORSAL VIEW
V OF THUMB, , PALMAR VIEW1
. OF THUMB ,

THUMB SIDE (RADIAL VIEW) LITTLE FlMOCR SIDE (ULNAR VIEW)

The Skeleton * HAND

The SKELETON OF THE HAND is designed to the radius and minimally with the fibrous disc
perform the most heavy brutal chores* as well attached to the distal end of the ulna.
as extremely precise* sensitive, and delicate The METACARPUS consists of the five meta¬
movements. In life* the hand is predominantly carpal bones. The box like base of each bone is
bony* with its surface form based for the most located at the proximal extremity of the shaft*
part on its skeleton* especially its back or dorsal while the rounded head is located at the distal
surface. It consists of the carpus* the metacar¬ extremity, Metacarpals two through five (index
pus* and the phalanges. The phalanges together to little finger) as a group radiate di stall y. The
arc longer than the metacarpals, which in turn dorsal surfaces of the metacarpals arc wide and
are longer than the carpal s. These proportions flattened, especially distalKy, and all have a
are opposite to those found in the foot between slight convex curvature. Metacarpals two
the tarsals* metatarsals* and phalanges. through five create a plane on the back of the
The CARPUS consists of eight small irregu¬ hand that curves side to side; it is especially
larly shaped carpal bones arranged in two noticeable at the knuckles. This curve, or trans¬
rows—a proximal and a distal—of four bones verse arch, helps create the concavity of the
each. The proximal row contains the scaphoid* palm. The curvature of the transverse arch flat¬
lunate, triquetral* and pisiform. The distal row tens when the open hand is pressed against a
contains the trapezium* trapezoid, capitate, and flat surface.
hamate. As a unit* the carpal bones form half a Distal Ey* the heads of metacarpals two
disc which is curved side to side, so that its through five arc connected to each other by lig¬
dorsal surface is convex; the concave palmar aments; the head of the thumb is unattached*
surface is transformed into the carpal tunnel for allowing it to have a great range of motion at
passage of the flexor tendons to the fingers. the carpometacarpal joint and the ability to op¬
On the back of the carpusk between the two pose the other fingers in grasping. The thumb's
carpal rows, is a depression (located toward the metacarpal is rotated around its long axis so
radial side). It is especially noticeable when the that its dorsal surface faces laterally when she
wrist joint is flexed. Also noticeable in this posi¬ palm is directed forward (its dorsal surface is
tion is another depression between the distal almost perpendicular to the dorsal surfaces of
end of the radius and the proximal carpal row the ocher metacarpals).
(the articulating proximal surface of the carpus The heads of metacarpals two through five
becomes a raised prominence between the two are somewhat spherical. Their distal surfaces
depressions). become exposed in life as rounded knuckles
On the palmar side of the carpus* bony when the fingers are flexed at the metacarpo¬
prominences arc formed by the pisiform at the phalangeal joints. These four metacarpals end
ulnar side (at the base of hypothenar eminence) distal[y along a curved line* with the middle
and by the tubercles of the trapezium and sca¬ finger projecting the farthest. The width across
phoid together on the radial side (at the base of these four metacarpal heads is greater than the
the thenar eminence). These bony projections width across the humeral epicondyles at the el¬
are especially noticeable when the wrist joint is bow. Because the thumb's metacarpal head is
extended. not as rounded as the others* and because of
At the wrist joint, the arched proximal carpal limited motion at the metacarpophalangeal joint
row articulates primarily with the distal end of of the thumb, the distal surface of this metaear-

*7
 The Skeleton * PELVIS

POSTERIOR SUPERIOR
CREST ILIUM ILIAC -SPINE
TUBERCLE
S’V.

POSTERIOR
ACETABULUM INFERIOR
ILIAC SPINE
PUBIC
PUBIC SYMPHYSIS
TUBERCLE
ISCHIUM ISCHIAL TU&CROSI
PROMT VIEW BACK VIEW

articular surface
CREST ^OR SACRUM

PO5TERI0R
POSTERIOR SUPERIOR
SUPERIOR ILIAC SPINE
ILIAC

POSTERIOR
INFERIOR /
ILIAC SPINE ANTERIOR SUPERIOR ILIAC SPINE
SACRUM ANTERIOR INFERIOR ILIAC SPINE IOR INFERIOR
ILIAC SPINE
ISCHIA -ACETABULUM
SPINE
COCCYX UfllC TUBERCLE HIAL SPINE
ARTICULAR SURFACE OBTURATOR
ISCHIUM
AT PUBIC SYMPHY5I! FORAMEN
ISCHIAL INFERIOR RANUS OF PUB«S\ ISCHlOPU&lC
ISCHIAL
TUBEROSITY EftlOR RAMUS Of ISCHIUM/ RAMUS UBEROSITV
OUTRIDE VIEW INSIDE VIEW
POST-*—►ANT, AN X** POST.
(fci&HT HIP BONE) (RIGHT HIP BONE)
ANTERIOR INFERIOR
SACRUM POSTERIOR SUPERIOR PUBIC SYMPHYSIS ILIAC JPINE
'ILIAC SPINE ■PUBIC TUBERCLE /
I
PUBIC ARCH
\acetabulum I/
reentering OUTER LIP
ANGLE V OF CREST
/ CREST

^ tubercle

ANT
ISCHIAL
T URE POSIT Y POST
SACRUM1 POSTERIOR
ANT. SUPERIOR
ANTERIOR SUPERIOR COCCYX'
TOP VIEW BOTTOM view ILIAC SPINE
ILIAC SPINE

JO
 The Skeleton * PATELLA

The PATELLA, or kneecap, is the Largest sesa¬ patella is seen in the flexed knee, not in the
moid bone of the body. It is attached to the extended knee, because the quadriceps tendon
deep surface of the tendon of insertion of the meets the patella at an angle during flexion,
quadriceps muscle of the thigh. The function of fn the standing position with the thigh re¬
the patella is to move this tendon away from laxed, the bottom of the patella sits at a level
the joint* giving rhe quadriceps greater mechani¬ just slightly higher chan the line of the knee
cal advantage. The deep surface of the patella joint; it rises slightly when the thigh muscles
articulates with the distal extremity of the fe¬ are tensed (with no motion raking place at
mur, protecting the articular cartilages of the rhe knee joint between the femur and tibia).
condyles, especially while kneeling. The patella is wider than the distance across the
The patella is triangular with founded cor¬ anterinr portion of the ridges of the medial and
ners and is flattened from front to back. Its lateral condyles of che femur, and therefore cov¬
apex is directed inferior]y. The two upper ers a portion of these edges when the knee is
rounded corners are prominent on the surface extended.
in life. The anterior surface of the patella is When the knee is straight, rhe patella sits in
convex! while the posterior surface has a wide the anterior shallow part of the femoral condyle
vertical ridge which glides in the groove be¬ groove. As the knee is Hexed, the patella slides
tween the condyles of the femur. The inferior down into deeper parts of the groove. This ac¬
apex, attaching to the patellar ligament! is not tion displaces fhc patella posteriorly in relation
seen on the surface in the straight extended to the anterior profile of the lower leg. When
knee5 however, a horizontal skin furrow may the knee is flexed* the thigh appears longer, be¬
appear at this attachment, When the knee is cause the patella has been dragged around to
flexed, the anterior surface of the patella forms the distal surface of the condyles of the femur*
an angle with the patellar ligament, revealing adding its thickness to the length of the thigh*
the apex (in side view). The upper edge of the

RIGHT PATELLA

POST
t, AT 0.
\ AWT

TOP V!£W
ARTICULAR SURFACE!, FOR, rcMUR

FRONT VJEW OUfflhPC VIEW iNiilDE VE

PoST^XNT WE L At. A*iT^I>Q5T

AN T
latched
POST
BOTTOM VI fc W

FATEE.LA
SHIFTS
P0ST£ai0fU.Y
|M RELATION
TO FRONT
OF
TJ&I'A

EXTENDED FLEXED
FOST4WVN r KHZ*
SIDE VIEW

35
 The Skeleton * RIGHT FOOT

TALUS
NAVI CUU A ft
TROCHLEA TUBERCLE
NECK NAVICULAR
l l CUBOID,
LATERAL CUNEIFORM
INTERMEDIATE CUNEIFORM

SECOND METATARSAL
/ proximal
phalanx middle
:>C / P H A L A N X
CALCANEUS DISTAL
TUBEROSITY OF PHALANX
OUTSIDE VIEW FIFTH METATARSAL
POST—* ANT

.TROCHLEA TALUS
NAVICULAR NECK
intermediate cuneiform \ Tjead'1, tubcbdsity
OF FIF TH
MEDIAL CUNEIFORM \\ V'
FIRST
METATARSAL
, \
,
' J NAVICULAR
TUBERCLE
METATARSAL

DISTAL PROXIMAL \
PHALANX CALCANEUS

NAVICULAR
TUBERCLE

INTERMEDIATE CUNEIFORM
LATERAL CUNEIFORM
,MEDIAL CUNEIFORM
NAVICULAR TUBERCLE
HEAD BASE SHAFT HEAD
TALUS \ BASE SHAFT
CALCANEUS

TOP VIEW
CUBOID
MED.
tuberosity of fifth metatarsal
POST <4^-ANT

TUBEROSITY OF FIFTH METATARSAL

CALCANE US | LATERAL CUNEIFORM

fATFftiL *££££ /CUBOID

PROCESS / \
Pftocess / <r^T -i

TALUS'"

BOTTOM VIEW
HEAD \ \ 'INTERMEDIATE CUNEIFORM
LAT. OF TALUS \ ^MEDIAL CUNEIFORM
POST ANT
NAVICULAR TUBERCLE
MEP

40
 The Skeleton * FOOT

The SKELETON OF THE FOOT is designed to bones: the talus, calcaneus, cuboid, navicular,
provide stability in supporting and distributing and three cuneiforms. There is substantial
the body's weight and resiliency when receiving movement within the tarsus.
the impact of the body's weight while walking, 1‘he talus (astragalus), located above the cal¬
running, and jumping. It also acts as a lever, caneus near the hack end of the medial side of
pushing the body forward during locomotion. It the foot, consists of a body, an anteriorly pro¬
is rigid upon takeoff and flexible upon impact. jecting neck, and a rounded head in front. The
The foot skeleton is composed of the tarsus, upper articular portion of the body* the
metatarsus, and phalanges, and except for the trochlea, is spool-shaped. It is the highest hone
phalanges of the lateral four toes, its bones are of the foot and articulates superiorly with the
characterized by their thickness and strength. tibia and fibula to form the ankle joint. Only
The phalanges are shorter than ihc metatarsals, flexion and extension are possible at this joint.
which in turn are shorter than the tarsal s. This The talus articulates infcriorly with the calca¬
arrangement is opposite to that found in the neus at the subtalar joint and anteriorly with
hand, where the carpus is short and the pha¬ the navicular. The subtalar joint permits inver-
langes are long. In the foot, the big toe is re¬ sion and eversion of the foot. The lateral edge
stricted to lying parallel to the other toes, un¬ of the trochlea of the talus becomes visible on
like the thumb, which is capable of opposing the surface in front of the lateral malleolus of
the other fingers. the fibula during extreme plantar Ilex ion of the
The foot has two perpendicular arches; a lon¬ foot (toe pointing). During inversion of the foot
gitudinal arch from front to back and a trans¬ (facing the foot inward), the lateral part of the
verse arch from side to side. These arches not head of the talus shows under the tendons of
only distribute weight but also afford the foot a the extensor digitonim longus, while the medial
degree of elasticity, providing shock absorption. pan of the head shows during eversion (facing
The longitudinal arch is actually a senes of five rhe foot outward) between the medial malleolus
almost parallel (slightly radiating] arches pass¬ and the navicular tubercle. These points of the
ing through the long axes of the five toes. There talus, when seen, appear as subtle prominences.
is a high medial arch on the inside of the foot The calcaneus, or heel bone, is blocklike, flat¬
and a very low lateral arch on the outside {the tened side to side, and Founded on its posterior
base of the metatarsal of the little toe does not surface. It is rhe largest foot bone. It is. inclined
support weight in the foot flat on the floor). upward, forward, and slightly laterally, resting
The transverse arch curves across the foot, its lower back edge on the ground (protected
bringing the outer edge of the foot down below by the fatty cushion of the sole of the
toward the ground. It is most noticeable at the foot). The calcaneus acts as a lever. Most of rhe
midpoint of the foot, where it is high on the lateral surface and part of the posterior surface
inside and low on the outside. The muscles, ten¬ (between the insertion of rhe Achilles tendon
dons, ligaments, and fasciae of the foot main¬ and the heel cushion) are subcutaneous. The
tain these arches. Achilles tendon conceals the upper part of its
Tile TARSUS contains seven stout tarsal hack surface.

. at. p.
RAMP
CUAVE&
DOWN
y~| WTEfi*^j

THROUGH FOOT
LOWER FRONT VIEW
MtTAT
ETATARSAL
PhAlAn&ES

RAMP keel
e i& toc
MET KAL-

HAV. TiHSEA

■ post: post *■— i AWT toe* I-j

TOP VIEW IMS IDE VIEW OUTSIDE VIE W SIDE VIEW

41
 The Joints

Closed O PEN
(conDvle
ADVANCES)

TEMPOROMANDIBULAR JOINT

TORSO
i'LT VitM

EXTENSION

FLEXION

TORSO
c.4Hri v ■L

ERCCT

J A
(PEFtR€NC^j l

Ik \
/lateral.
/ BENDING
SHOULDER
JOINT

EXTEN
 The Joints

THUMB INDEX FINGER METACARPO¬

Z (BAW^vjEw
WJTiiD
RJ&h T h*MD
OwT*lPL JfcAfeVAl}
Rl&Wf
VILW
J4Ah[> PHALANGEAL
JOINT
FRONT fPALh) VICW
MTftt^CWTtFfMCN AT
RIGHT HAND
REFERENCE ME r^KP^HAUlWUL
JGir+f L*T.i—• hto.
^lLE-hT Pi A.C X T C MIDN AT
IN T[ fl;*H>._i^i*,£; A|_ JbNT)

W.TAI, MOkuhal
PWA; *J¥«: A**HWK Hr TACAR;FH-

REFERENCE

53
 The Joints

5-pc VIEW
KNEE
*l4MT LC6
IT. JOINT
EXTENSION (I

DORSIFIEXION REFERENCE PLANTAR

FLEXION

SUBTALAR JOINT
FMnt vikhv
ftrfrNT FOOT laT.«—s-J^ED,

EVERSION REFERENCE INVERSION

 The Joints

BIG TOE
/HV^TKeXTCHPtD
/ At TAfHUiiL^j.Li-iHiL
JOINT (jUSH’Orf)

EXTENSION
S2SL *“5
REFERENCE
^MT Cm l^duhc*;

FLEXION

2NO TOE
>>JTSiDE vp(w
ftfttHT F0OT
AMT, .

EXTENSION

^toUMAl
!At,AM>C

REFERENCE
{f®bt -rjF.- .>«i>i/HCr|

FLEXION

ALIGNMENT
5J0C VIEW
The Muscles * STRUCTURE, FUNCTION, AND FORM

usually not possible lo make a fist when the cles, because that is where their form begins
wrist is fully flexed, because the finger flexor* and ends. Know the lta$k individual shapes of
are too short to contract further (active insuffi¬ each muscle. Think of the form of a muscle as a
ciency) and the finger extensors are fully swollen axis passing between the centers of its
stretched (passive insufficiency), preventing the areas of attachment.
fingers from flexing fully. Beware of illustrations that simply diagram
In analysing muscular activity, ir is. important the surface muscles' outlines without giving in¬
to think in terms of the combined actions of all dication of the deeper structures that may ac¬
the muscles in a given area—some work indi¬ tually he creating the forms we see (very little
vidually, others work as groups; some stabilize of the form of the latissimus dorsi is directly
one region of the body while others create mo¬ seen; it is the forms of the deeper structures—
tion in another region; some begin an action erector spinae, serratus anterior, teres major,
while other muscles complete it; some oppose and rib cage—that create surface form). Keep in
the puli of gravity. During complex actions, mind that the form of one muscle can blend
note the sequence of the contraction and relax¬ with the form of a neither muscle or with far
ation of the numerous muscles Thai are func¬ pads, that the shapes of muscles are sometimes
tioning. Observe the action, visualize the skele¬ affected by overlying fascia, that muscles appear
ton deep in the body and what changes are tak¬ shorter and thicker when contracted and longer
ing place at its pints, and then determine which and thinner when stretched, and that they be¬
muscles are working in order to perform Thai come more defined when they are contracted. In
action. For further information on function, re¬ other words, the same muscle will appear dif¬
fer to the most recent updated medical, physiol¬ ferently in different actions and poses.
ogy, kinesiology, and physical therapy texts. The artist must understand all the anatomical
components that create human surface form,
and when studying the living model, be able to
mentally impose these structures diagram mari¬
Form
tally on the model. For while everything is
I he muscles of the body are independent con¬ there, most of it is usually concealed to the un¬
vex forms, and when placed side by side and trained eye. It becomes the artist's job to ana¬
one on top of the other to make up the figure, lyze, select, and then create.
they structure the figure into a series of adja¬
cent, bulging, convex forms which are covered Note: In the following illustrations, muscle at¬
by the skin. An appreciation of the fullness of tachments on the skeleton are indicated by solid
these convexities will produce artwork with vi¬ red areas, while nonbony attachment areas are
tality and a feeling of energetic inner life radiat¬ usually indicated by red cross-hatching. They
ing from the center outward. True concavities are labeled G for origin and I for insertion. A
show up only rarely in the body, and one must curved arrow indicates that an attachment is
he careful not to mistake a series of convexities hidden from view, AH illustrations are of the
for a concavity. Know the attachments of mus¬ right side of fhe body.

HEAP
#1
\
FIBER
bundle:
|BELLY
contracted-.

RELAXES SHQHT&R RELAXED

HE AD
(STfcETCHE^ THICKER

FLEXION
/ EX TENSION

■TENDON
 The Muscles • STRUCTURE, FUNCTION, AND FORM

DO no visible: tenooh at TENDONS AT WipE

tendons one end BOTH ENDS TENDON

TENSED LIMB - CONTOUR

CONrORMS TO INPlVHHiftw MUSCLES

K ehxeti thrift Tensed fimh

 The Muscles ■ STRUCTURE, FUNCTION, AND FORM

TEMPORALIS ■FRONTALIS
orbicularis cmT^ .PROCERUS
ZYOOMATICUSMINOR^ .LEV. LABN SUP ALAt NAS CRANIUM
ZYGOMATfCUS MAJOR LEVATOR LAB 11 SUPER SEMlSPlNALIS CAPHlS
masse ter— DILATOR NARlS l I 5PUNIUS CAPITIS
RlSORlUS- ►ORBICULARIS ORIS \ sternomastojd
platysma—--" DE PRES. LABI I INFER. \ levator scapulae
DEPRESSOR AN&ULl ORIS 'MENTALIS \ trapezius
LEVA! SCAPULA ■STERNOMASTOID i \ SPINE OF SCAPULA
TRAPEZIUS ■OMOHYOID \J
'STERNOHYOID
■DELTOID-
TERES MINOR-
CORACOBRACHIALIS-^^ INFRASPINATUS-—
TRICEPS-LATERAL HEAD TERES MAJOR.—I— TRICEPS-LONG HEAD
&RACH.IALIS ■——^ 'PECTORALIS MAJOR rare EPS-lateral head
BICEPS BRACHII — RHOMBOID MAJORSl TRICEPS-MEDIAL HLAD
TRICEPS-LONG HEAO^— ■SERfiATUS ANTERIOR V ■TRICEPS TENDON
TRICE PS-ME DIAL HEAD—*. -EXTERNAL ODUOUE / SRaCHIORADJAliS
BRACU10 RADIAL 14-^^ ‘LATISSIMUS OOftSI-|T .EXTENSOR CARPI SADlAJS LONG.
BRACHIAL 15-—j ■SEMUUNAR LINE 1 \ ^ULNA (olecranon)
EXTEN.CARP RAO LONG 'yf -LINE* ALBA jl \ Aanconeus
EX TEN CARP RAD.BftEVlsWL "RECTUS ABDOMINIS VLeXTEN. CARPI RADIUS B-RtY
PRONATOR TE RES ■'"'"'T -EXTERNAL OBLIQUE-iL -VwXTENSOft DIGITORUM
RALMfcRlS long US-J— -PELVIC CREST flLIUNl)^- j—U-FLEXOft carpi ulnaris
FlEXDR CARPI P.A6IALIS-—4-J- - GLUTEUS M.E0IUS-y V-U EXTENSOR CARPI ULNARJS
FLEXOR DIGIT SUPERFIC GLUTEUS MAXIMUS—4- ,V+\- EXTENSOR DiGiTr MiAirMI
FLEX CARPI ULHARLS-WlM - ILIOPSOAS [ \\ k\ abductor pollicis tm
FLEX POLLICIJ -TENSOR FASCIA LATA 1 EATER EXTEN POLL I CIS BREVIS
-SARTORfUS V
IRQlttKH k- EStJEN. POLL. L0N&
ADD. PC LHC IS LD«()
ADD POLL 1C IS ADDUCTOR LOMOUS
AflDUC™
FLEX POLL.iRLV. ADDUCTOR MAGNUS'—■- DJ&ITI ^
AD DOCTOR POLL 1C IS ' W W iff if -RECTUS FEMORIS MINIMI FIRST DORSAL
■GRACILIS-
INTERO^EOUS
-VASTUS LATERALIS-—4
BICEPS FEMORIS (l H.)--
SEMlTENOiMOSUS—4
-VASTUS MEOIAUS \
FRONT VIEW SEMIME NBRANOSUS-"
„ ILIOTIBIAL TRACT
QUADRICEPS TENDON PLANTAftlS--^^
-PATELLA
-6ICEPS F£ MORIS (shJ-
PATELLAR LIGAMENT -sartorius-
HEAD OF FIBULA- -TIBIALIS ANTEHKW
-PERONEUS LGN&US
-SOLEUS
-GASTROCNEMIUS-j
-TIBIA
TENDON Of G AST ROC -J
'EX TEN. DIG I TO RUM long
-SOLEUS-
-PERONEUS LONCUS--^.
-PERONEUS BREVIS-^
-FLEX DI&lTORUM LONG %
PERONEUS TEftTHJS--—
- EXTLNSOR hALlLJCIS LONG MEDiAL MALLEOLUS (TIBIA)
LATERAL .MALLEOLUS (ttBULA)
.-EXTENSOR halluc. brev .ACHILLES TENDON
EXTENSOR DIGITORUM, BREVlS-
TIBIALIS POSTERIOR — EXTENSOR WGITOHUM BREVIS
-ABDUCTOR HALLUC IS PERONEUS BREVIS
 BHO^
£Y£l
EVE
UPPE
ROOT
BRJpe
i,&w£i
'TCAJ

primary muscles^
OF FACIAL
EXPRESSION AMD
THE JR PJ RECTI ON
OF PULL
 The facial Musc/es - FRONTALIS

P
D5
d-
00e MEDIAL - LATERAL PORTIONS

MEDIAL PORTION ft COR RUG AT OR!

MEPIAL-+LATERAL PORTIONS

MEDIAL PORTION (+C0RRU&.)

l)S Depmsuf jupifcifc t‘|L) —liitrntlp*irtinn F(M/ hiuthtiit — ntedtalpottiun
GA f .'jAm OpGIUMFOlidi OOc Othkillitlit ttfttii I* TniffWlf

70
 The Facial Muscles * FRONTALIS

Fronlalis ends of the eyebrows *ire pulled upward. How¬

The frontal o. is the Ulterior muscle belly of the ever, depending un the position (obliquity) of
extensive cpicramus ntusdr. tht; eyebrows in the resting position* the medial
rhe cpicranius muscle oqn.qst$ nf a braid ends may not appear to have been F.used. Hori¬
layer uf tendon (the galea agin neurotica) and zontal wrinkles on the center of the forehead
thin muscle bellies; it covers the top and sides are diagnostic of medial frontalis contraction.
o! the skull, from dir brows in front to die base Because the entrugator typically contracts when
of the iskull in back* and over to the tops of the only the medial frontalis contracts, the eyebrow
ears. develops a "kinking" near its medial end or an
overall S-shaped curvature; irs medial end is
ORlGEN The franc edge ut the galea aponcum-
pulled upward by the medial frontalis, and its
ttcaT gust posterior to the top of the forehead.
center is pulled downward by the corrngator.
INSERTION The skin at the eyebrow and root As j person ages* the forehead wrinkles do
of the nose, blending with the fibers of the pro- not fully disappear when the frontal bellies are
fcras, orbicularis oculi. and corni gator super- relaxed.
cilii. When lhe eyebrows arc raised, the root of the
ACTION Medial and lateral portions together: nose becomes thinner and the glabella becomes
Raise the entire eyebrow, increasing ns overall smooth. Raising the eyebrows also pulls the
curvature It he central pardon is palled higher). skin between the eyebrow and upper eyelid up¬
They also pull the scalp ihairlinr) slightly for¬ ward* exposing more of rhe eyelid. The skin
ward js they pull on the galea aponeurotic^ below rhe eyebrow (ihe eye cover fold) then
Medial portion only: Pulls up the medial end of loses us form fits bulging quality ) and beauties
the eyebrow. Lateral portion only: Pulls the stretched over the bone beneath* revealing the
middle and lateral end of the eyebrow upward, form ui rhe bony orbit. The distance between
giving the eyebrow a strong curvature. the medial end qf the eyebrow and the inner
The medial portions of both sides of the face comer of the eye increases; this is especially
always contract together and are almost always noticeable when only the medial portions are
accompanied by contraction of the correlator contracted.
supcrdlii (as in madness). The lateral portion When lhr eyebrows arc raised, the ears also
only occasionally contracts by itself, and usually rise slightly.
in one eyebrow only. EXPRESSION Medial and lateral portions of
STRUCTURE The frontalis is divisible func¬ hath sides of the face: surprise, astonishment;
tionally into medial and lateral parts. The two fear, [right, horror; interest, attention; question¬
frontalis bellies of the head are in contact with ing. doubt. Medial portions of both sides of the
each other at their lower portion* on the mid- fare [with ajrmgainr); sadness, grief, suffering;
line of rhe forehead. sometimes fear. Medial and lateral portions of
one side of the faee: inquisitiveness, skepticism.
EFFECT Contraction of rhe frontal bellies pro¬
Lateral portion of one side of the fare; sly, de¬
duces horizontal wrinkles across the forehead.
vious look.
The wrinkles are superiorly curved above each
Contraction of the entire frontalis is often
eyebrow and dip downward on the centerline.
used as a greeting signal or for conversational
When only the medial part of the frontal belly
emphasis. This use is not an expression ul
contracts, horizontal wrinkles form un the cen¬
emotion.
ter of the forehead only. In this case the medial

M It T t t T

REDIAL + .-ATtRAk PDRTlQNS MEDIAL PORT JON ONLY lateral pc an on only

t T

mm*.L tlateral Portions

EYEBROWS
* CORRU^T09 •'\E0rA_ PORTION + C(?RRU(-*fOS

7i
 The Facial Muscles * ORBICULARIS OCUU

OUTER PORTION

l)S Dcprcsivr supemhf J Hiw&iJm l I S if mitoriti/jp; sHpermri',

I LSAX 1,4*2- jjrPf jWjn iirperrrrri.s jm# Mn I AJriEira ODc (-1 r Jrrcrj/ffrj ^ jj/j
OOc(Or) gcw/I - or/wfoi/ pnrfn m OOc{ Pa i) (frbkittiirts otuli - palpebralp**ftiort
\y Protcrus Tc Ttmporntis 7M a Zygo^w/ifi/s uitfjpr ZMi ZjUgMfirr^

72
The Facial Muscles - CORRUGATGR SUPERCILII

Comjgator Supercilii pulls the brows shelf]ike over the eyes, shading
ORIGIN The hone at the medial end of the them from strong light.
superciliary arch* near the upper inner comer ul A depression forms in the vkin above the
the orbit. middle of the eyebrow (actually closer to [tie
medial end) as the corm^tor contracts. It often
INSERTION The skin ol the middle portion of
gives she eyebrow .in S-sh.sped curve—the eye¬
the eyebrow, and the skin of the forehead im-
brow develops 4 central downward dip initially
mediately above it. The fibers interlace with fi¬
close to the medial end) as the muscle pulls the
bers ol the frontalis and orbicularis oeub,
middle portion of the eyebrow downward and
ACTION Pulls the middle section of the eye¬ inward. This is especially noticeable if the me¬
brow downward arid medially sti an oblique Ji- dial portion of the frontalis is also lifting the
f ret ion, thereby pulling the brows together. It medial end of the eyebrow . The corrugator may
usually works simultaneously with the procerus also create a long, oblique, shallow1 furrow on
and depressor superdlii to lower the eyebrows the lateral side of the front of the forehead,
and poll lhem together, li can work without dins furrow is directed upward and outward
these muscles, pulling the eyebrows together* front the medial end of the eyebrow or from the
when thi1 eyebrows are raised by the frontalis, skin depression located above the middle of the
Both sides usually work together; except when eyebrow.
une eyebrow is pul ted downward and [he other The lowering of the brow by the corrugator
upward, narrows the eye opening by pushing the skin
STRUCTURE I Tie corruga to r su per l i hi is a below the eyebrow and upper eyelid downward.
narrow-, elongated muscle. Most Lit the uiusJl-
EXPRESSION Anger; sadness, suffering, grief,
is deep to the orbicularis ocuti, bin the lateral
pain; frowning; interest* thoughtful reflection*
tips of its fibers pierce the orbicularis 10 pass
concentration (focused thought), curiosity, eon-
superficially and insert into the skin,
fusion, lire corrugator can be considered a
EFFECT I "he corruga tor supered i i typica 11 y muscle nf negative feelings, being typically used
creates strong vertical or slightly oblique wrin- in sadness, tear, and anger. Concentration and
Utrs and vertical bulges on the glabella between determination, which also make strong use of
the medial ends of ihc eyebrows, tr also swells the corrugator, may he regarded a-, unresolved
the skin at [he media] end of the eyebrow- into a stressful (negative} states.
wide, thick, Crescent-shaped bulge. This action

fDEEP)

t S Corrugator stipertihi DS Deprn&ur svperriiii ¥ Trotttalk OOc Orbitutat^ ^etth P Procerus

75
 The Facia* Musc/es * LEVATOR PALPEBRAE SUPERIORS

Levator Pafpebrae Superior^ EXPRESSION Shght raising of (he upper eye¬

ORIGIN Peep in shr Kick of the eye vockt-r, lid beyond the normal open eye produces a
from (he roof of rhe orbit, staring, fixed gaze or the expression of surprise.
Full contraction produces intense expressions
INSE RTION The entire lower edge of the u|v
ranging from fear* (error, shuck, astonish menu
per eyelid.
and intense joy to a blank, hypnotic look. Slight
ACTION Raises the upper eyelid. It holds the relax at con of the muscle (causing the upper eye¬
eye open in (be normal neutral positron. lid to droop) with the eye still remaining par¬
Expression develop® only after the eyelid has tially open suggests drowsiness or Intoxication,
been raised above this position. especially U the frontalis is also contracted in an
STRUCTURE 'Hie levator palpebrae superium attempt to hold the eyes open by raising the
is ii long muscle which poshes over the eyeball, eyebrows. This expression exposes more uf (he
deep tn the eye socket, along she run I of the upper eyelid, which has descended onto the up'
tirbis. Narrow behind, it widens as it advances per portion of the ins. Upper eyelid dmop and
anteriorly, becoming aponeurotic before insert¬ gentle eye closure (when the lower eyelid does
ing into (he margin of the upper eyelid. nog rise) are caused by relaxation of ghc levator
palpehrJe superiorly not hy con traction of [he
EFFECT Exposes the upper portion of the iris
orbicularis oculi.
jnd the white of the eye - sclera) above the iris,
Hy continued jetton it pulls the upper eyelid
back so it disappears from view1 under (he eye
cover fold.

o- (m*)
O

CONTRACTED \

E>S D(fir«n)f suptteihi F Fnmt&lti i PS Let vrfor palpcbrjc superioris

7&
The facias Muscles - PROCERUS

Procerus procerus automatically contracts when the leva¬

(Pyramids lis Nasi) tor lahu superior!* alacque nasi is tensed, h can
ORIGIN The fcsdn covering the lower pan of be seen working by itself if the eyebrows are
first raised by the fmntahs and then the levarnr
the nasal bone* and the upper pari of the lat¬
tabii super ions akteque nasi is contracted.
eral ns sal cartilages,
INSERTION The ^kin between the eyebrows STRUCTURE The procerus niusdes of hiuh
and on the tower portion of the center ol the siJl-s form a single triangular sheet of musde
forehead, hi fibers blend with fibers ol the fron¬ between the eyebrows,
talis in the same region, EFFECT The procerus may occasionally pro-
duce a horizontal wrinkle a cross the bridge of
ACTION Pulls down the skin of the meddle of
the nose.
I he forehead and the medial ends of the eye¬
brows. I his muscle works in conjunction with EXPRESSION Anger, aggressiim, pam\ frown,
the corrugaior supemlu and depressor supercilu concentration; contributes to disgust
ru lower the media\ ends of the eyebrows. The

OOc(Or s Orbicularis otttlt - orbital punum t X>c(Pa31 (Irbieutans oath—pu/pebia/ fiitrrkm P Procerus

77
 The Facial Muscles * NASAUS

1L5AW

dist
LLSAN
OOr

UN Uililtiirnorii LLSAN t.fi-iU”/ l.ilm stifM-rmris ittaeqm-imsi N A .Viitp.irt

NT Ndw/iwriwiOTSi’ p,n I OOr f hfaciiLtnt arts I* Percents

7«
 The Facial Muscles * DILATOR NARIS

Dilator Nans fcctangular muscle rhai lire on the outer eurJace

(Alans) of lhe wing of the nose.
ORIGIN Edge of she- nasal notch of the max¬ EFFECT Enlarge the opening o( the nostril.
illa (bony origin) and the lesser alar cartilages Ihc upper edges iif the wings of the rinse be¬
and lower edge or ihc Literal cru* of the greater come depressed (pulled medially)* and (he fur¬
a tar cartilage (cartilaginous origins). row at the upper edge nf the wing becomes
INSERTION The skin at rhe inferior margin mote pronounced. 3n side view, the middle of
of the wing of the nose, the lower edge of the wing is raised, exposing
more id the nostril,
ACTION Dilates Libre*} ihc wing of ihe nose.
Both sides Work simultaneously, EXPRESSION Passion; auger, rage; labored
breathing, exertion.
STRUC TURE The dilator nans in a very thin

[)\ Dilator naris Li.SAN JLeiviur Lilm superions alatiitu nan N‘l Xjsalis—tTiinsxvrsepiirt

So
 The Facial Muscles * ORBICULARIS ORIS

REtJ up PORTION

REP UR PORTION
DLI Depressor Ubti infer turn LLS Levator Ubit supmoris, LL^AN Lti'nw labit supmoris. ihr*jur r mi
M c Menialk N L F Nasohilmt fmtou1 >fn Nmlv OOr l C) u i ) Orbicularis arts—outer portion
O O r[ R t) Orbicularis otis—wd ftp portion t1 i L Ptaiy&m—ta hurl porting ZMi Zygpntasktt* motor

8z
 The FaciaI Muscles ■ INCISIVUS LABII SUPERIORIS AND JNFERIORIS

ILl inci$ivu$ tsihti inf trior is 3 L.S fncmi'ns hhtt superttms Nti Nt*dir OQr dfbtcut&i&ont

84
 The Facial Muscles • LEVATOR LABII SUPERIORS ALAEQUE NASI

I> N DtUuir mms D S Depressor supercdii L L S jLaiwtor Libit supenons

LLS A N JkiJfjfi sNpmcvns trfi-ittjue j-ThT^? !S L fr Nasolabial fun mi' N T S\i salk — tfiiusi vrstr pjrt
OOt Orbicularis qcuU OOr Orlmularts oris lp Procerus

M6
 Tht Facial Muscles - LEVATOR LABII SUPERIOR IS

I S Let‘jior hihti ftiptrwrif L L S A N f ri j/itr ftibn s uperiom dliftfiit: nun N l, F: Nwn Ax /ixm >u ■
OOc Orbit itLms in: nil OOr OrbirufanS nrif it Mi Zygi ntnilicus mwo>

K8
 The Facial Muscles > ZYGOMATICUS MINOR

Zygomaticus Minor pull nf the levator labii ■superioris is straight up.

(Guadratus Labii Su periods— The zygoma tic us minor does not pull the angle
Zygomatic Head) of the mouth.

ORIGIN The front surface nf the zygomatic STRUCTURE From its origin, this small mus¬
bone, below the lateral edge of the orbit (below cle passes medially and then curves downw ard,
the outer corner of the eye). h lies deep to the orbicularis oatli at its origin.
I INSERTION The skin of the middle section of EFFECT Ihe Eygomatkus minor deepens the
the nasolahi.il furrow and into the cheek fat. portion of the middle section of the nasolabial
Other fibers continue further downward to the furrow located midway between the level of the
red lip< passing over as well as through the bottom of the nose and the top of the upper
iMass nf the orbicularis oris (sec insertion of lev¬ iip.
ator la hit stiperioris). EXPRESSION Sadness. Sr pulls the upper lip
ACTION Pulls the middle section nf the naso¬ in in the crying post! ion, The* zygoma [tens minor
labial mstow and the middle portion of one does ntil express disgust or happiness* although
side oE lhe upper hp outward and slightly up- Us action may look similar to disgust.
ward. This is a subtle, oblique pull, whereas the

1- A C 3 Levmor jnguli ons L LS Lei Jtor Lfm fufwrroris \L¥ SdsoUhtdl fitr.* \ m ■ So \Wr

t;o
The Facial Muscles * LEVATOR ANGULI ORfS

Le valor An gull Oris EFFEC1 Pulling the angles n| the month

(Canlnus) straight uph the levator anguli oris curves the
inoutli lint upward ai its ends. This is a
ORIGIN The can me fossa of the ina\iltah be¬
low the mi Julie nt the lower edge of rhe orbit. rounder* tighter curvature than that caused hy
the /ygomaiuius major during a normal* true
IN SER MON The muscular node at the angle
smile. The levator anguli oris also stretches the
of the inmid'L
hpsr The front ot the cheek is lifted and putted
ACTION Pulls the node, and therefore the an¬ out. The nnsohibial furrow rises and moves
gle of the month (not the upper lip), straight laterally.
up. This is a difficult action to do volurirarily. EXPRESSION Uncomfortable, uncertain* or
STRUCTURE This &c*mcwhat fanjshaped mus- Mstupid" smile. This muscle is probably not
de converges mfcriorly into tile node, It lies used m e* pressing the basic emotions; u may he
deep so other fat Nil muscles. used primarily to stabilize the nude.

OOc Orbit titans ttft/h OOt Orbicularis arts ZMa Zygotmiifcm rtMfor 7 Mi S.ygnm.mais mmor

9X
 The Facial Muscles * ZYGOMATICUS MAJOR

#T» >

Ru BucdnMor LAO Ltii'jttw om Ma Masff/fr MjI AT.rZ-xrjs NI K X.iwi.ihi^f furrrm'

No Node ZMsi /.ygnwMmis mjfur ZM i gygwrtutiau wmor

91
 The Facial Muscles * RISORIUS

Risorlus age of people have no nsunus at all. while oth¬

GRIG l N The fascia of the cheek overlying the ers have an expansive one, In some individuals,
m.isserer muscle (a nonbony origin}, the muscle is present on tine side of the hive
only* The nodular plalysma. however, is present
INSERTION flic muscular node at the angle in all people. Structurally, the nsomis ranges
of the month and sometime* into the posterior
from a triangular muscular sheer that converges
edge of the upper end of the depressor angulr
into the node to a narrow hand that may con¬
Otis.
tain only n few strands of muscular fiber.
ACTION Pulls the node, nod therefore the an¬
gle of the mouthk backward and outward—hor- EFFECT ] Ivc risonus widens the mouth,
nontatfy—toward ihe ear lobe. This very weak stretching and flattening the lips. Ii pulls [he
actum is probably used tor creating subtle lower end of the nasolabial furrow ouiward
movements of the mouth during speech. and backward.
Strong retraction of the angle of the mouth is
EXPRESSION When present* the risorius may
produced by the nodular portion of rhe pla*
contribute to facial expressions that involve re*
tysma, which also pulls u slightly downward.
tracrion ol the angle of the mouth* especially
STRUCTURE The risorius is one of the most smiling {happiness)* along with the more pow ¬
variable 14 the i item I muscles. A good percent¬ erful zygornaticus major.

Bu Btttti&afQr MaAluifrter No Node PIN PUiy&riit — tuukthr p&rtl&ri Rs Rixttrius

94
The Facial Muscles - BUCCINATOR

Bucdnaior cal (cheek} far pad lies on ihe muscle's outer

surface.
ORlGJN The outer surfaces «f the upper ,111J
lower jaws, 1 List above and below the three
EFFECT The angle of the mouib is pulled in¬
back molars respectively* and from .1 tendinous
ward or puckered inward and is usually also
band that spans across the posterior end of
pulled slightly upward, curving thu mouth line
these bony origin*.
siiglitIy upward at its ends. Lines may radiate
INSERTION Into the muscular node at the an¬ from the angle of the mouth* especially one that
gle of the mouth. passes outward and downward. The lip* arc
AC tiON The buccinator pulls the medial edge widened and elongated as thu* ate pulled
of the node amt the angle of the mouth the j round the cylinder of the rrtimle, and the
extreme lateral end of she mouth line? straight fleshy prominence of the chin is widened and
fwk (posteriorly, not laterally I, and usually Flattened slightly. The lower end of rhe nasol.i-
slightly upward. If compresses the cheeks to hial furrow may deepen, while the cheek tissue
force out air filter they have hern distended {or iusi lateral to the dimpled angle of rhe mouth
prevents them from being distended] and keeps develops several bulged forms.
food between the teeth while chewing.
EXPRESSEDN Sarcastic smitli, annoyance,
STRUCTURE This relatively deep, quadrilat¬ contempt, disapproval. These emotions arc ex¬
eral muscle forms [he lateral wall of the cheek, pressed by either unilateral or bif.uei.il contrac¬
lying on the outside oi the teeth. 'The thick buc¬ tion of the buccinator.

/ M 3 /yyrJ unjtKits major

95
The Facial Muscles * DEPRESSOR ANGULl QR!S

Depressor Argyll Oris STRUCTURE The depressor angull oris is

(Triangularis; Triangularis Menti) made up of two layers: a superficial head aris¬
ing from fascia, and a deep head arising from
ORIGIN Deep hrud (long head}: A line on the
bone, The Jeep head is. often narrow and strap
outside id the body ol the mandible* extending
hhe. arising from the small bony area of the
forward to die menial tubercle. This line is van-
mental tubercle. Together* both heads create a
able in length—often the long head arises only
fan-shaped muscle that converges into the nude-
from the mental tubercle at the comer of the
chin. Superfine heud \titpui hiurn): The fascia
EFFECT The depressor unguli oris curve* the
covering the placyyntil and depressor lahii iti-
mouth downward at its outer corners* which
ferioris. also lengthens the nasolabial furrow while deep¬
INSERTION The muscular node at the angle ening its lower end (producing the ,+long face'1
of the rnoudu of sadness:. It widens the month slightly and
ACTION Pulls t hr node (and angle of the stretches the lips, flattening them. Strong con¬
mouth) only slightly downward and Laterally traction will produce several bulging forms, be¬
from its normal resting position. This muscle is low and lateral to the angle of the mouth. The
the antagonist of the zygomattcu* major* and furrow descending obliquely from the angle of
the long head may he seen on the surface as a the mouth is deepened and prolonged,
raised ridge during strong smiling action ni> she
zygnmativijs pulls the node upward and out¬ EXPRESSION Sadness, grief, sorrow, depres¬
ward. sions disgust.

0AO lh'prt'iior atiguli ons DU l Vpn.r kbit mfenvr« Mc Mental*t N£> Nrn/r
The Facial Muscles * DEPRESSOR LABII 1NFERIORIS

Depressor Labii inierioris acrinn csf Jahia] platysma). The depressor la hi

(Guadralus Labii inferiors Quadtatus Merit!) inferior^ assists m eversion of the lower Up,
ORIGIN An oblique line on the outside of the exposing the inside wet mucous membrane. Its
body o( ihe mandible, just superior to the ori¬ medial fibers push the chin prominence down¬
gin of the depressor angull oris. ward,
STRUCTURE The depressor La hi e tnfmoris is
INSERTION The skin of the medial portion of
each half of the lower lip, almost up to ihe red
a quadrilateral muscle Its lower lateral portion
pan, And into the substance of the orbicularis Iks deep to fibers of rhe depressor anguli oris
oris. The fibers of these muscles of each side of and the labial platysma*
the face blend at the riiidlinc just below the EFFECT The lower lip curves downward at its
lower bp. center. A horizontal skin Fold lihe [iitntulabial
sulcus:- below the lower lip may develop or
ACTION E~hv muscles nf both sides contract
deepen. The fleshy prominence of rite chin is
together r« pull the middle third of she enure
pushed downward. Tlu- mouth does not widen.
lower bp straight downward* This parts rhe
lips, exposing ihe teeth and lower gum (also sec EXPRESSION Primarily used in speaking.

97
 The Facial Muscles ■ MENTAUS

attachment* MUSCLES Of
ON ONE 5 I DEI 8&TH 5I&£5

9»
 The Facial Mvsc/es * PLATYSMA

Ac Acrninityn C ('.favitff 11 Deltoid DAO Depressortnignit turn 11 LI Depressor hiM inferioru

Ma Si&ssfiw Ho \Wc OOr OriitsuhirM oris IMa Platysma fpH- j — fohialportion
PtM PldM-mdnditwtflrportion T11S Pfotysmv — nodularpnrlkm PMj IWiomin ir
Rh Unarms Sh Srcrruihymd Sim Stmtomasioid

100
Expression of the Emotions

come slightly parted. When the levator labii su- the person or object of interest. Slight turning
perioris a Deque nasi contracts unilaterally* skin of the head so as to direct the ear toward the
wrinkles form on that side of the nose only. sound stimulus may also he present, interest/
The corners of the mouth are pulled straight excitement is the opposite of boredom, and
hark (posteriorly> not Literally) and dimpled, on often accompanies other emotions (happiness,
both sides or on one side only (buccinator). fear). It is similar to surprise* but surprise is a
Disgust and contempt arc closely related yer very brief emotion. If the appearance of surprise
distinct* and arc grouped together. lasts for an extended period of time, it is proba¬
bly interest/excitement.
Disgust often blends with anger and surprise.
It is brought about by the actual experiencing
of unpleasant sights, tastes, smells, or tactile ex¬
Pain/Distress
periences, or just by the thought of them. Stick¬
ing the tongue out, as in an attempt to remove Variations of the basic sensation (type/imen-
undesired matter from the mouth, is an extreme sity); Discomfort, ache, hurt, unbearable pain.
form of disgust, Vomiting is the ultimate dis¬ Appearance and muscle action:
gust reaction. The eyes are completely and tightly closed for
Contempt is the expression of condescension long periods of time; the cheeks are raised (or¬
toward people, with a feeling of superiority felt, bicularis oculi—both orbital and palpebral por¬
or hoped for, by the expresses The head may tions).
be tipped back so the eyes look down at the The eyebrows are pulled together and down¬
other person, hi this position, the nose is raised ward (corrugator superdlil, procerus, depressor
and the upper eyelids are lowered. supcrcilii).
The mouth is usually wide open, and the lips
are squared-off in preparation for crying or
Interest Excitement screaming. The angles of the mouth arc pulled
Variations nf the hasic emotion (type/intensity): outward and downward (upper labial tractors,
alertness, brightness, attentiveness, expectancy labial and nodular platysma).
and anticipation. 1 he mouth may be tightly pressed together,
Appearance and muscle action: and the jaw tightly clenched (orbicularis oris—
outer portion, mentalis, nasalis—transverse por¬
The eyebrows are raised, producing horizon-
tion, temporalis, masseter).
tal wrinkles across the entire forehead (fron¬
talis—both medial and lateral portions)* High skin ridges appear on the neck (all three
parts of the platysma).
The eyebrows may be pulled together (in
either their normal or raised positions), creating Pain/disfress is usually characterized by in¬
vertical furrows between them (corrugator su- tense muscular contraction. It is often accompa¬
perrilii). nied by sadness, crying, or screaming.
The mouth is open and may be relaxed or
rounded and pursed (incisivus lahii supenoris
and inferiors).
Author's note: T he complex subject of what ac¬
The head may be advanced forward.
tually constitutes the emotions, and their
Inierest/cx cite mem is also characterized by a expression on ihe face, is still under much dis¬
focused gaze with continuous eye tracking of cussion in the psychological literature.

107
Expression of the Emotions
 Expression of the Emotions

Dtsgitst—Levator (aim wpert&rts ataeque m$i Disgust - Levator tabu superior i$ Contempt

109
The Head and Neck Muscles • TEMPORALIS

MmMasseter M a I Malar is OOc Grbtcufom omh Tc Tcntpurjlis 7. \ Zygomutfc jr ch

 The Head and Neck Muscles * TEMPORALIS

Temporalis neath the fascia (on top nf the muscle), The

ORIGIN Entire temporal tr»sa un (he side of plane of this lower fascia is basically oriented
the skull and the deep surface of ihe temporal oblk| uely oar ward and upward, in contrast to
fa sem covering rhu muscle* the vertical orientation of the larger portion nf
Sa'J' the temporal fascia, which lies mi the tempor¬
INSERTION Ape* and deep surface of the co*
alis muscle belly. Because the plane of the lower
mntrid process m| the mandible (jaw bone.I and
i.isci.i is directed slightly upward, it receives
■mo the front edge of the ramus of the mandi¬
more light than ihc vertical temporal is. The
ble almost as far down a-* the fast molar.
lower fascia Hows into (he zygomatic arch,
ACTION Lilt*. the mandible, which closes the creating a single, rounded, horizontal form on
(aw- the posterior fibers puli the jaw backward. the side ol the cheek. There is usually no visible
The temporalis holds the (aw closed when the separation between the top edge of the ?,ygo
bead is upright, and it clenches the teeth lor mntic arch and lower portion of the fascia. The
chewing, plane of the lower fascia gradually blends into
fjTRUCTURE The temporalis Is a (Lie, him the ptane of the temporalis.
vhaped muscle thin at its margin, that fills the tk’caiihe the lower portion of the fascia spans
depression tin the side of the skull. The side of over ro the zygomatic arch, the temporalis
5E£T IQN A
the skull [the area of origin of the temporalis) never appears to actually pass under the zygo
and the inner surface nt the temporal fascia nutic arch. The bony zygomatic arch itself is
I which covers the temporalis: form a El aliened usually not sharply deli lied. On Is occasionally
■’ *■-* amt container from whose insult; Mir faces the tem¬ dues ie show dearly.
poralis ordinates. The fibers oS the temporalis ■\t the temple !posterior to the bony orbit of
converge into a strong tendon Jeep to the zygo¬ ihe eye and superior to the zygomatic arch), the
matic arch. tempo rafts is seen bulging when the jaw is
The superficial portion nt the temporalis pro closed the bdly is shortened and thickened)
Liiites .1 hormmt.i] ovaf rd ief on the surface ;uid sinking in when it is opened (the belly is
when seen. The anterior portion of the muscle stretched and thinned). When the jaw is fully
5.DE VlEw1 may be slightly recessed from the outer fumy opened, however, the condyle and ramus of the
portion of the orbit, which then becomes prom¬ mandible move forward, compressing ibe hi
inent. The posterior portion of the temporalis is and muscular tissue in fronr of them. Ibis
usually covered by hair. pushes the bt lodged under rhe zygomanc arch
The temporal fascia is a strong, dense layer upward, which bulges the lower portion of the
of fascia that lies on tup of the ienipor.ilis, at* temporal fascia outward. The advancing man¬
taebing to the skull just beyond the margin of dibular condyle and compressed tissue a bo
the muscle lithe muscle attaches in (he inferior bulge the ma*serer m uscle below the zygoma tic
temporal line on the skull; the temporal fascia arch outward [laterally), rhe net result being
LA f*SCH*
continue* past u to attach u> the superior (em- that the horizontal zygomatic arch becomes re*
poral linei. Interiorly (a short distance superior cessed between rhe fatty bulge above and (he
to the zygomatic arch)* the temporal fascia muscular bulge below. This is unusual, because
leaves the surface nf the temporalis to attach to stretched and elongated muscles always become
the upper edge ol die zygomatic arch. At (Ins thinner, increasing rhe projection of adjacent
point, a substantial accumulation of fat lies be¬ bony areas.

F30MTAL SECTION

113
 The Head and Neck Muscles • MASSETER

Masse ter teeth because of tension,, or when ehewuig„ the

bulge of the masseter belly can he seen separat¬
ORIGIN Superficial part; Anterior two-thirds
ing into several thin* elongated, parallel hum
of the inferior border of rhe zygomatic arch,
dies, directed along the overall axis of the form
continuing forward 10 the zygomatic process of
of The muscle. The most anterior of these bun¬
:-c'. 'JOh *
the maxilla. Deep parts; Inner deep) surface of
dles shows up on the lower hall of the (rant
the entire zygomatic arch.
edge of the belly. The entire (rout edge id the
INSERTION Lateral surfaces of the cornnoid muscle mav be seen if the cheek fat is thin,
post ——►AiyT.
process, ramus, and angle of the jaw. whereas the back edge is not distinct as a is
softened by the overlying parotid gland.
ACTION Closes the jaw by lifting the niaiido
The surface planes of the nussetersVui both
hie; clenches the teeth for chewing.
sides of the head usually converge slightly inte¬
STRUCTURE The masseter is a thick quadri¬ riorly, hut may at limes be parallel or even di¬
lateral muscle that lies obliquely on the side of verge interiorly. The surface of the masseter
the jaw. It is. directed from the lower margin of may flow into the surface of the zygomatic arch
the zygomatic arch and cheekbone downward (no separation), or the superior end of the mav
6m VIEW and backward to the angle of the jaw. Only its scler rnay be recessed slightly, leaving the lower
superficial port ton is seen. When clenching the edge of the zygomatic arch defined.

A | Angle of jaw flu Huccnutor DiA Digastric—an terror h*Uy Hy Hyoid bone Mi Masseter
Md Mandible Mci Molar Mx Alaxif/u My Myhhyoid PG Parotid gland

114
 The Head and Neck Muscles * MYLOHYOID

Mylohyoid sides span the bottom of the jaw and are up¬
ORIGIN A line along the anterior ihreiiMjwaf¬ wardly recessed from the lower border of the
ter*; of the inner surface ui the body of thc body of the mandihie ai thru- lateral edges
lower jaw+ sheir origins). The overlying anterior bellies of
the digastric* submandibular glands, and fat
INSERTION A median tendinous line* or
join with the mylohyoid* in creating the hoi turn
raphe (actually part of the mylohyoid itselfj,
plane of the pw,
which passes from the mi dime at the bottom ol
Hie mylohyoid of each side passes medially
the chin to the in id line on the I root of the
POST. *-—* flNT, and doumuwrd to sis insertion tm the median
hyoid hone. Most of the muscular fibers of the
raphe and hyoid hone. Looking at the side view
mylohyoid insert into ihis raphe [the fibers (rum
of the bottom plane of the jaw, its profile fat
the muscles of both sides meet here), while the
the midline] passes backward and slightly
most posterior fibers rnsert directly into the
downward (is almost horizontal], w hereas (he
frnnr surface of the hyoid bone.
line of the bottom edge of the mandible passes
ACTiQN Lifts the floor of the mouth and the backward and slightly upward is oblique).
hyoid bone when swallowing.
STRUCTURE The mylohyoid is a flat, sheet-
like triangular muscle. The muscles of both

FtN Platysma—nodular portion Rf Rjpbt' Ri SG SnhnututihuLiT

7, A Zygomatic arch ZMa Zygomaticus wujor

JI5
 The Heed and Neck Musc/es * DIGASTRIC

Digastric (if the body and greater horn of the hyoid bone
(Bsveruar Mandibulae) by .1 fibrous sleeve through which it passes.
The anterior belly of the digastric is larger
ORIGIN rT"hc mastoid notch on the bottom of
and thicker than the posterior belly. The ante¬
the mastoid process of the skull.
rior belly sometimes appears ns a subtle elon¬
INSERT tots! The lower edge of the deep sur¬
gated relief that is directed posteriorly and
SECTION a face of the mandible behind the chin (just off slightly laterally. It lies on the bottom plane of
the nil dime). rhe lower jaw, on the surface of the mylohyoid
ACTION Opens the mouth by pulling the from muscle, When the head is extended, exposing
of the lower jaw down; lifts the hyoid bone. the bottom ot the jaw, the muscles nt both sides
STRUCTURE The digastric consist* of two can sometimes he seen diverging posteriorly
bellies, an anterior and a posterior, that are from the chin. The posterior belly is covered by
Connected end to end by a short, centrally lo¬ the parotid gland.
cated tendon. The tendon is hooked to the side

bOTTf-M v;EW OF JAW

HEAD TIPPED BACK

Di A Digastric—dnfarter belly D i P Digastric—posterior Miy I \ y Hyoid bone L S Del ator scapulae

MP Mastoid proem My Mylohyoid Cm Omohyoid SC SieriionUtstoid—eJavutifar head
 The Head and Neck Muscles * OMOHYOID

Omohyoid dtr. The omohyoid bends at this tendon as it

OfliGl N A shorr tine on the superior bonier of ascends upward and forward nri the side of the
ihc scapula, just medial to the notch at rhe base neck. The omohyoid is occasionally seen, part
of the coracoid process, And somctimes from a directly, part indirectly, when speaking, when
ligament that crosses this notch. she muscles on rhe bottom of the jaw are tensed
or when the head ts fully turned to one side.
INSERTION Inferior border of the side oi the
When contracted, it straightens between its two
body of the hyoid bone toward the front i; |u$t
points of Attachment lifting the stemofnastoid
lateral to the insertion of the sternohyoid).
in the process. The tendinous portion beneath
A C T 1 O N Pul Is the hyoid bone d< j w n. the sternomastoid is then seen as a thick,
STRUCTURE The omohyoid consists of two oblique, cnrdlike relief whose Form is continued
narrow, flat bellies—a superior and an infe¬ both superiorly and inferrorly by rhe now visi¬
SECTION A ble superficial bellies.
rior—connected end to end by a short tendon.
The tendon lie* under rhe stemomastoid mus-

SG Subtniitulibkfargfond Sli Sternohyoid SM Sctiietiif* wtdmf SS Stemtownstoid—st&mlhe&f

Stm Sieruumastmd TC Thyroid tariitage Tr Trapezius Ve Vertehrj

try
 The Head and Heck Muscles ■ STERNOHYOID

Ct Cricoid cartilage HyHyotdbone Om Omohyoid SK Sternohyoid

S5 Steriwrnastoid—sternal f>t\id TC Thyroid cartilage

1I 8
 The Head and Neck Muscles • STERNOHYOID

Slernohyoid as they ascend, but never actually touch. The

ORIGIN Posterior surface of the medial end of space between the two muscles therefore nar¬
the clavicle; the upper lateral portion of rhe rows superiorly. The thyroid and cricoid carti¬
posterior surface of the manubrium of the ster¬ lages and rhe thyroid gland ate partly covered
num near ihe notch for the clavicle; and the by these muscles* bur are subcutaneous in the
ligament between these two bones. interval between them. The narrow, flat form of
the sternohyoid lies on top ofn hut doesn't con¬
-INSERTION Lower bo rule r of th e an term r
ceal, rhe forms of the throat (thyroid and cri¬
portion of the body of the hyoid bone* just to
coid cartilages, thyroid gland).
the side of the midline.
When contracting* the sternohyoids occasion¬
ACTION Pulls the hyoid bone down, as in ally appear as two raised straps on the front of
swallowing; assists in flexion of the head and the neck* oftentimes confused with the anterior
fleck. edges of the platysma. The anterior edge of the
STRUCTURE The sternohyoid is a thin, nar¬ platysma is more stringy* more oblique* and lo¬
row* strap!jke muscle located on the front of cated more laterally than the almost vertical
HYOID the ruck* just to the side of the mid line. Com- sternohyoid s. Also, rhe platysma passes owr the
iiumlIv separated by a short distance ai ihe pit stemonustoid, whereas the sternohyoid passes
of the neck, the muscles of both sides converge under ir.

rftqr*r vr^w
 The Head and Neck Muscles * SEMISPINALIS CAPITIS

£>M Dsep muscle Nm Nuchal ligament Sc Semispinalfc capita SpC 'ipfattius capita
!irm Stemomastoid Tr Trapezius * Undtr trapezius

HQ
 The Head and Neck Muscles 9 SEMISPINAUS CAPfTtS

Semispinahs Capitis nuchal ligament. These muscles of both sides of

(Com plea us) the body are therefore partly responsible tor
ORIGIN Tips, nl the trimvi'iw processes o| the creating ihc two thick cords that characterise
verfebrac hum the seventh cervical down to the t ally appear on the back of the neck {except
sixth or seventh thoracic vertebrae and I mm ihr when (he head is lully Hexed], The furrow on
the mid lint between these two columns the
a rite u La r pmains of the fourth through sixth
posterior free edge of the nuchal ligament
cervical vertebrae*
deepens as it approaches the skulk ending supe¬
INSERTION An elongated area oh the base of riorly at the external occipital protuberance (the
the skull between the superior and inferior nu¬ cranial attachment of the nuchal ligament), A
chal lines of the occipital bone, jusr lateral to depression may form between the upper end of
the imdliML%
the semlipmalis capitis and the sternocleidomas¬
ACTION Exrctids the head and rotates if -so toid, in which 1 he subcutaneous portion of the
that the lace i^ directed to the opposite side. splemoN capitis lies.
STfiUC 1 URE Primarily a deep muscle on The Basically vertical, the thick, somewhat flat¬
back of the neck rh.it thicken* -is it ascends* the tened belly ol the semi spin alls capitis wraps
SECTION A around the deeper structures ol the neck* hesi
setni spin ,\hs e.ipuis makes an import Lint comri-
seen in cross section, The scmispicnihs capliis is
bun on to the farm of this region, A very small
part of the transversospmails muscle group—the
part of r? is actually subcutaneous jim below
the vkull, hui is is never distinctly seen and 11 deepest muscle group of the hack—which in¬
usually covered h* the hair.) It lies under the cludes the mult 1 fid us, The medial portion of
thin uppermost portion os the trapezius, and the ttrrmspinalts capitis, which tends to merge
both muscles create the muscular column nn the with the spinalis capitis* is called the biventer
hack nl the neck immediately to the side ot the cervktt.

SECT JON a
 The Head and Neck Muscles * LEVATOR SCAPULAE

LS Lrivtor sejpuLu- lie Setnisfiiiiiilii tjpitif SN Sf,ttenui meJiut Spl Splemus i jpith
Stm Sttmamnstoid Tr Tupezius

Hi
 The Head end Neck Muscles • LEVATOR SCAPULAE

Levator Scapulae splniiis capitis is directed downward juJ medi*

ORIGIN Transverse processes of the first lour uity tow ard the itndline of the batk, the levari ir
cervical vertebrae. scapulae is directed downward and lofurdtiy
toward the sop of the scapula. The levator sca¬
SfL flON * INSERTION lJpper piJith sn of t he vertebra I
pulae is the more prominent of the two, hut
border of the scapula, between the superior an¬
they may also blend together.
gle and the base of the spine of the scapula.
The levator scapulae is located at the front
ACTION Rustics the scapula while pulling it edge *>l the muscle mass of the back of she
slightly medially* It assists in rotation ol the neck. This mass is made up of the trapezius*
scapula by raising the vertebral border* which semispinalis capitis, splenius capitis, and levator
produces downward rotation of the acromion. scapulae; it can he seen separating from the
When the shoulder is Fixed > it will bend the stern omasto id and the front half of the neck
neck laterally. when the head ih fully rotated to one side. The
STRUC T URE Beginning deep m The vide ol levator scapulae and scalenus medius are re-
the neck |Ust below the skull, and ending deep spomible for the width at the side of the base
m lhe back .it the top of the shoulder, the leva¬ of the neck.
tor scapulae is superficial only in us middle The levator scapulae is often difficult to see,
third, in the space between The sternumastoid regardless of muscular development. U is most
iCCT.O*, C
and trapezius on the side of the neck. When the likely to he seen in individuals with very little
m live lev loc j led in this interval are defined, the hii ami in ihv elderly., especially when the arms
levator scapulae is usually the most prominent. are carrying weight and the shoulder is sligjiTU
In side view, the axis of its narrow, cylindrical* raised, or when ihf neck is bent literally
POST ■% PANT subcutaneous form is one tiled on a line directed against resistance. When seen, the combined
from she earlobe to the deep superior angle of forms of I he levator scapulae and lUtrnomastoid
The scapula. l"hc levator scapulae is located an- create an inverted V with the upper end of ihv
tenor to the splcnius capitis, bsil whereas the former passing deep 10 the latter.
 The Head and Neck Muscles * SPLENIUS CAPITIS

Splenius Capitis STRUCTURE 'The splenius capitis is j broad,

ORIGIN The lower hah of the posterior tree sheet]ike, inconspicuous muscle located un the
edge of the nuchal ligament and the sptncuis back of the neck, Only a small area of its supe¬
processes of the seventh cervical and first three rior portion is superficial. When seen, its super¬
5£CTiQH A or four thoracic vertebrae. ficial pntritm is> directed ft# thtk mastoid process.
The front edge of the muscle, which lies at the
INSERTiQfa A line at ihe side of the base of back edge of the form o! the levator scapulae,
the skull, just deep to the insertion of the sicr- can he traced along a line from the lip of the
nomdstoidi from the up of the mastoid process
mastoid process downward rt> the hack of the
extending hack about two inches.
base of the neck, fhe form uf the levator scapu¬
ACTION Rotates the head, turning it toward lae is stronger and more pronounced than that
5LtT«etJ 13 the same side .is the active muscle, The muscles of the splenius capitis.
uf both sides contracting together extend the
head.

LS Lci'dtor scdpufac Nru Nuchdl ligament Qnt Omohyoid SA Scalenus mt ter iur
SC Steruomastoid—eLwiciildF htud Sr St'mispnhtitf ijpttis SM St'dUrnus nttdiui SP Sfttlmiti fmtfmw

124
 The Head and Neck Musctm * SCALENUS MEDIUS

Scaleous Med i us short, vertical, conical farm, pointed superiorly,

ORIGIN Transverse processes of rhe second between the inverted uf the forms of the ster-
through seventh cervical vertebrae (and occa¬ nomastoid and levator scapulae. The scalenus
sionally from the atlas). medius may appear during forced inspiration.
The sealtuitis posterior, arising from the
INSERTION Upper surface of the first rib*
transverse processes of the fourth through sixth
from ns midpoint hack to the tubercle,
cervical vertebrae, and inserting onto the top
ACTION Bends the neck laterally; lifts the first surface of rhe second rib posterior to its mid¬
rib during farced inspiration. point, is never distinct, hut hi ends into the hack
POST. < of the form of rhe scalenus medius. The sea-
STRUCTURE Largest of the scalene muscles,
the scalenus medius show** up on the middle of ten us anterior is too deep to affect surface form.
the lower half of the side of the neck, but not At timesp some of the nerves of the brachial
very prominently. Ft adds thickness in the hot- plexus can be seen as a raised cordlike ridge
mm of the side of the neck where the neck passing down along the anterior edge of the
Harts, and is usually covered by some of the form of the scalenus medius.
VPiJfiLE supraclavicular fat. The muscle appears as a
PORTION

5JDE VIEW

SpC Splenius capHis Sim Stmomostaid Tr Trapezius Vc I'er/cfrm

I 25
 The Head and Neck Muscles * STERNOCLEIDOMASTOID

LS Ltrv*jtfrr sttipuhit' Mn Mjnubrmrn MP MastuiJ p-n>£dss Dm OmohyuiJ PG ParQttdghmt

SA Sciifcnus jntertur SQ Siermimaitutd -duviattitr htwd Sh SU'nmhytnJ SM Stalrtius mtditis
SpC Splmhts oipitk Su'rttnmjftrrtti —sn'nul ht'jci Sim Xttmomasttrid TC? Thyroid gfond

116
 Hie Head and Neck Muscles * STERNOCLEIDOMASTOID

Sternocleidomastoid in front of if). When the head (skull) faces for-

fSternomastoid) ward, the inferior end of the sternal head curves
ORIGIN Sf&rtat head: Upper pan of rhe ante¬ slightly forward toward the sternum. When the
rior surface of the manubrium of the sternum* head o completely rotated io one side, the ster¬
near the m id line. C Livnuiiir he&tk Upper sur¬ nal head becomes vertical and almost cylindri¬
LEI ak&-+ A
face of ihe medial third of the clavicle, exclud¬ cal in cross section, and forms the anterior pro-
ing the media) expansion of the clavicle. The hid of the neck. Along with rhe upper edge of
area of origin ex lends downward qnio rhe front the manubrium of the sternum, the tendons of
surface of the clavicle. the sternal heads of both Hides of rhe body (nor
rhe medial ends of the clavicles) define rhe pu
I MSERTI ON A line along ihc tip* anterior bor¬
SE C. T I DM ft
of the neck.
der, and lateral surface of the mastoid process
The inferior end of the clavicular head usu¬
of the skull (behind the ear), continued around
ally dips downward slightly before heading for¬
posteriorly into the lateral part of the superior
ward to rhe clavicle (creating a gentle concav¬
nuchal line of the occipital bone at the base of
ity), The widened form of the clavicular head
the skull,
usually ends interiorly at the top of the clavicle,
ACTION Both Sides together flex the head and leaving the form of the front of the clavicle visi¬
neck forward. Acting atone, it will bend the ble, This head continues onward to the from
head and neck laterally and rotate the face surface of ihe clavicle, bur only via it* nonvisi-
toward the opposite side. ble flattened tendon. The upper half of the clav¬
ifllPOfi C icular head normally becomes partially or com¬
STRUCTURE The sternocleidomastoid [vfer-
no mastoid) is a wide, basically straplike muscle, pletely covered by rhe sternal head as the two
thickest at its center, that spirals obliquely Heads blend together;
down the vide of the cylindrical form or the Die most posterior libers of rhe clavicular
*J»Gb£tfiiQ3ia
neck. Jr passes from behind the car toward the head are usually inconspicuous, but when ex¬
pii of the neck, anti stands out prominently in tremely reused (head hem laterally again si resis¬
action. The single belly consists of two heads, tance), they become visible along their entire
which when tensed can he seen separating into lengrh, passing from rhe skull to the clavicle.
the thicker, more prominent, fusiform sternal They then appear as one or more independent
head and the wider, fbtrened, strap]ike clavicu¬ narrow bundles descending from the aponeu¬
lar (“cU'ido”) head* The sternal head can he rosis at the very posterior end of ihe line of
seen from origin lu insertion; the clavicular attachment on the skull to rhe lateral end of the
head is usually visible on the lower half of the line of attachment on rhe clavicle. The inrcrval
neck only (the upper half of the clavicular head between the posterior edge of the st-ernocletdo-
blends into the dominant sternal heads. mastoid and the anterior edge of rhe trapezius
Tlie superior end of the muscle (the jungle then appears narrower.
belly made up of its two fused heads) becomes The srcrnodL'idomastoids form the sides of
aponeurotic, especially posteriorly, before it no the neck, converging as rhey advance anteriorly
wrts into the skulk Inlci-iorly, the sternal and in their descent- When relaxed, the stemomas-
clavicular heads are usually separated by a toids contribute so the cylindrical nature of rhe
small Triangular interval just above the medial neck: when tensed, they become relicts that rise
expansion of the da vide. up from the surface of the cylinder. The neck
The sternal head tapers interiorly into a widens when it is extended, becoming widest
strong tendon rhar appears round, conspicuous, two-thirds of the way down rhe sternocleido¬
and cord like on the surface as it passes mtdkl mastoid*.
to rhe expanded medial end of the clavicle [not

1*7
The Need and Neck Muscles * THROAT

A i Air passage Cr Crk oui car iiiage E. Es&phtigus Hy HymJ hatic Om f himhynni
PN Pit &f neck Sh Sternohyoid SS SivrnntMJHimt —sternal htdd Stm Stcmnm&stiiid
TC Thyroid cartilage TG Thyroid gland Tr clrjthtu \rt Vertebra
 The Head and Neck Muscles * THROAT

The THROAT is The windpipe, nr breathing ut the ihyroid cartilage, vocal cards, atid cricoid
ruhe, and consists of the larynx and trachea* cartilage.
The thyroid gland contributes to its form, The thyroid cartilage is the largest cartilage
Hie throat is basically a semirigid cylindrical of the throat. Suspended by a membrane from
structure located on the front of the neck, the hyoid hone, it is shaped hke the bow nf a
which connects the mouth to the lungs. The ship. Its two sides, or laminae, men .u a sharp
upper front edge oi the throat cylinder is angle to form its front edge [more acute and
formed by the U-shaped hyoid bone (the hyoid sharper in the male than in the female!. In side
hone inconspicuously lies at the |unction be¬ view, ihe upper and lower portions of ns front
tween the bottom plane of the jaw and the edge are cut back to produce a point on its
SECTION A
front of the throat cylinder). The throat cylin¬ anterior edge* The upper portion has an elon¬
der is directed downward and backward into gated V-shaped notch, which is easily palpated
the chest cavity to the lungs, passing behind die and often seen (especially in the extended head .
manubrium of the sternum. The cylinder is reka I he thyroid cartilage is larger and more promi¬
lively wide—almost halt the width ol the nent m the adult male than in die adult female,
neckband lies between the bellies ol the sterno- -md is called the Adam's apple.
masttjid muscles* Because the throat cylinder ta¬ The cricoid cartilage is a cartihginuus ring
pers mfenoriy* and because its lower portion is located inferior io the considerably larger tiiy-
partially covered on the sides by ihe ste mo mas¬ mid cartilage and superior to the narrower tra¬
toid s. it appears on the .surface to he an in¬ chea. li has a wide U-xhapcd notch on the front
s'cried cone. It is also covered on us front by ok its upper edge, which registers as a subtle
the strap I ike infrahyoid muscles (sternohyoid*, depression on the surface, E he cricoid cartilage
SECTION 9 omohyoid*. etc.!, which contribute to us cylin¬ is subcutaneous and is \ isiblc in the- male,
drical form. where it creates the smaller, rounder, interior
As a unit* the throat moves up when the head bump on the front of the throat. In die female,
is extended or the tongue protruded* and down its form is masked .although not covered' by
when the head is flexed. During swallowing. i[ the swelling of the larger thyroid gland.
is pulled up to-, and then drops down iront, the The thyroid gland lies roughly n the level of
hyoid bone. The throat cylinder Inis two bumps the maud cartilage. Et consists ut a relatively
no its anterior surface: the thyroid cartilage on large, oval lobe on each side of the throat {cov¬
its upper third and the combined cricoid carti¬ ered by the sternohvoids: connected in iron? by
lage and thyroid gland on its middle third (the a narmwr isthmus ot gland across the upper
form of the cricoid cartilage predominates in portion ok the trachea (over the second and
the male; in the female, the thyroid gland is thud tracheal rings). The gland is visible in the
often most prominent). The trachea at counts adult female and its youth, where it creates the
SECTION C for the lower third of the cylinder* but is not vtjfi swelling oi the inferior bump on the front
seen directly as it is covered h\ the skin draped ol the neck* while concealing the cricoid h.;iTil¬
over the structures of the lower portion ol the lage. hi men. the gland is usually inconspicuous.
throat. What remains is a concave depression at The trachea, begum mg |usi below the cricoid
the pu of the neck. In the male* the upper cartilage* is the inferior component oi the sub¬
bump is larger than the lower nn^ In ihe adult cutaneous Windpipe. It continues the form of
female, both bumps are mure or less equal in the throat cylinder behind the siernoui into the
Hive; sometimes hath are inconspicuous* form¬ chest. Although its actual cylindrical form is
ing a simple curve along the front profile of the concealed by the thyroid gland superiorly and
neck. The bumps become more prominent when rhe suprasternal fat interiorly, it can easily he
the head and neck are extended. palpated. I is individual cartilaginous rings are
The larynx, or "voice hfi\," consists, m part. not visible.

129
 The Trunk Muscles

THORACIC
POST*—* ANT.
VOLUME

FLEXIBLE
MUSCULAR
BODY
WALL
PELVIC s
VOLUME

FEMUR

EXTENSION ERECT FLEXION

THORACIC
VOLUME

&ODY
WALL

PELVIC
VOLUME

-FEMUR

LATERAL BENDING ERECT ROTATION

 The Trunk Muscles

The region from the shoulders to the iliac lines to each other. They are connected by the lum¬
is considered the trunk, The TRUNK MUSCLES, bar vertebrae in back, wrhich allow, and also
described on the following pages, for the most limit, the movements possible between them.
part lie on the trunk itself, although some cross The irregularly shaped interval between the
the shoulder joint and the neck. two bony regions (between the bottom of the
The shape of the trunk is largely determined rib cage and the top of the pelvis) is bridged by
by the rib cage, upon which the pyramidal the thin, soft* muscular body wall, made up of
shoulder apparatus of both sides—the bony the rectus abdominis and the external oblique
shoulder girdles and their muscles—sit and (as well as other thin layers of deeper muscles).
glide. The trunk is flattened from front to back* These muscles accommodate all the twisting
noteworthy in the human figure because in and bending of the bony regions by stretching,
quadruped mammals the torso is laterally com¬ contracting* folding, and bulging.
pressed from side to side. The trunk (including the shoulders) is easily
The rigid rib cage is separated from the pelvic visualized as a flattened box. The back of the
region (the rigid upper margin of the pelvis) by trunk appears larger than the front, and can be
the muscular body walk These "Tigid units” arc visualized as an inferiorly poinred triangular
independent of and often dynamically opposed wedge* especially in the male.

DELTOID
IN FR AS P STATUS
VERT BORDER
TE NDOrd
OF SCAPULA
rhomboid —.
TERES MAJOR
TERES MAJOR
TRiGEPS
lateral HO. INFERIOR ANGiE
OF SCAPULA
lon&head FLAT
RJ& \ SERRATUS
MU5CLE
It AGE * ANTERIOR
BELLY
ANTERIOR BORDER OF
LATSSSlMUS DORS!
EXTETRMAL O&UQtJE-^ LATfSSlMUS PORSl
ERECTOR SF^NAE
CREST OF THE ILIUM '
'-LATERAL FORM
POSTERIOR SUPERIOR - MEDIAL FORK
ILIAC spike: FLANK RAP
DEPRESSION Of POSTERIOR
GLUTEUS MEDIUS—-
& LUTE US MAXIMUS- SUPERIOR UJAC SPINE
Gluteal form
SURFACE FORMS
ANATOMY OF OF THE
THE BACK SACK
 The Trunk Muscles * ERECTOR SPINAE

ES (rt)

11M Deep musdit E S EncU j r spmav t S (I E wit jr sputa?—lateral form

E S (M) E rerUtr spmae—medial form !■ F Ffouk fat pad G M a f r la feus max turns G M c titutem mtdim
i Ilium t tjttittrmm durst Mu Multifidut PSlS ibs/morsuperioritiacspine
QL Quadrateslumbarum R Ribs Sac$atrwn ScA Srmttus anterior Tr Trapezius Vc Vertebra
* Under latissimm dorsi

1 31
 The Trunk Muscles * ERECTOR SPINAE

Erector Spinae of ihe spinous processes). As the thorax ilexes

(Sacrosprnalis) forward at the waist, the muscle immediately
ORIGIN A continuous line which hegmson tenses and hardens* and the cylindrical form of
the inner surface of the posterior third of the each sitltr divides into two forms—a narrow*
ilt.K crust, passes down the bnfr.il emt uf the lower, vertical medial form and a wider, higher,
sacnitn fruit the bter.il edge}* curves .1 round to oblique lateral form.
and then up the median crest of the sacrum (on The medial form is made of the imilrifidus
the riisdline , and continues straight up the tips muscle interiorly dying under the tendon of the
of the spun ms processes and supraspinal liga¬ erector spinae! and part of ihe belly of the erec¬
ment or the lumbar and lower two thoracic ver¬ tor spinae superiorly, Tins form begins mid-sac¬
tebrae, I’here -ire additional deep sue-* of origin rum. slightly below the level of the posterior
inn her up the hack.) superior iliac spine* ami ends superiorly fust be¬
low the lower tip of ihe trapezium It lies be¬
INSERTION IW many muscular slips mm riti- tween the spin oils processes of the lumbar ver¬
nuTLius points on ihe hacks of alt twelve ribs, tebrae and 1 lie depression lor bumpf of she
between the angles of the nhs hiiivatly and ihe posterior superior iliac spine. The inferior end
liberties nf fht* nhs t> 1 rtitally 1 into the spinous of the medial form widens slightly on the poste¬
and/or transverse processes of all the thoracic rior surface of rhe sacrum.
ami cervical vertebrae; and into the mastoid Tile lateral form begins interiorly .11 the level
process of the skull. of the top of the crest of the ilium and disap¬
ft ACTION Extends the vertebral column and pears superiorly at the level of ihe bottom of
ihe head. Portions tif the erector spinae assist she scapula, where it thins out and passes under
SECTION B
10 rotation and lateral flexion of the vertebral the Trapezius ■ it is occasionally seen higher,
column. bulging under the trapezius). Ifm form is
oblique, being directed upward and slightly me¬
STRUCTURE The erector spinae* or caero- dia lb, ft is made up of fleshy muscle libers of
sp mails consists of several combined muscles rhe erector spinae. The lateral form is usually
which form a thick h cion paced musetc mass nn wider interiorly (the portion of the belly be¬
the back CO the side of the spinous processes of tween the rib cage and the pelvis bulges Ini -
thi' vertebra! lulmnn, U extends from the sac¬ tfrally because of the fullness of the muscle). It
rum to the base of the skull. Il is thickest in the narrows superiorly (its lateral edge shifts medi¬
lumbar and cervical regions* and 1 hi liner and ally) as the ascending muscle bundles along its
wider in the thoracic region. In the thoracic re¬ lateral side Thin into non Visible tendon?. The
gion, 11 widens out top hut not past, the angles tendons continue to insert out to rhu angles ol
of the ribs. At about the level of the bottom of the ribs, but rhe visible lorm Joes tioi extend
the scapula, ns form becomes less distinct as it that far laterally. The lower end of the lateral
til ills and passes upward under rhr rhomboids form is created where us Ik shy fibers attach
and ihe trapezius, into us wide tendon of origin.
lit the side view of the body, the back profile As the trunk reaches full Ikxion (Hexing at
of the muscle creates a transit ton between the the vertebral column* not at the hip joints), dir
ihit'fi plum* of ihe back of the thorax and rhe erector spinae is pulled relatively thin arid flat,
up plane of the back of the sac nun. The hack and the spinous processes of the lumbar and
profile usually appears as a series nf two con¬ sacral vertebrae* as well as the posterior >upe¬
vexities, as the erector spinae separates mm me¬ rm r iliac spines, begin to project. When ihe fig¬
dial and la [era I forms (see below}. The I uni bar ure is erect, the vertical median furrow of the
portion of the erector spinae forms a powerful back ai the bottom of which lie the vertebra I
and prominent muscular Column on each side spinous processes ends interiorly halfway down
ol the spine in The lower back, referred to as the sacrum.
the si mug cords or ihe common mass, The latissnnus dnrsi may confuse the shape of
5ECTJDN D I lie erector spinae is simple and tendinous at the erector spmac m two ways. First, if the
its origin* As it ascends, it divides into several erector spinae is relaxed when the Jaiissrmus
muscles which split into numerous bundles; dor si i\ tensed* the latissimus pulls on us wide,
new fibers arise as lower fibers insert. The sepa¬ sheet like tendon of origin (also culled the thora¬
rate muscles and bundles are occasionally seen columbar fasemk which lies on the surface of
1 in the surface—usually momentarily duritig the erector spmac. This pulling causes ridges or
motion. furrows m develop across the long axis ut the
When the figure is standing erect, and rhe soil erector spin at. These ridges are m line with
crector spinae is relaxed, the muscle appears as the direction of the muscle fibers of the lufissi-
a angle wide wnsatlar form on either side nf in us, and arc therefore almost honzonr.il supen
the median spinal furrow itlie depressed ridge urly and more oblique interuiHy. Second, when

*33
The Trunk Muscles * ERECTOR SPINAE

the I.Ttissimus \> tensed, the line of aieach mem form of the erector spinae. It is located lateral
of its muscle fibers inns its wide tendon of ori¬ to the oblique line which separates the erector
gin occasionally becomes visible—its muscle fi¬ spinae into its medial and lateral forms. The
bers are in slight raised relief where they meet latissimus line appears only when the latissimus
the tendon. This visible diagonal line, either dorsi is tensed,, regardless of whether the erector
curved or straight, sits on top of the lateral spinae is relaxed or contracted.

CONTINUE* UN0E R

COKlvtxiTV
D0U5CE
 The Trunk Muscles - MULTIFIDUS

Multifidus cross over two to five vertebrae at a time, de¬

(MultifkJi) pending on their length, to insert into a higher
OR i G ! N The medial half of the posterior sur¬ vertebra.
face of I he sacrum, rhe inner aspect of the pos¬ The upper portion of [he muscle is deep to
terior superior iliac spine, the posterior sacra- she other spinal muscles. It progressively be¬
5ECTSON A
iliac ligaments, and various points on the hack comes thicker and wider as it descends. Interi¬
of the Literal processes of all the vertebrae ex¬ orly, n tv covered only by the tendon of the
cept the first three cervical vertebrae, erector spinae in the lower lumbar and sacral
region. The gluteus maximum originates in part
INSERTION The spinous processes of all the
from the surface of the lateral portion of this
vertebrae, except the atlas,
tendon. The multi lid us therefore directly creates
ACTION Extends, laterally Ilexes, and rotates surface form in the lower lumbar and sacral
the vertebral column. areas,
STRUCTURE The multifidus (multifidi) lies When the back muscles are tensed, the multi¬
deep to the crccror spinae, It fills the bony fidus creates the lower portion of the narrow
groove tin both Miles of the spinous processes of vertical form that ties immediately on either
the vertebrae along the entire vertebral column* ^ide of the spinous processes of the sanrurn and
5€CTION & |r consists of numerous short bundles passing lumbar vertebrae.
obliquely upward and medially. They variously

E5£tf>*

P5IS

GMa

E 5 Erector spitm E 5 (L) Erector spittae— lateral form L$( M) Erector zpwae— media! form
CMi Gluten* maxtmus bin Multifidus PSIS ibsUrior superior iliac spin* Sac Sacrum Ve Vertebra
* Under laiissitmis dorsi t Under erector spmctc

*35
 The Trunk Mmdes * RECTUS ABDOMINIS

Ap Aponmirnsis Car * arfthgt EO Externaltrhiiqu? EpD Eplguttricdepression 1O Internal oblique

I.A Lmeaaihd PMj Ptcior&Us mufor RA Ream abdominis St Senti lunar Une
Tl Tendinous intersection X Xiphoid protest

136
 The Trunk Muscles * RECTUS ABDOMINIS

Rectus Abdominis The three tendinous intersections divide the

ORIGIN Pubic crc£t of the pubic bone (a short rectus abdominis into four fleshy, muscular seg¬
horizontal line at the top of the pubic sym¬ ments- Hit superior segment is continued up¬
physis) and front ligaments on the from of the ward over the costal cartilage on the front of
pubic symphysis, the rib cage and is the least conspicuous of the
INSERTION An ec r u > r surfaces of t he costa I four. Its upper edge usually coincides with fhe
cartilages of the fifth, sixth, and seventh ribs lower border of the pectoralb major; therefore,
and the anterior surface of the xiphoid process. this segment ends before reaching the bottom of
the sternum, leaving the Intrasicrnnl notch (epi¬
ACTION Flexes the trunk at the lumbar verte¬ gastric depression) exposed. It may end higher,
brae* continuing under the pectoral is, m tower, c»
STRUCTUR E The rectus abdominis is a lung, posing costal cartilage. Sometimes this segment
flat* vertical muscle on the from of the abdo¬ divides into three vertical bundles of unequal
men. It is wide and thin above and tapers be- length, progressively becoming longer and in¬
low. The muscles of each side of the body meet serting higher laterally. "lire overall plane of the
at the midJine at a tendinous vertical line, the upper segment is directed slightly upward. The
linea alba (white line)* which extends from the medial bundle ol this segment anache* into the
xiphoid process to the pubis. The linea alba ap¬ seventh cartilage; the middle bundle, into the
pears as a vertical furrow bet ween the two be I sixth; and the lateral bundle* into the fifth carti¬
lies, gradually disappearing below she navel, lage and its bony rib, Thu lowest segment—long
Vi
Ihe navel is variably situated halfway to two- and tapering iuferinrIy—bulges the must. This
third* n\ ihe way down this line. During lateral segment i* pan of the pelvic volume, and the
SECTION B trunk flexion, only the portion of the linea alba segments of the twro sides of the body are usu¬
above she navel curves laterally i cor responding ally not separated by the linea alba. The comers
to the curving him bar vertebrae in bach). of all the segment* arc slighth rounded.
The lateral edge of the rectus abdominis ls The rounded abdominal or Greek arch, as
separated from the fibers of the external oblique con figured in classical Greek sculpture, is com¬
by a tendinous furrow called the semilunar line. plicated, and is composed of several struc¬
11 is located medial to a line dropped from ilu¬ tures—cartilage* muscle belly, and tendinous in¬
mp pie (or straight down from mid-clavicle) tersection, It begins laterally and interiorly at
which is directed downward toward the middle the costal cartilages of the rib* (from the tenth
of the thigh (in the anatomical position.'. The rib,' and continues up and over through the up¬
semilunar line begin* just below1 the lower bor¬ permost tendinous intersection of the rectus ab¬
der of pectoral is major (on the surface of the dominis. The upper must fleshy segments of the
rib cage, where n is taint) and continues down¬ rectus abdominis oi both sides bulge above the
ward beyond the rib cage, where it is more pro tendinous intersection and fill the sharp, angu¬
nounceJ, Inferiorly, at the level of the navel, the lar summit between the two sides of the upper
semilunar tine begins to widen into a tendinous ends of the costal cartilages, where they meet
triangular expansion* the lower end of the sternum a[ an angle of yoJ
Usually, three fibrous hands, the tendinous (more acute in the female). The tip of the xiph¬
imerscctiurn, are situated m the muscle nnd iri¬ oid process propers forward, pushing muscle
se ribe transverse furrows across fhe belly. T hey and tendinous intersection anteriorly, which
do not necessarily pas* straight across both rec¬ also helps to round off the abdominal arch.
tus abdominis muscles, bur are sometimes lo¬ Since the rectus abdominis muscle belly crosses
cated at different levels on each side, giving the over the costal cartilage, in muscular individual*
abdomen an asymmetrical appearance. An indi¬ the entire form of the upper segment may pre¬
vidual intersection may be cither straight or zig¬ dominate and be seen as a distinct fleshy bulge,
zag. Classically, the lowest tendinous intersec¬ whereas in thin individuals the form of the un¬
tion is horizontal and is located it, or slightly derlying costa! cartilage may predominate.
above, the level of the navel. The highest is di¬ The two "arches11 to look for at the from of
agonal and is directed approximately from the the nh cage are the unaided Greek arch, pro¬
tip of ihe xiphoid process to the point where duced by the rectus abdominis muscle and it*
the semilunar line crosses the ninth costal carti¬ uppermost tendinous intersection, or the sharp
lage. Tile middle tendinous intersection is lo¬ skeletal arch, produced by the costal cartilages
cated at or above the level of the waist, and its meeting ihe bottom of the sternum |ust above
degree of obliquity is midway between the other the pit of the stomach. The sharp skeletal arch
two. Occasionally a fourth tendinous interact: often predominate* in the female, while the
non is found below the navel, but is not always rounded Greek arch usually predominates in the
seen. The obliquity of the intersections is, highly male.
variable* and they may all be horizontal* Faint oblique ridges on the surface of the rec-

•37
 The Trunk Muscles • RECTUS ABDOMINIS

tiifi abdominis^ especially at its upper end* are move closer together. Two horizontal skin
occasionally created when the pecroralis major ft)Ids, seen at nr above the level of the navel*
nind external oblique contract and pull on the separate the thoracic and pelvic masses. Lat¬
thin abdominal aponeurosis that covers the rec¬ erally, these skin folds end at or just beyond the
tum abdominis. These ridges are in line with the semilunar line, which remains visible.
direction of the fibers of the pectoral is and ex¬ When inhaling, the diaphragm pushes the ab¬
ternal oblique; the fibers of the rectus abdom¬ dominal contents downward, causing the rectus
inis ate vertical. abdominis to protrude. When the trunk is
During forward trunk flexion, the muscle fi¬ flexed forward* the belly (and the rectus ab¬
bers shorten and the tendinous intersections dominis) bulges below the level of the navel.

I 38
 The Trunk Muscles * EXTERNAL OBLIQUE

u U

A p Aponeurosis A 5! S. A rumor superior itiac sprite C ar C^rtibge CTC'test of tlttiut

F O £xstmal oblique EO{ ¥) Lxtrrml oblique —flank portion EO f T' J External oblique - ■ thoracic portiutt
¥ F FLtik fas pad GMt Gfuteus medtrn J L Inguinal I lament I Li IJW line IO I titenul oblique
L Laiissimus dorsi PMi Pect&ftiUs rtmf&r R Rib RA Rectus abdominis A Serratw anterior
£ L SetfiiluriJr tine
 The Trunk Muscles * EXTERNAL OBLIQUE

pad posteriorly—bus a high curved are. The il¬ insert into its aponeurosis do sn via separate
iac line has a subtle, donga led S curve. It inter¬ bundles, which often creates a jagged, irregular
sects with the iliac crest at a point one’third of line (the lateral ed^e of the rectus abdominis ls
die way back on the crest (at die widest point smooth}.
of the pelvic). The actual overlap of the posie- A triangular depression may occur in the por¬
rior portion of the dank pad, past the iledc crest tion of she external oblique belly mi mediately
and onto the surface of the gluteus medium con¬ below the costal cartilage—qust lateral to the
sists of I at ami skin. The overlap increases semilunar line and just above the front portion
when ibe thorax is bent laterally toward that of the Ibink pad. In this case* the costal carti¬
side i the iliac line descends)* as the extra skin lage becomes prominent.
accumulates. When hem in rhe other side* the Tile inguinal ligament Pou part's ligament: ts
iliac line and the overlap o! the flank pad even¬ the thickened lower border of rhe aponeurosis
tually completely disappear as they are ol the external oblique (it is not a separate
stretched, which can expose almost the entire structure}, it is attached laterally to the inside
iliac crest. When the trunk is Hexed forward, of rhe anterior superior iliac spine and medially
the posterior part of rhe iliac line disappears. to rhe pubic tubercle, near rhe mid line. Ei forms
The semilunar line ts the tendinous furrow either 4 curved or straight line* marking rhe
located on [lie front of the abdomen between freparasion between the abdomen and rhigh. It
the rcctu.s abdominis arid extern a I oblique Inte¬ straightens and deepens when the thigh is
riorly, ai the level oE the navel, it begins to flexed. When seen in I he female {where it is
vt
expand into a triangular tendinous area whose usually very fault), the inguinal ligaments of
surface bulges outward because of the abdnmi both sides form a wider V than in The male.
SECTION B nal contents deep to it. Part of the deep internal Ibis is because in the female the level of the
oblique muscle lies directly beneath this EL-ridi- anterior superior iliac spmes «* closer to the
jo
nous expansion, occasionally producing a nar¬ level of rhe pubis, and the two anterior superior
row, oblique relief form beneath it, directed iliac spines arc relatively farther apart (rhe fe¬
downward and medially (immediately above male pelvis is shorter and wider than the mute
and parallel to the inguinal ligament). pclvbh
The muscle fibers of the external oblique that

FLANKpad

BACK VIEW

FRONT VJEb/

Tf USltJom Abwr,i*>L
-TFuAn&Ci:
fTUORiiCit PflRT'igW Gw

An t i d nAL

FLSHH
PORTION
MT fis^s. A I- 3 A

GRIDS* 5ECTJ0W FROM! VtEw

*4»
 Tfie Trunk Muscles ♦ PECTORALtS MAJOR

HIS Bittps bwchii B L Biceps krachtt— hmg head BS Bicepsbrjchii—short head Car Cartilage
Q Dfhoid DA Deltoid—Outer tor portion EO External oblique H Humerus Mn Mjtiahntim
I * A h Ftctotafis—abdominal porn* m PC Pectornlss—tLiicuhr portion t1 M a Pi^turjhs major
PM 1 Pectoral** minor PSt Fettaralis—sternocostal portion B Rih HA R?cttt$ abdominis
Sc A Swains anterior Sic Sternum

142.
 The Trunk Muscles - PECTGRAUS MAJOR

Pectoralis Major variable outline and the development of its

ORIGIN The anterior surface of the medial muscular mass The pectoral is major forms the
half of the divide, the entire length of the ante¬ thick muscular anterior wall of the armpit. TTie
rior surface of the sternum toward it^ lateral deep and unseen jKcforalu minor lies behind it,
edge I not from the xiphoid process), the cam- adding thickness to rhe medial end of the wall
Ijfw* of the first six or seven ribs, and the upper of the armpit, A small part of the pectarati*
end of the aponeurosis of rhe external oblique minor may actually come to the surface be*
muscle {abdominal aponeurosis! lying on the rwit n ihe pectoral is major and the uppermost
-SECTiOW A
top of the rectus abdominis muscle. visible Jigitaiioii uf the Nerratus anterior, but u
is not defined or seen as a distinct form.
I NSEfl T ION Lateral lip of the mtmuhercuhr As they come off their origin, (he muscle fi¬
sulcus (bicipital groove) on the front of the hu¬ bers of the pecEoralis major divide into numer¬
merus, ous bundles The bundles taper ami converge
ACTION Adducts the arm* pulling it across rhe laterally; progressively overlying one another, a
chest; medially rotates the arm. The clavicular superior bundle crossing in front of the bundle
portion will raise (flex) the arm, while the lower immediately inferior Eo it. These bundles, be¬
lateral sternocostal portion will then pdl it come quite conspicuous when the muscle is
down (extend it, but not hyperextend it, bjek contracted. The uppermost clavicular fibers are
past the nb cage). directed downward and laterally toward the
bottom of rhe line of insertion; the lowest and
STRUCTURE Tile pectoral is major is a large, most lateral abdominal fibers from the side of
thick* tan-shaped muscle lying on the front of the chest are directed upward and laterally
rhe thorax. It crosses the front id the armpit, toward the top of the line of insertion- and ihe
where u remains thick, and then attaches to us remaining large group of bundles between them
tinn, square tendon of insertion, which enables are* as a group, directed across toward rhe
it to pass under the deltoid Eo its insertion. No middle ol that line. This arrangement creates a
V# muscular fibers of the pectoral is pas* under the thick, muscular, crisscross tw isiing of the fibers
deltoid—only its tendon Joes. in front ol the armpit, with the clavicular por¬
The pecrtvralis is divided into clavicular and tion on top (in from) and the abdominal por¬
ACTION C
sternocostal portions based on rhe origin of tion deep in hack. All these fibers, attach into a
these sections The most lateral and inferior di¬ square common tendon which then passes
vision of the sternocostal portion is called the through the narrow space under the deltoid and
abdominal portion, Classically. the pectoral is over the biceps 10 reach its insertion on the
maior is flat, planar, and squared-offT bur it can humerus. Several vertical skin wrinkles appear
also be rounded and bulging, depending on its in life on top of the crisscrossing fibers when

FRONT VIEW
LAT. *-> H£t>

M3
 The Trunk Muscles ■ LATtSSSMUS DORSI

Ap ApQMcuTQtiM t;j Crest of ithtm BO External oblique BS Erector spotnc FF t;ljob futpjd
GMa Gluteus mammas GMc Gluteus medius ILi lime ime In Infraspinatus L l^tisslmus dorst
R Rih Rh Rhomboids StA Serratusmtariar TMa Teres major Tr Trapezius
* Under lanssimos dam

146
 The Trunk Muscles • LATISSIMUS DORSI

teres major, rib cage [and individual ribs), and der, superior border, and the line of attach mem
especially the serratus anterior, These forms are of its muscular fibers into its tendon. The mus¬
more clearly seen when the trunk k Flexed for¬ cle sheet of the latissimus thickens as it ap¬
ward, the arm raked, and the shoulder did for¬ proaches the armpit, filling tlu- space surround¬
*
ward, stretching and thinning the latksinius. ing the forms of the teres major and sc trains
The direct evidence of the Intissimus on flu stir- anterior.
SECTION & fate, in order of prominence, is its lateral bor¬

SECTION 0

147
 The Trunk Muscles - TRAPEZIUS

C " Vr a nth ctri 'tail vertebra t S f- reas* r apt nae 1 n f nf r aspmalus L l .Jitsnmu* jJm fsj
LS Levator scapulae Su Nuchal ligament Hb Rhomboids % Sc-jpufa Sc Srrrmprrwhs cxpttis
SM Scalmwmedttn SpC Spizmm inputs SSc Spttii of scapuLt Tt First thoracic rrrtebra
Tr Trap film. Ve Vertebra

148
 The Trunk Muscles - TRAPEZIUS

Trapezius ward toward the scapular tubercle. This portion

ORIGIN A line thru passes across she medial can be visualized as a separate Hat muscle belly
third ol flic superior nuchal line, M she base of with flattened 1 codons at both ends.
the skulk over to she external occipital protu¬ The lower lateral edge ol the trapezius ^an be
berance* Is then descends along the posterior seen passing obliquely upward and outward on
free edge of the nuchal ligament, the vertebral the middle of the back; it js clearly seen when
spinous processes down ro the ns dish thoracic the arm is held horizon rally out to the side and
vertebra, and the intervening supraspinal liga¬ pushed down again sr resistance.
SECTION A
ments. The hue of or (gin is an upside-down L ITie entire trapezius can he reduced to three
major planes: the hack plane of rhe neck, the
INSERTION A continuous line that passes
top plane of the shoulder, anti the vertical plane
across the posterior border of the lateral third
of the back.
of the clavicle, onto the medial border of the
Ihr majority of the trapezius creates ihi* ver¬
acromion, and along the upper edge of the
tical plane of the haekp also called the rhom¬
spine <if the scapula (excluding the expanded
boid plane (based on ihe orientation of the un¬
triangular area at the spine's medial cnd)+ The
derlying rhomboid muscle}. This vertical plane
WCTIIIM B line of insertion then doubles back around for a
is directed medially and anteriorly from rhe ver¬
short distance along the louder edge of the spine
tebral border of the scapula to the spinous pro¬
of the scapula* ending at the tubercle of the
cesses n| the vertebrae ttn the mid line of the
spine. Seen from above, the line of insertion ts a
body. The rhomboid planes til both muscles
V, pointed laterally, on the top ol the bony
(both sides of ihe body], along with both scapu¬
shoulder girdle,
lar planes (the planes created hi the infraspina¬
ACTION Rotates ihe scapula hy lilting its lat¬ tus a ml spine of the scapula), create a wide W
eral end and pulling its medial cud downward, configuration when weu rd from ihr top* When
SECTION C Working separately, the upper portion lifts the the shoulder blades art- pulled together in back,
scapula, the middle portion pulls it medially, rhe rhomboid planes disappear anti the trape¬
and the lower portion pulls it downward. zius muscles of both sides bulge and touch each
STRUCTURE The trapezius is an extensive* other, producing a tight vertical cleft between
wide, triangular muscle located on the hack of them.
the chest, the top of the shoulder, and the back The top plane of the shoulder, for rhe most
of rhe neck. part, is directed upward and backward. The
The upper ribers of the trapezius pass down¬ posterior edge of this plane is formed by the
ward and outward; the middle fibers pass hori¬ s*pme of the scapula. Anteriorly, the shoulder
zon tally outward: and the lower fibers pass up¬ plane curves over the top of the shoaider*
ward and outward, beading toward the tubercle Tlit- back plane of ihe neck, created hy the
on the spme of the scapula via a small apnnem cervical portions of the trapezius of both sides
rosis, I he muscle varies in thickness in in Jit of the body, can be visualized in two ways—on
ferent areas. The part on the back of the neck is the one hand it is often ll.uicued and planar,
very thin; along wnh the deep semi spinalis capi¬ while at other times n is rounded (side to side)
tis muscle u creates a muscular column on and participates in producing the cylindrical
pWu
colter side of the midline. T he nuchal ligament volume of ihe necfc-
lies or the nudlinir of the hack of the neck, at There arc ihtee irsangular apuncurolk or ten¬
the bottom of the vertical groove between these dinous areas in the trapezius, as follows:
SECTION £
columns when the neck ts upright. It becomes a
raised ridge when the head and neck are flexed I, A relatively hr^c triangular area surround¬
forward. In side view, the back profile of the ing the seventh cervical vertebra. These ten¬
neck can he concave, straight, or convex. dinous areas of the muscles of both sides of
In txmmuscukf individuals, or when the sca¬ the body create a diamond, oval, or tear¬
pula has been slid laterally and rotated so the drop-shaped depression, prolonged upward,
upper portion of the trapezius becomes elon¬ on the back ol the neck, li usually reaches
gated and chin, the vertebral border ol the sca¬ up to die base of the skull and ends mkn-
pula located above the base of rhe spine may Orly M the level of the spinous process of die
become evident on the surface, bencaih the third thoracic vertebra. Tlse prominent spi¬
muscle. When the arm is abducted, ihe oval nous processes of the seventh cervical and
form of the supra spinucus can be seen bulging lirsr thoracic vertebrae pm jeer at the center
deep to the trapezius |ust above the medial pot of this tendinous, depressed area.
lion of the spine of the scapula. L. A smaller triangular area a I the upper lateral
The lowest fillets of rhe trapezius may sepa¬ end of die fibers of the lower half uf the
rate visually, creating an independent elliptical trapezius. This tendinous area lies partially
Of elongated form, directed upward and out¬ on ihe expanded triangular base of rhe mc-

M9
 The Trunk Muscles * TRAPEZIUS

dial aid cj-f the spine of the scapula (which the body, automatically rotating the scapula,
shows through as a bony plane) and par¬ the scapula and overlying infraspinatus slide
tially on the surface of the infraspinatus mu laterally from under the small scapular
z muscle. The infraspinatus portion uf ihe ten¬ portion of the belly of the trapezius.
to don may appear as a depression, caused by J. The smallest triangular area al the inferior
£ the fullness of the surrounding muscular and [ip of the muscle. It is this small triangular
o bony forms. The lower edge of this tendi¬ aponeurosis* not the actual muscle fibers,
nous triangle can sometimes be seen con¬ that reaches the very bottom of the line of
stricting the muscular form of the infraspina¬ origin of the trapezius (at the spinous pro¬
tus. Ihe lateral ends of the lower muscle cess of the twelfth thoracic vertebra). Be¬
fibers of the trapezius attach into- the infra¬ cause this tendinous area is not visible as it
spinatus portion of the tendon in an elon¬ lies on the erector sp iliac* the inferior end of
gated S-eurve line which lies lateral to the the form of the muscular belly of the trape¬
underlying vertebral border of the scapula. zius ends superior to the final attachment.
This produces a plane change of the trape¬ The triangular tendinous areas of both sides
zius belly as its fibers pass over this scapular of the body create a diamond shape, with
border; most of the belly lies medial to the the inferior ends of both sides of the muscu¬
vertebral border on the rhomboid plane* lar form of the trapezius ending in relief as
while only a very small portion of the belly an inverted VP or at least appearing blunt,
lies lateral to it on the scapular plane- When rather than as a single sharp point.
the arm is abducted away from the side of

TEWDON ffiOTH 5I0E5)

I 50
 The Trunk Muscles * RHOMBOIDS

Rhomboids leral muscle on the upper hack. When contract¬

(Major and Minor Together) ing and shortening (pulling the scapula towards
ORIGIN From the inferior portion of the nu¬ the midline}, the rhomboids may produce an
chal ligament down to the fifth thoracic verte¬ oval bulge which can hr seen under the rrape
bra, along the spinous processes and intercon¬ mis. This form lies closer to the scapula than to
SECTION A
necting supraspinal ligament of the vertebrae the mid Line in rhe back.
\tm the midi in* of the upper back). The lateral portion of rhe oblique inferior
border of the muscle is superficial, hut is not
INSERTION Ilie very edge of the mcdi.il iver¬
always easily seen. It ties in rhe triangular space
tebral) bonder of the scapula, extending from
bordered bv the media! border of the scapula,
the top yf the triangular expansion of rhe base
the lateral edge of the trapezius, and the top
of the spine down to the inferior angle.
edge nf the tasivumus dorsi. The resr ot rhe in¬
ACTION Together the rhomboids adduct and ferior edge can sometimes be seen under the
raise the scapula. They assist in rotating the trapezius, heading diagonally upward and medi¬
scapula (during rotation, the bottom of the sca¬ ally to its attachment on rhe vertebral column.
pula moves medially and the acromion moves Any line or form directed upward and medi¬
inlenorlyK ally from the inferior angle of the scapula to
SECTION B
STRUCTURE The rhomboid major and rhom¬ the midline is pan of ihc rhomboids, not rhr
boid rnumr muscles arc batch separable and trapezius.
are here considered a* a single, flat, quadrda-

E$ Erectorspime In infraspmatm L Laiisstmus thrsi Rli Rhomboids !i Scapula TM» Teres major
ft Ttjpezws Vc Vertebra
 The Trunk Muscles * SERRATUS ANTERIOR

EQ External ahtiifur L Latksimits darsi PM,i P*cl&ratl$ major PMi Fectarvlis minor R Rfh
S Scapula Sc A Setratus anterior Sub Suhscdputam TMa 7W*s *tw}nr Tr Trap fans
* Under iaitstwws Jam

I51
The Trunk Muscles * SERRATUS ANTERIOR

Serralus Anterior external oblique}, but as they head toward the

(Serratus Magnus) inferior angle of ihe scapula, they pass deep to
ORIGIN: A line uf itnall triangular arras on the latissirnus dona; however, the form of the
the t hi Err surfaces and superior borders of the tower portion remains visible under the thin la-
lirst eight or nine ribs. and the aponeuroses cov¬ fisstmiis. The uppermost visible dictation be-
girls .it or mst ahovc the level of the inferior
ering the intervening intercostal muscles
border of the pect oralis major. The digital in m
INSERTION Narrow strip on the costal (deep) can begin quite far forward on the side uf she
surface of tti-c scapula at its vtmhrjl border, rib cage, almost reaching the front ot thr chest.
which expands in area at the inferior angle of
I lie hue of origin of the Sips of the exposed
the scapula. dimitations on the side ori the rib cage forms a
ACTION Slides the scapula around forward, as toothed (serrate], anteriorly curved hue, which
in punching, and by us inferior fibers rotates its appears rn be directed from the nipple io she
inferior angle laterally, which elevates the lat¬ posterior superior iliac spine w hen looking at
eral end of the shoulder, and therefore the arm, she figure in side view. Therefore, the length of
STRUCTURE When considered in its entirety* [hr exposed part of each of the djgita lions,
from its tip to the lateral border of the latissi-
The terrain* anterior is a large quadrilateral
mus dorsi, diminishes inferior)/* Sometimes the
muscle which embraces the curved form of the
tip of the lowest dipiiasion may he completely
rib cage- tt is divided into fingerhke dictations
(hunjte), each originating from an area on the hidden from view under rhe from edge of she
side and upper border of a nh and the intercos¬ latissimra* especially if the latissimus is drawn
tal space above. The mu&clc cap he subdivided lor ward in the advanced shoulder.
The digiut ions {>1 the sc trams anterior arc
rnres upper and lower portions 1 he upper por-
lion partially ties inconspicuously against the bulged and mure horizontal than rhe Barter and
upper side of the rib cage in the armpit and more oblique digit at ions of she external
partially sits sandwiched between the scapula oblique. The ribs, often seen under the external
and rah cage. oblique* are not seen under the serrutus.
The inferior border of the serratus anterior
The lower portion consists of five or si*
will sometimes continue inserting past the infe¬
pointed digital ions which create a thick, fan-
rior angle of rhe scapula imo the lower edge
shaped mass radiating forward from the inferior
angle of the sea pub. Only the lowest three nr of ihe rhomboid major muscle for a short
four of these digital urns can be seen—their an- distance; consequently, the form of the serra-
TuS under the latksimus will extend further
rerun half is superficial on The side of the chest
[where they interdigirare with the bundles of she medially*

*53
 ORMAL
1ELAXED)

5H0ULPER,
VOLUfAe

!S\ ADVANCED
 The Shoulder Muscles - DELTOID

fl R Biceps hrachii B L Biceps hradftt - long head B r Brachiali* BS Bicep* brachii — short head
C i lavkfe C V Cephalic vein D Deltoid DA Deltoid - anterior portion
DAc Deltoid—acramuttportion DP Deltoid-posteriorportion H Humerm In Infraspinatus
Ft: Peetorahs—clavicular portion PMj Fcciorahs major 55c Spine of scapula
TLa Triceps -Literal head T La Triceps—tans head TMa Teres maw TMi Teres minor
Tr Trapezius

!56
 The Shoulder Muscles * DELTOID

Deltoid The anterior portion of the deltoid, originat¬

ORIGIN A continuous line pacing along die ing from the divide, is shorter than the other
anterior surface of the Lateral third of the clavi¬ two portions, tc shows up as a teardrop or oval
cle, the external border and ad latent top sur¬ relief on the surface, and sometimes split** down
face of the acromion of the scapula, and the the middle info two forms. I he lateral form
lower edge of lbe spine ot the scapula (extend¬ descends slightly further. The belly of the ante¬
ing medially up to* but not including, its medial rior portion ends in its own wide tendon a
triangular expansion). The deltoid roughly orig¬ short distance above the final insertion cm the
inates just below the insertion of the trapezius humerus. Tins belly* arid the belly of the clavi¬
SttTiO N *
(the scapular spine remains subcutaneous), cular portion of the pectoral is major, end at
about the same level (the anterior portion of the
INSERTION Hie deltoid t tiberosi ty haEfwa y deltoid actually descends slightly further). The
down the outside of the shaft of the humerus, fibers, and therefore the forms, of these two
muscles lie side hy side—she deltoid does not
ACTION The antetiur portion flexes the arm
cover the muscular fibers of the clavicular pec-
(raises re hi front of the body) and pulls the
horizontal arm toward the fmnt of the body;
tatilUs; however, the (rndmi of the clavicular
pectoral 15 (without fibers) does pass under the
the middle acromial portion powerfully abducts
anterior deltoid. The tendon of insertion of the
the arm; and the posterior portion extends 1 he
anterior portion of the deltoid then descends no
arm back ward and pulls the horizontal arm
the front mot outer) surface of the acromial
backward. The anterior and posterior portions
fibers of the deltoid and inserts toward the
are antagonists when they flex and extend the
SECTION a irons surface of the humerus, adjacent to ihe
arm at the shoulder joint,
origin o! the brachial is, Ei is actually the other
STRUCTURE The deltoid is a thick triAngular two portions of the deltoid that Insert onto the
muscle, pointed mferioHy, which cups ihe outside of the humeru*.
shoulder joint. The muscle is divided into three Hie anterior portion of the deltoid projects
pontons: an anterior (clavicular) portion, an ac¬ anteriorly owing to the forward projection of
romial ''middle) portions and a posterior por¬ lbe underlying spherical proximal extremity of
tion. hi from, the deltoid and pectoral is inaior the humerus, especially when the arm is hyper-
srcTiow c are separated fur a short portion of fhar extended back past the trunkr
lengths, iust below the clavicle, hy a in angular The posterior portion of ihe deltoid is located
depression called the infra clavicular fossa. on the kick of the shoulder. It thins into an

TWO

SECTION &

157
The Shoulder Muscle s * SU PR A SPIN ATUS

Supraspinatus is abducted, its form is occasionally revealed as

ORIGIN Mt'ilmI fwo-thirds of the posterior 4 bulging egg-shaped or teardrop form (pointed
surface of ihe scapula superior io the spine fs#r- end directly laterally} above the medial half of
pmspmatus fossa). the spirit: of the scapula. In this position, the
Mipraspinatus is ar its shortest and thickest.
ENSERTiON Superior fact! of the greater tu¬
If the scapula is prevented from rotating
bercle an the top of the lateral part of the prox¬
(cither by external resistance or internaE muscle
imo] extremity of ihc humerus.
fixation) as the arm is abducted to the horizon¬
AC Fi ON Abduct* the arm; stabilises rhe shoul¬ tal away from the side of the body* any bulge
der joint from above by pulling the head of she developing above the scapular spine must be the
humerus into its socket. supraspinatus, since in this case there is no
STRUCTURE The supraspinams passes lat¬ shortening of the trapezius.
erally over the fop o! the shoulder joint (under When the arm is down by the side of the
the acromion) to its insertion on the outside of body, there is no indication of the supra spina-
the top of the proximal extremity of the hume¬ tils on the surface, A slight hollow may actually
rus. Although it lies deep to the trapezius under develop above the scapular spine, as the supra-
a substantial thickness of muscle, when the arm spHiatus is now- stretched thin.

Om Omohyoid S Scapula S$c Spme of stapuLi Su Supraspmatui Tr Traprztm * Under trjprzius

*59
 The Shoulder Muscles * INFRASPINATUS

Infraspinatus shortens and thickens the muscle), Because its

lateral portion is covered by the deltoid, the
ORIGIN Most of the posterior surface of the
superficial area ol the infraspinatus may appear
scapula below the spine fossa}.
as a wide vertical form when the arm is down.
INSERTION Middle facer of the greater tuber¬ When she arm is raised, the posterior portion of
cle of the humerus. the deltoid slides upward, exposing more sur¬
ACTION Laterally rotates the arm: helps Stabi¬ face area of the infraspinatus.
lize the shoulder joint from behind by holding The muscle fibers, directed outward and up¬
ttCT ION A the head of the humerus in it* socket. ward* seem to be folded on themselves, which
occasionally divides the infraspinatus into two
STRUCTURE The infraspinatus is a Hat trian¬
forms—a superior and an inferior—separated
gular muscle that sirs on the bark of the shoul¬
by a shallow furrow I ha I is directed outward
der blade below the spine. Although rypEcally
and upward toward the head of the humerus*
exhibiting a slightly planar surface surrounded
This furrow may or may not reach all the way
by bulging muscles, the infraspinatus itself can
over to the medial border of the scapula.
bulge considerably when the humerus is lat¬
SECTION S
erally rotated to its maximum [this action

D Detfokt DP Deltoid—posmiorportion H Humcrus In Infraspinatus Rh Rhomboid* 5 Scapula

S c A Scrtatus anterior SS c Spine of scapula T Lo Triceps—hng bead T M a Ttres major
 The Shoulder Muscles • TERES MINOR

Teres Minor STRUCTURE Rarely seen on the surface, the

ORIGIN Raised ridge of bone on rhe posterior teres minor is a small* elongated* cylindrical
surface of the upper two-thirds of the lateral muscle that usually blends with the plane cre¬
ated by the infraspinatus muscle. Both muscles
i

4.1 biliary) border of the papula, And partly from

the fascia covering the posterior surface of the are covered by a layer of dense fascia which
infraspinatus and the deep surface of the medial consolidates their forms. The Eeres minor runs
end ul the lercs major. obliquely upward and outward from us origin
and inserts via a [hick, Elat tendon onto rhe
INSERTION The lowest of rhe three facets of
back of [he superior parr of the humerus. It is
the greater tubercle of the humerus and a short
occasionally seen when the arm is held horizon'
distance immediately below rt on the shaft,
tally* laterally rotated* and then pushed down¬
ACTION Laterally rotates the arm and weakly ward and backward against resistance.
adducts it: helps stabilize the shoulder joint by
holding the head rtf the humerus in its socket.

TM» Tfrej minor Tr 'Trapezius * Under latissrmm dorst

161
 The Shoulder Muscles TERES MAJOR

1>P Deltoid—potUntiT portion In Infraspinatus L Latistimus durst Rh Rhomboids S Se&puta

SeA S^rratus anterior Sab Suhicapularis TLo Triarps—hmfthtad TMi Tert$ mafar
TMi TettS mmor Tr Trapezius * Vuder laiusimutjdorsi

161
The Shoulder Muscles * TERES MAJOR

Teres Major the back of the shoulder (bottom of the sca¬

ORIGIN Raised oval area nti the posterior $ur- pula) to the inside [runt carrier ui the arm. Do ¬
face of ihc inferior angle of the scapula {exclud¬ ing ituo the armpit, it* axis is directed outward,
ing a narrow vertical area immediately adjacent upward, and forward. When the arm* lies
En [he medial border), continuing one-third of against the body and the teres major is tensed,
the way up its lateral border, and partly from the belly is shortened, becoming oval and
the adjacent fascia covering the outer surface of hulged 1 the infra spin aius and teres minor are
the infraspinatus ami teres minor muscles* flattened and planar). In this position, the teres
ma 1 or may not appear to be directed toward
tNSERTION A short vertical line on the me-
the inner I rant corner of the humerus., bin it
dial lip of the bicipital groove (intenuhercuhr
ultimately is. In the raised arm position, the
sulcus} on the inside front corner of ihe hume¬
stretched teres major becomes noticeably longer
rus* unc4aurth of the way down the hummis
and thinner, and the upper edge of the kirissi-
medial to and slightly lower than the insertion
tttiis dnfsi can often be seen as a raised relief
of the latissimus dorsi).
lying across its belly. The latissimus covers the
ACTION Adducts am! medially rotates the lower medial portion of the teres major.
arm; extends the flexed arm. Note: the teres Because the teres major inserts lower (distal)
major and minor both adduct the arm, but are onto the humerus than does the htissirmis, the
antagonists for rotation of the humerus—the cylindrical form ot the teres major can he seen
major rotates u medially; the minor, laterally, as tl leaves the sling of latissimus, giving the
STRUCTURE The teres major is .1 cylindrical, posterior wall of the armpit a double convex
bur somewhat flattened, thick, bulging muscle. curve—the teres major is seen closer to the arm
Laterally* ie flattens imo a broad tendon as u {lateral and higher) and latissirniis closer to the
inserts. The medial end of the belly does not body 1 medial and lower). This is best seen when
quite reach the medial border of the scapula. the .urn is held horizontal out ro the side of the
The teres major creates p.irt of the posterior body l see L.irissmius Dorsi).
wall of the armpit, crossing from the bottom of

U.PP£R
£9£C OF
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UATlSSlHUS
PORS!

<-*lAT.
BACK VIEW

163
 i NTERMU^eUt-AR
SEPTA

wnj.dsr Jj«nwa^j.isr "0 3W

TWICERS- ^
V LOWfr HEAR
fTAJ«RJ-

M£OlA-

LAT iNTgRUUSt
ATPV£il4S
UtTEWCS
■NERVES
 The Upper Arm Muscles * BRACHIAL IS

INSIDE VIEW

BA Bicipital aponeurosis BB Biceps brtfdfii Hr Brjchuiit; Btt Bradfior^diMs BT Biceps tendon

Co CordcobrjMalts Cp Capitutum DAc Deltoid—dCfumi&l portion H Htitriertii
M J S M t'Ju/ iuttrrmusaihir septum P f T Promitor teres TL j Triceps—lateral he*id
TM c Triceps—medfat head Tro Trochlea

166
 The Upper Arm Muscles * BRACHIALIS

Brachlatfs humerus. Its front surface is somewhat flattened

to receive the flattened posterior surface of the?
ORIGIN Lower half of rhi? anterior surface of
biceps. The fibers at the upper outer end of the
the shaft of the humerus (Hu- upper end of the
hrachtails blend directly with some of the in¬
origin continues aruutid to the Literal side of
serting fibers of the deltoid. A depression may
the bcwic, embracing the insertion of deltoid}*
appear ai [his fusion.
and from both the late till and medial intermus¬
On the inside of the ami, the brachiahs is
cular septa.
concealed by nerves* arteries, veins, and espe¬
INSERTION Anterior surface of the coronnid cially fat. When the elbow is partially flexed
process ot the ulna. and the muscles tensed, this area appears as a
action Flexes the forearm. flat plane, bordered in from by the bleeps arid
the raised medial edge ol the bicipital aponeu¬
SECTION A 5THUCTUHE Lying under the bleeps and in
rosis and behind by the medial head of the tri¬
from of the elbow joint, this relatively wide,
ceps- The hrachialis may occasionally be seen in
fleshy muscle rs seen only on the outside of the
[his area as a recessed bulge* but it is always
upper arm. The narrow visible portion passes
covered by blood vessels and fat thas protects
obliquely downward and forward, first between
these vessels. When the elbow is fully extended*
the biceps and triceps and then between the bi¬
this portion of the brachialis is pushed forward
ceps and hradnoradsalis. Its obliquity increases-
at the elbow joint by the underlying trochlea of
as the elbow is flexed; it also becomes shorter
the humerus. It is still not seen independently;
and rounder during elbow flexion, appearing as
however, [his area becomes fuller as it is pushed
an oval relief on the outside ol the arm at full
forward.
flexion, The brachial is tics on and adds muscu¬
lar fullness to the front of the lower hall of the

SECTION B

EXTENSION r LEyJON

SECTION C

167
 The Upper Arm Muscles * BICEPS BRAG HI I

BA BfcipitatapQttmrosis BB brachii BL Biceps bradm— longhead Rr Brachialis

Bjr Br^hmradktis BS Brtcpi bradtn^sh&rt head BT Biceps tendon Co Corottbrachiatfo
CV emphatic vein l> Dehtmi DA Deltoid—anterior portion D Ac Drhoid—acramiai portion
H Humerus PC Pi-ctaralh—cLvicuhr portion PM n Feciariitis major PrT Pronator term
PS t Pffctoraiis—tUmottitat portion TLo Trieepi—ion# head TMc Triceps —medial head

168
 The Upper Arm Muscles * BICEPS BRACHII

Biceps Brachii flexed. The deep posterior surface of the belly

ORIGIN Long head: Supraglenoid tubercle on of the biceps is flattened where it lies on the
thi1 lop of the glenoid fusy {socket) of the so- brachi.ilis. The separation between the heads,
pub. Short head* Tip of the coracoid process of w hich at times may extend all the way dow n
the scapula (in common with the coracobra- the belly, is usually not very pronounced. The
chialis). different characteristics of the two bellies can he
seen at the upper end of the belly when the
SNSERTIQN Tuberosity of the radius. The hi dhow is hilly flexed—the [ting head is fuller*
ceps has no attachment to the humerus—it has more rounded, and directed toward the head of
two origins from the scapula and one insertion the humerus, whereas the short head is more
into the radius. elongate and directed toward the armpit.
At she inferior end of the muscle, [he fibers at
ACTION Hexes and/or su pi nates the forearm.
the medial side of the belly descend lower than
Supination is most powerful when the forearm
those of the lateral side. The medial portion of
has been flexed to It also assists in flexing
the belly may further divide longitudinally,
the arm in front of the body at the shoulder
forming a narrow, elongated muscle slip on its
joinC The long head holds the head of the hu¬
extreme medial edge. This is not the separation
merus in its socket* which also keeps the head
between die medial and lateral heads.
away from the acromion when the arm is ab*
dueled. The bicipital aponeurosis (laccrtus fihrosus) is
a broad, shcetiike* aponeurotic expansion which
structure Tile fusiform fleshy belly of the originates oft [lie anterior surface of the muscle
biceps is divided into a long and a short head. fibers on the medial side of the lower end of the
In its entire^, it extends from the shoulder to biceps and off the front surface of the upper
SECTION B the elbow. Emerging from the under the pector- portion of its tendon (it lies medial to [he len-
alis major, the- hdty expands into its familiar don of insertion of the biceps). It fans out
bulging nbape and ends abruptly into a very downward and medially, wrapping around and
strong, narrow^ tendon. This tendon inserts deep constricting the bulging form of the forearm
in the elbow between the extensor and flexor flexor mass a couple of inches below their ori¬
masses of the forearm. gin at the medial epicondyte of the humerus.
The front protile of the hieeps (seen in side The constricting action of the aponeurosis cre¬
view) is .straight for a considerable length when ates either a wide or narrow furrow* or a flat¬
the elbow is extended, but becomes quite tening, oil the forearm flexor mass, so that the
rounded and bidgitig when the elbow is hilly flexor mass bulges above and below the apo-

SECTION C

SECTION Q

J 69
 The Upper Arm Muscles * CORACOBRACHIAUS

Coracobrachiafis the armpit. It runs alongside, but separate from,

ORIGIN Fip of rhe coracoid proms of rhe the short head of the biceps. The belly of the
scapula (in cummon with the short head of the coracobrachinlis is seen on the surface for only
biceps). a short distance before it dives deeply between
the biceps and the medial head of the triceps
INSERTION Short vertical Itne halfway down
The short head of the biceps covers most of the
the humerus on its medial surface.
aniLTior surface of the coracobrachial is.
ACTION Flexes and adducts the arm af the The coracobrachiaJis and biceps are separated
shoulder joint, from the triceps by a groove within which lie
STRUCTURE The coracobradiialis is a ihick tlie nerves and blood vessels [surrounded hy fa El
cylindrical muscle that is partially seen on the of (he arm.
inside of tile upper end of the raised arm* near

SECTION &

BB Bictps brachii Br Bmdsiath BS Bittps brathii—simrt htrdd Co C&racoiwchiala I I Humerus

PM a Pcciordhs mafof TL o Triceps—hag httf d T M c Triceps— medial head

171
 The Upper Arm Muscles * TRICEPS BR ACHI !■—LATERAL AND MEDIAL HEADS

inside view

An Anconeus \\& Steeps hrachu Br Brachtatts Brr Hi achmr adults Co Coracohrachialu

l> Deltoid ECRL Extensor carpi radrahs tongas H HtmicruE LL Late rat epicondyle
ME Medwiepkandyte MIS Xirdial mtermns-cufor &ptum t) QUcranmt TLa Triceps—intcraibrad
T La Tramps — kmg hiud TM c Trtttps — medial head TT Triceps tendon

17Z
 The Upper Arm Muscles * TRICEPS BRACHI!—LATERAL AND MEDIAL HEADS

Triceps Brachii—Lateral and Medial Heads tendon, it is seen on the surface as a long, nar¬
ORIGIN lateral bead: A vertical line on the row, cylindrical form on the tower half of the
outer back comer of ihe shaft of the humerus, inner back corner of the upper arm. It can
beginning jnsr below (he head of the humerus sometimes be seen From the front view. Superi¬
ami ending almost ha It way Ju wn ihe bone, and orly, th*s form dives deeply between the long
ihe admeent lateral intermuscular s-u-pnim. Afe- head of the triceps and the biceps to reach the
dial brad: A large, elongated, rnangular area upper extent of its attachment on the humerus;
occupying the lower portion of ihe back surface it never appears on the surface on the upper
of rhe h Li menus which ex tends Ljpward on ihe half of the inside of [he upper arm.
medial yidc of the hack surface of the shaft* and A large pan of the medial head lies under rhe
from the posterior surfaces of part ot ihe lateral triceps tendon. Although a narrow portion
SECTiQN A in term u scu I a r septum and all of ihe medial in- comes to the surface past the lateral edge nl the
termuscular septum. tendon, the medial head is usually not distinct
there, but may add to the form ot the lower
t N S E R T! 0 N Lateral brad: Upper twu-thtrds
end of the rail of rhe lateral head. Most of the
of the lateral edge and deep aspect of the upper
fibers of the medial head attach to the deep
portion of the triceps tendon. Medial bead:
aspect of the tendon, but some of them actually
Lower third of both ihe medial and lateral
insert into the olecranon directly*
edges and the lower portion of the deep aspect
On either side of the humerus, the medial
oi ihe tricep* tendon. The triceps tendon inserts
head takes origin from [he posterior surfaces ot
into [he horizontal posterior edge of ihe top of
the intermuscular septa. ITie subcutaneous
the olecranon process of the ulna*
edges uf the medial and lateral intermuscular
ACTION Powerfully extend the forearm at the septa can occasionally he seen on rhe surface—
SECTION & elbow joint. medially as a short* ihui, cordlike elevation as¬
STRUCTURE The majority of the superficial cending from rhe medial cplcondylc of the hu¬
portion of ihe lateral head appears as an ellipti¬ merus (easily felt when the elbow is fully ex¬
cal or teardrop shaped form located on the tended) and laterally as a short ridge rising
middle third of the outer hack corner of the from rhe lateral cpieondylc of the humerus
upper arm (more on the side than on the back). (when the elbow joint ss Hexed 90* and ex¬
The remaining fibers of the lateral head con¬ tended against resistance}* The edge of the lat¬
tinue down the lateral edge of the Triceps ten¬ eral intermuscular septum lies anterior to fhc
don, from the bottom of ihe teardrop, as a de¬ lateral edge of the triceps tendon (just above
scending “toil." These fibers insert into ihe edge the elbow), amj rhe two may or may not he
of the tendon in an irregular fashion. When the separated by the muscular fibers of the rail of
in ceps extends the elbow joint, the elongated the lateral head. Inferior I >\ the intermuscular
muscular ridge of the tail appears as a narrow- septum attaches to rhe lateral cpi condyle,
inverted cone. The lateral head can easily be whereas the triceps tendon attaches 10 rhe ole¬
si^en from the front view. cranon or uniu the surface of [he anconeus.
The medial head by itself is a llatrened rear- Because the lateral and medial heads origi¬
drop shape, pointed superiorly, thiit curves nate in part from rhe lateral .md medial inrer-
around the back of the lower halt of the hume¬ muscular septa, the width of the belly of the
rus (side to side, see cross section)* Because ie is triceps is greater than the width of its origin
mostly covered by the long head and the triceps from the humerus.

BACK VIEW

173
INSIDE VIEW The Upper Arm Muscles * TRICEPS BRACHII—LONG HEAD

R R Brcirpa hrdchn Rr Brjthuiti Co Carncabrachtatis D Deltoid DP Deilaid—posterior portion

H Humerus L Latissimus dorsi O Otter anon TE Tendinous expansion TLa Tricep*—lateral head
TLo Triceps^longhead TMa Tcr«major TMe Trietpt^mtdidhead TMi Ttresmnar
TT Triceps tendon

174
 The Upper Arm Muscles * TRICEPS BRACHIf—LONG HEAD

Triceps Brachn—Long Head upper portion of the long head* ]usr before ii
ORIGIN Infragknuid tubercle at the bottom of disappears between the teres muscles* is crossed
the socket of the scapnla and a short distance by an almost vertical skin fold (running perpen¬
below it along the lateral (axillary} border of dicular (o the long head muscle fibers).
the sea pub. It does nor originate from the hu¬ As the lung head emerges from between the
merus. teres muscles, it is flattened from above to be¬
low. Ir 1 hen twists media] ly, liar tens consider-
INSERTION Upper two-thirds of rite medial ably side to side, and expands front to baek-
edge of the tendon t>f insertion of the triceps Thin* tendinous material cl mi mg off the origin
which m turn inserts inro [he homontal poste¬ ol the long head ar the scapula descends and
rior edge of the sop of the olecranon process of expands onto the surface of the upper part of
SECTION A the bln a. this 11 aliened head {on the medial aspect of the
arm)- This nonclastic material com presses the
ACTION Extends the forearm at die elbow
fleshy head when it is tensed, creating a wide
joint; extends the arm from a previously flexed
vertical furrow that separates [hr upper end of
position at the shoulder joint.
the long head into anterior and posterior forms.
STRUCTURE Largest of the three heads of The elongated anterior form* part of the long
(he triceps* this flattenedh t«rdrop-shaped head head is commonly mistaken for the medial
is located on the inner hack comer of the upper head of the triceps.
arm. It descends three-fourths of the way down In the inside view of the upper arm, the en¬
the .inti, The inferior end of the head is tire triceps muscle is seen to have a double
pointed. curve along us front edge—the long head curves
At the upper portion of the inside nt [he arm, anteriorly on the upper half of the arm, the
the volume of the long head projects quite far medial head curves anteriorly on the lower half.
SECTION b forward, reaching almost three-fourths of the in the armpu* there is usually a tendinous
way toward the front of the arm. The upper and/or muscular connection* the iriceps-latissi-
end of the long head 'maintaining a wide* fleshy mus connection* between the anterior edge of
thickness) dives between the teres major and the long head of the triceps and the tendon of
teres minor muscles toward its attachment on [he latissimus dorsi near its insertion. This con¬
the scapula, With she arm dawn by the side, the nection represents [he dorsoepi trochlea ns bra-

humerus

SECTION C

TEiC£PS“ SURFACE
LATISSp^US OF
CONNECT! SCAPULA
LONG HEAP TERES
AMT. FORM
PtfST. form
TXNOI
EXPANSION
HUM£flU$
ME pi At. HEAP

SECTiQN D 3 TEARDftOPS LAT

BACK view
FRONT VIEW
t Ri&HT AEtt
LAT.(-^h£D,

narrow
TRICEPS TENDON

175
 The Forearm Muscles

SUhUATED RIGHT FOREARM

ANTERIOR (PALMAR) VIEW POSTERIOR (DORSAL.) VIEW

M£P. *-» CAT

wc rc WC
ftADlAL SlDC
c> _0_ _o
WC ’ WRlSY
CA&U£ V/R (ST
FC " FfH&Cft CROSS
CA&LE
SECTIONS

O O
wc wc
PCR PO PCU
0 0 0

PALMAR
[*M-f XflflS)
■f RADIUS ULNA

FCU
L TEMPO (VS palmar
+ FAT
0 0 O
tCR ED ECU
J [ iif

% hmf. &ONES ifi

> DORSAL, _
|£ * T| USoRSj
BOX OF W ft 1ST
{cross section)

Kit Bradtiorddiahs ECR Extensor carpi radiatis ECRK Extensor carpi radiatis br^is
ECRL Extensor carpi radiates tongus ECU Extensor ^arpi uhuns ED Extensor digitornm
EP1. Extensor pollkfc fongus FCR Flexor carpi rtfdialis FCU Flexor carpi uinaris FD Flexor digttorum
EDS Ffew^ftoraffl superficialis PL Palmarh loHgvs

178
The Forearm Muscles

FLEXORS EXTENSORS RIDGE MUSCLES

(FROM MEDIAL gPlCQNDYLEj) (FOm LATERAL EPlCMWlE) (FROM SUPRACONDYLAR RlDGf)

I I I
-FLEXOR CARPr -EXTENSOR CARPI -EXTENSOR CARPI
RADlALlS RADlALlS BREVfS RAOIALIS LONOUS

-FLEXOR CARPI -EXTENSOR CARPI -BRACHJQRADIAUS

ULNAR IS ULNAR IS

-FLEXOR DlGirORUM. -EXTENSOR DIOITDRW

SUPERFICIALIS (t PALM, l)

ADDITIONS ADDITIONS
' I
-PRONATOR TERES
-1
-anconeus

flexor. EXTENSOR
TENDONS RETINACULUM

FLEXOR
RETINACULUM

RIGHT
PALM VIEW
HAND DORSAL (back) view
 The Forearm Muscles * ANCONEUS

Anconeus When l he elbow |oint is fully ex tended, the

ORIGIN By iiv own separate Tendon (mm the anconeus creates a distinct, bulging* low relief*
bony surface and inferior to the laierit] quite separate from the forms of the triceps and
epicondylc of the humerus. the muscles originating from the lateral epicon-
dyle of the humerus. The anconeus flattens as
INSERTION Literal surface of the olecranon*
the dhow is flexed. Tile posterior edge of the
continuing down ihe tipper fourth of the pos¬ upper hall of us insertion h in contact wish the
terolateral surface of the ulna. ulna* while its lower half lies up against the
ACTION Extends and stabilises (be elbow flexor muscles of the forearm. The upper edge
ioini. of the anconeus is in contact with ihe media!
SECTION a STRUCTURE The anconeus is a small trian¬ head of [he triceps.
gular muscle Incited cm the outer back corner Aponeurotic fibers from the lateral edge of
of the elbow, below the elbow joinr. Ii fills the the triceps tendon continue downward onto ihe
space between the lateral epiccmdySe and olecra surface of the anconeus. These tendinous fibers
non and then continues one-fourth of ihe way may affect us form by creating a furrow or by
down the fctiratrm, Its belly is sharply pointed producing a ridge.
mfmorly. Tlic anconeus does not cover the
head of the radius.

A n An c omit $ ECRL Extensor terfn radtiik fongus EC U Extensor curpf ultuim

ED Extern**? digitotum F D P If ex or dI o rum p ro fit tidus LE Lateral epicemdyU O Qhctiirmn
Ra Radius Tri Triceps U Ufm * UtiJer flexor carpi uhtans
 The Forearm Muscles > EXTENSOR DJGITORUM

A h I11. Abduetor pallid* hngm A n Aneontm E C R B Extensor carpi radiates brevis

ECU L Extensor carpi radmtis tongue ECU Extensor carpi ulnaris E D Extensa r digitontm
F l>M Extensordigrti rmmmi £1 Extensor mdteis ERB tlxtensor poilias brevis
E P L Extensor pollids tongas 1M Interosseous muscle L E Lateral cpimndyk M Meiawrptil
R J Radius Sup Supinator U Ulna
 The Forearm Muscles * EXTENSOR DIGITORUM

dig! to mm, |ust proximal ro ihe heads of rhc When making a fist, the tendons become dull
mcidtarpals, on the hack of the hand. They crests on rhq rounded ends of the heads of the
limit fttli extension of one finger when an adja¬ metacarpal hones. When the fingers are cx-
cent finger is flexed and conversely limit Ilex ion tended, the ttnduns disappear from view' about
of one finger when an adjacent finger is ex- one-third to one-half of the way down the back
tended. The mtertcndtnous connect tons are dun, of the proximal phalanges, as they flatten into
wide, and flat and are rarely seen Jireedy, lie- the dorsal extensor aponeurosis. The tendon to
cause the tendons of the extensor digitomm are the index finger can occasionally be traced all
SUCTION h
layered, the intenendinous connections will pul] the way down to the proximal incerphaiangea!
the various layers of these ten dons sideways joint.
when ihe fingers arc flexed and extended. This
reveals the layers, especially those of the
middle, ring, and little lingers.

SECTION B

SECTJDN C

SECTJQN 0

section r
The Forearm Muscles ■ EXTENSOR CARPI ULNARIS

AbDM Abductor *iigm itmimu An Anconeus ECU £xttusor carpi ubuns ED Extensor digitomm
EDM Extensor dtgiu minimi Et Extensor mdids EPL Extensor poHicis tongas
V D P Flexor dlgnorum profundus H U Head of ulna LE Lateral epiamdyte Raj? adim U Ulna
* Under flexor carpi uhuris
 The Forearm Muscles * EXTENSOR CARPI ULNARIS

Extensor Carpi Ulna ns the ulna on the outer comer of the wrist as it
GRIMIN' lateral cpicondylc of the humerus [by crosses lhe wrist joint. Hie tendon becomes
the common extensor tendon)« and by an apo¬ prominent at, above, and below the head of the
neurosis along the upper rwu-thirds of the pos¬ ulna when the forearm as sup mated. It becomes
terior border of the ulna, prominent during supination because the ten¬
don is pulled slightly out of the bony groove in
INSERTION Tubercle on the outer surface of
the head of the ulna by the rotation of its inser¬
the base of the fifth metacarpal bone (of the
ECU tion point on the hand away from the head of
tittle finger).
the ulna (the ulna stays fixed and the hand ro¬
SECTION A
ACUGN Extension and ulnar deviation of the tates along with the radius during supination).
hand at the wrist joint. The wrist can he visualized as a box. When
Pal STRUCTURE The extensor Carpi uharis is a the forearm is pronaitd, the tendon of the ex¬
narrow, elongated* flattened muscle, whose tensor carpi y Snaris lies inconspicuously in the
overall axis curves toward the ulna between its notch of ihe head of the ulna, on the ulnar $uie
proximal and distal points of attachment. On of the box of the wnst. During full supination,
the back of the middle ihird of the forearm, the the tendon becomes raised and conspicuous and
extensor carpi ulnar is and forearm llexor mus¬ is located cm the hack of the bux of the wrist,
cles arc separated by a groove* at the bottom uj In the middle position of proniilion/supiuationT
which lies the posterior border of ilm* ulna. the tendon is located in the actual comer of the
The tendon uf the extensor carpi ulnari* be¬ box of the wrist, again lying inconspicuously
gins three-fourths of the way down the forearm. within the notch of the head of the ulna. This
f c-^PdL ^
shifting of the tendon relative to the box of the
The muscle fibers continue down each side of
the tendon, almost all the way down to the wrist occurs because during pmnaEion and supi¬
head of the ulna. The muscle and tendon may nation, the dixtai end of the radius (wKilN is
show up as a single elongated form, or the responsible for forming two planes of the box)
ECiJrt tg £P1_'C- lower muscular portion may spin info two cion- rotates around the fixed I.nonmoving) head of
5 E C T I ON C gated, parallel harms (the tendon appears re- the ulna. Since the relationship of the tendon to
cessed as a furrow). Distally, before reaching the head of the ulna is also fixed (ItidgeJ in the
the wrist, the tendon may appear raised on the notch), as the radius rotates it exposes different
surface. surface areas of the head of rhe ulna. The
The tendon then passes through the bony planes of the radius (or the surface of the box)
groove in the head of the ulna, where it is changes its relationship to the tendon, and the
lodged inconspicuously when the forearm is tendon therefore appears in different locations
pronafed. Jt may he seen distal to the head of on the box.

ULNA DOES
NOT MOVE"
RADIUS
ROTATES

DORSAL

ULhAH HrflWWAL
MID¬
SACK VIEW SUPINATION POSITION PRO NATION

1X7
The Forearm Muscles * EXTENSOR CARPI RADIALIS BREVIS

ED—

ECRB
ECU-

A bP L Abductorpollicis longm FC-Kfi Extensoroirpj nuSuits hrttm

EC R L Lx tensor c.irpi radidtis longtis EC' l1 Extensor carpi trhmm E1 > Extensor digits mm
E PR Extensor pottkis brn-ts E P L Ex tensor poHitts fangus L fc Loierai epifondylr PrT Pmttaio r teres
Kll jkjjidim Sup Supinator U Uitu
 The Forearm Muscles ■ EXTENSOR CARPI RAOIAUS BREVIS

Extensor Carpi Radial is Brevis belly appears to i*fluatT" longitudinally in this

0 RIG F N Lateral epicundyle cal the humerus I by region of the forearm, reaching neither the el¬
the common extensor tendon) and ihe radial bow nor tile wrist, as the Either epicondyle ex¬

coll.ie era I ligament of the elbow |oim. tensors do. The axis of the belly runs, parallel to
the long jxis ot the forearm. The belli ls mure
FNSERT JON Dorsal surface of the base of ibe
prominent during supination (with die wrist ex¬
metacarpal hone rat ihe middle ringer, toward
tended I than during pro nation.
its radial side*
The tendon uf the extensor carpi radial is
ACTION Extends and radially deviates the brevis, beginning on ihe radial side of us belly,
hand at the wrixr joint. travels down the forearm next to the tendon of
STRUCTURE The extensor carpi radial is the extensor carpi radi.ifis longtiy and passes
SECTION A hrevis begins proximally at ihe lateral trpicon- down the middle uf the back surface of the
dyle a> a short, wide, I Kittened tendon com¬ lower end of the radius in rts own bony groove.
prised between the bellies of the extensor carpi Together, the tendons ot extensors carpi radialis
radially lungus and extensor digitomm; its longus and brevis, barely visible as a single lin¬
Fleshy Fibers, and therefore its form* do not be¬ ear ridge on the lower half of the forearm when
gin at its origin at the lateral epicondyle. It the wrist is extended, pass under the abductor
soon expands nnu >i thick fusiform belly located pollieis longus and extensor poll ids brevis. At
on the outer surface of the radius. Its fibers end ihe point where they cross the wrist joint at the
halfway 11 f two-thirds oj die way down the end of the radius, they create a small, separate,
forearm into a long, narrow, Hat tendon. The transiticm.il plane between the back of rhe wrist
belly ot the extensor carpi radialis brevis there¬ and the hack of the hand when the wrist ts
fore shows up as a wdl-ddind fusiform relief extended,
■m the extensor side oi the forearm, beginning a I he oblique belly of the extensor carpi radi¬
5££TFQN B couple of inches Mow the elbow joint and end¬ alis longus covers, the superior rendon of the
ing gist below the middle of the Inrearm. The extensor carpi radially brevis.

SECTION t

SECTION 0
The Forearm Muscles * EXTENSOR CARPI RADIAL IS LONGUS

ECRt-

AbPI. Abductor palUas kmgus Hr Brachialii Btr Bracbioradrath Cp Capitukan

F.C R B Extensor carpi radiatk bra 'ts EC R L Extensor carpi rajialts fongus EC U Extensor carpi ulnaris
ED Extensordiptorum EPB ExtensorpoHidsbrem EPL Extensorpoliidsiongus H ifumcrus
LE Lateral epicondyle tta Radius Sup Supmator Tri Triceps V Ulna UO Ultta—offerjnvn
 The Forearm Mt/sc/es * EXTENSOR CARPI RADfAUS LONGUS

Extensor Carpi Ratfialis Longue tended, the belly of [he extensor carpi radial is
ORIGIN Lower rhird of the lateral supracondy¬ hangup is at its shortest and becomes a relatively
lar ridge of rhe humerus* the front of the adja¬ prominent, short* triangular relief when tensed,
quite separate from the brae hio radial is. A
cent lateral intermuscular septum* and mini¬
depression forms where the belly o! the exten¬
mally from the common extensor tendon
sor carpi radial is longus attaches to its tendon,
originating from the lateral epicomtyle of the
humerus, mat the upper end of the forearm. This belly is
v on side rabh shorier than the belly <if [hi; bra-
INSERTION Dorsal surface of the metacarpal chin radi alls.
hone of the index finger, on its radial side,
On the outside of the dhow, the lower (pos¬
ACTION Extends and radially deviates the terior) edge of the extensor carpi radialis longus
SECT 10^4 h. hand at the wrist [oint; assists in flexing the lies oblique to the directum of the forearm ex-
elhow joint. tensors, which art: directed more nr less straight
STRUCTURE The extensor tarpi radialis lon- Inun their origin on the lateral epicnndyle of
gus consists of i nhurt, flat* fleshy belly that the humerus toward the hack of the hand I com¬
ends at the upper third of the forearm and a pare the axis of the extensor dtgittmim with the
fottg, narrow, Hat tendon that continues down lower border of the extensor carpi radial is lon-
she outer edge of the radius, alongside the test' gus when the elbow is extended).
don cud the extensor carpi radial is b rev is. The The belly of the extensor carpi radi alls longus
lendon then parses down the back surface of noticeably bulges more, and is separate from,
the end of she radius in us own bony groove. the cpieondylc extensors. In other words* the
On the lower half of the forearm, [he tendons two ndgr must It's ihrachioradiahs and extensor
id these two radial wrist extensors, passing un¬ carpi radiahs Iongus—originating from the lat¬
der the abductor pol lie is Imsgm and extensor eral supracondylar ridge of the humerus) and
pot! iris brevis* may appear as a thin raised ridge the rhrec epkondyle muscles (extensor carpi ra-
SECTION &
when ihe wrist is extended* After these tendons iiialis brevis, extensor dfgitomm, and extensor
leave the distal end of the radius* they create a carpi 11 In,ms—originating from the lateral rpi-
small transitional plane between [he hack of the condyle of the humerus) are very different and
wrist and the hack of the hand when the wrist separate at the elbow. The ridge muscles as a
group arc oblique (from side to front) to the
is extended.
At their superior ends, the extensor carpi r;i- axis of the forearm* whereas the epieondylc
dial is tongus and brachioradialis begin side by muscles arc straight in line with the axis of the
side at ilu-ii origin* hut as they descend, the forearm, and their upper ends he recessed from
belly of the extensor ^arpr radialis lorigus is the ridge muscles. Lower down on the forearm,
soon partially covered by rhe belly of the brn- however* all five muscles blend to create the
chioradiahs. These two muscle bellies typically cylindrical (ovoid) form of the forearm.
blend together into a single form when the el¬ Occasionally, the ridge muscles will blend
bow is extended (there may be a slight separa¬ with the extensor digitorum, separating from
tum it the wrist is also extended!. When the the recessed proximal end of the extensor carpi
ulnaris.
elbow joint is flexed id ^id" with the wrist ex¬
Tfie Forearm Muscles - BRACHNORADIAUS

AhPL Abductorpalfous longue RB Btceps hracbtf Br Bruehuhs Brr Bradhkn^dr^lif

E C R B Ex/tra^r ewrpr radialU hrci its E C R t Extensor carpt riduhs fattgus E Pit Extensor pollias hr tv is
FCR Flexorcarpt ftidfatis FPL Flexor pothers kmgus H Humerus Pj L P&ltmms iongus
PfT ProttutQT leres Ra Rjidtus TLa Trtc&fis —latewi head TM c TWctfp* — medial htjA
TT Triceps tendon U Ultui
 The Forearm Muscles * BRACHI0RA0IAU5

Brachioradialis overlaps the medial edge of the latter as they

(Sup major Long us) both descend. Because they both originate from
ORIG IN Upper tw?o-t hinds ot the lateral supra “ the supracondylar ridge above the tat era! epi-
condyLir ridge uf the humerus and the front cl condylr uf the humerus, the muscular form on
the adjacent lateral intermuscular septum. the ouMde of the elbow extends higher than
the muscular form of the flexor muscles on ihe
INSERTION Literal I thumb) sidl1 uf ihe lower
inside, which originates lower down on the me¬
end of the radius, |imr proximal to [he sty Ltd
dial epieondyle. This is especially nuticeahk-
SECTION A process.
when the elbow- is flexed,.
ACTION Hexes the fcrearm at the elbow joint. When the hrachioradialis is relaxed and rhe
It dues riot pronate or supinatc rhe forearm. elbow is in any position of flexion, the h ra¬
STRUCTURE Origin at mg two-thirds of rhe ck io rad j ah* bends across the middle of its belly
way down the humerus between rhe triceps and at ihe from of the elbow. The upper fiber? tin
hradnahs, rhe he Hr of the brachioradialis be¬ conspicuously contribute to the laterally cum
gins wide and Hat at its origin, twists toward pressed cylindrical form uf the upper ami, while
the front of the arm as it descends {becoming its lower fibers participate in producing rhe
rounder tn cross section at the elbow g and w-id ovoid form of the forearm. If flic muscle is rhen
etis and flattens again before ending in a flat tensed (the forearm flexed against resistance),
tendon approximately one-hall1 n> two* thirds oi its belly pops up, creating a thickened raised
the way down the forearm. The superior end of ridge winch passes from the outside nt the
section & the braLhioradiahs begins near I approximately low er end of the upper ami to the middle of the
two inches from) the insertion o\ the deltoid. r.idial side id the forearm. The form of [his
On the forearm, the belly creates a transition ridgei however, remains slightly constricted in
between the flexor and extensor muscle groups, front of the elbow, where ihe bend appears in
partially overlapping rhe extensor carpi radialis the relaxed condition. During ftIhiw flexion,
longus on one side and the pronator teres and two or more skin folds cross ihe front of rhe
flexor carpi rndinhs on the other, The tendon of elbow region, passing over the brachturadiaks.
the brachioradialis lies on the radius and usu¬ The distal skin fold coincides with rhe bend in
ally is not seen. Unlike most of the long ten¬ the belly.
dons of the forearm, the tendon of the bra- When rhe elbnw is straightened* the brachsu-
ihio radial is dues nor eroxs rhe wrist joint, bin radialis and extensor carpi radial is longus—rhe
rather stops at the distal end of the radius. “ndge muscles’*—typically blend together to
The brathioradialis begins side by side with create a single bulging form on rhe outside of
SFCTJDM C the dhow.
the extensor carpi radial is Intigus on the supra¬
condylar ridge, hut rhe former soon partially

SECTION D

193
 The Forearm Muscles - ABD PGLUGI5 LONGUS AND EXT POLLIGIS BREVIS

A bP B fafar tar pcf/ros frmV bPL Abductor pofbas tongus B r r Bnji hioradtdHs
ECR B Extensor carpi mtiaks hrwti ¥. C R L Extensa r ca rpt radiatb longus E11 Extensor digtfnrum
El3B Extensor poltkit brent £ P L Extensor polbeir Inngus FDI Etrst dorsal utter*tsstrnus
Ra Radiol U Ultra

194
 The forearm Muscles • ABD POLLICIS LONGUS AND EXT POLLICIS BREVIS

Abductor Poll ids Longus two flattened muscle bellies emerge from under
(Extensor Ossis JVtetacarpi Pol lie is} the extensor digitomm and then cross over the
ORIGJN Areas on the posterior surfaces of the tendons of the extensor carpi rad I.ilk brevis and
ulna and radius and the intervening interos¬ iongux in their oblique descent down the lower
seous membrane* portion of the forearm. They become tendinous
on the outer edge nf the radius and pass down¬
iNSE RTiQN Base of the metacarpal bone of
ward together through a shallow bony groove
the rhumb* on its back surface toward its ratlt.il
on the lower end nf the outside of the radius.
SECTION A suit' 'near the palm).
The tendons usually appear m end at the base
ACTION Abducts and extends she trter.ic.irpa} nf the metacarpal nf the thumb, forming the
of the thumb. it also radially deviates the hand palmar tendon of the amttuniic.il snuffbox at
and assists in Hexing the hand at the wrist. the wrist (see hx Sensor Pollicis Longus}. As they
lfuss ihe wrist punt, the tendon of the extensor
pnl tie is brevis lies dorsal tn+ and usually adja¬
Extensor Pollicis Brevis
cent to* the tendon of the abductor poll tax
0*31 GI Im Area on the posterior surface uf the longus.
radius and the adjacent interosseous membrane. The tendnn of ihe abductor pollicis longus
SECT TON B
I NSERTiQN Back surface ol the base nf the inserts in to the base of the metacarpal of the
proximal phalanx of the thumb. thumb* frequently sending tendinous slips so the
trapezium hone of the carpus and the sjfrfita? of
ACTION Extends the pmftima I pha fanx of ihe
the abductor pollicis brevis muscle at its origin.
thumb, and hy continued action extends us me¬
I his tendon is thick and strong and actually
tacarpal bone. It also dev nates the hand radially.
consists nf up so seven or eight combined ten¬
STRUCTURE I’llc ahductor pnllids hitigm dons. Several of shesc are often seen on the sur¬
and extensor pollicis brevis combine to create face, especially when the thumb is moved for-
an oblique, narrow, triangular muscular harm iviird and back at rhe carpometacarpal joint.
which wraps around the lower end of the ra¬ The very slender tendon of the extensor polli¬
dius. Together they can be considered the cis brevis passes down the back oi the metacar¬
“oblique carpal muscle group," Their single tri¬ pal of the thumb. Is may be inconspicuous, or
angular lortn can he seen as a small swelling on quite distinct., first passing down the middle of
the lower portion of the lateral side of ihe ra¬ the snuffbox and then down the hack surface
dius, The two muscles separate when they are of the metacarpal of the rhumb. When the ex¬
strongly contracted. ITse oblique carpal muscles tended thumb is advanced forward away from
produce a small but important convexity three- tbe? palm (along a plane perpendicular iu the
fourths of the way down the forearm on ns plane of The palm I< the tendons of extensor pul-
outer (radial) profile. hcis brevis and longus converge distal ly at the
Arising deep m the hack of the forearm, the metacarpophalangeal |oint of the thumb.

195
 The Forearm Muacfes * EXTENSOR POLLICfS LONGU3

A b P B Abductor poHicis l*rem A h P L Abductor poUtcis longn ■ E C R B Extensor ojj^jj radw/K 6reris
E C R L Exttttsvr eprpi r&dktis hngus E D Extensor digilomm E fJ B Jlx po/iras tiwis
t PL Ex/mfor ptilbas I nit gw FDl Frrst dorsal interosseous M Metacarpal Ra Radius U Ufm

196
 The Forearm Muscles * EXTENSOR POLLICIS LONGUS

Exlensor Pollicis Longus don), the base of the proximal phalanx receives
ORIGIN Middle third of rhe lateral portion of the tendon of the extensor poll ids brevis, and
the posterior surface nl the ulna and the adja¬ the base of the distal phalanx receives the rem
cent area on the interosseous membrane, don of the extensor pollicis longus. The tendons
of the abductor pollicis longus and extensor
INSERTION Back surface of the base of the
pollicis brevis usually combine together visually,
SECTION A distal phalanx (if the Thumb,
ispeeulty at the anatomical snuffbox (see be¬
ACTION Extends the distal phalanx of the low1).
thumb, and by continued action, extends ns I be three tendons to the rhumb are part of
proximal phalanx and metacarpal hone, It a bo rhe- extrinsic muscle group of the hand. These
adducts the thumb at the carpomcracarpal joint, muscles originate in rhe forearm and insert mtn
even when the thumb i* fluxing at rhe metacar- the hand. Only them tendons are present in the
pupha I a i igcaI and mtcrph.iLiingeat Joints tc as¬ hand (on the thumb),,
sists; in extending die hand at the wrists,
STRUCTUR E Beginning deep in the forearm,
The Anatomical Snuffbox
only the tendon of the extensor poiliizis lemgus
SECTiQM B
becomes visible after if leaves its oblique bony The anatomical snuffbox is the square, hollow
groove on the middle of the back of the distal depressuin located on the radial side of [he
end of the radius. At this point* it turns sharply wrist. Ie is bordered by die tendon of the exten¬
toward [he thumb, crosses over the tendons of sor pollicis longus on the dorsal (posterior) cor^
the extensor carpi radialis brevis and longus, ner of the wrist* the combined tendons of rhe
and descends along the hack of the thumb—not extensor potikis brevis and abductor pollicis
directly on the mid line, but slightly toward i tv longus on the palmar (ventral or an tenor) cor¬
ulnar index finger) side. The tendon can usu¬ ner ol the wrist, rhe distal end of the radius
ally he seen as far down us the inlcrphalangeal proximally* and rhe base of the metacarpal ot
joint. This tendim is. very prominent when tlie the rhumb distalk1. The lateral carpal bones lie
thumb ss extended and disappears when she at the floor of the snuffbox.
thumb in flexed at the carpometacarpal joint. It The snuffbox appears when rhe thumb is ex¬
the cine mb h extended and then adducted tended with rhe tendons prominent: If the
toward the index finger, the visible tendon of thumb is then abducted away from [he palm
the extensor pollicis longus bends [changes di¬ (along a plane perpendicular to the plane of the
rection! at the metacarpophalangeal joint of the palm), the tendons bordering the snuffbox con¬
thumb* verge Ji stalls:
i The icndon ol lhe extensor pollicis brevis
may either combine visually with the tendon ol
Tendons lo the Thumb the abductor pollicis longus, be inconspicuously
I he Thumb has three hones: a metacarpal, on the outside of [he wrist, or become vis tide
proximal phalanx* and distal phalanx. I he base between the tendons of rhe extensor pollicis
of each bone receives a tendon from a muscle. longus and abductor pollicis longus as si passen
In other words, there are three bones and three down lhe center of the snuffbox and then
BONES OF THE tendons, one tendon per hone. The base of the down the dorsal surface of the metacarpal of
THUM&
metacarpal receives ihc tendon of the abductor the rhumb.
pollicis longus [often a complex [Multiple ten¬

197
 The Forearm Muscfes * FLEXOR CARPI RADIAL1S

BA Bicipitaldpoutitrmii Brr BrjcJnorntJkstis FCR Flexor t&Fpi radialis

F DS Flexor thgtiarum superficmlis FFL Flexs?r polheis longus FR Flexor retinaculum
ME Medial epictmriyle Pal_ f\iItthirulungus PrT Pronator teres Ri Radius ThE Thenar ettiincth-e
LI Ultui

198
 The Forearm Muscles ■ FLEXOR CARPI RADIAUS

Flexor Carpi RadLaJis end of ihe tendon usually becomes slightly de¬
ORIGIN Medi.il epj condyle of the humerus (by pressed between the bulging V ^hapcd distal
i he ei i m i pi on flexor nendon)« end of she belly. The muscle fibers on the radial
side of the tendon then blend visually with the
INSERTION Boies of the metacarpal bones of
form of the bmchioradialis.
ihe index and middle lingers, deep in the palm.
lust proximal to the wrists the cord like ten¬
ACTION Flexes and radially deviate rhe hand don of the flexor carpi radial is is very promi¬
at the wrist joint. nent, especially when the wrist is flexed and
section a STRUCTURE The fleshy belly of the flexor radially deviated. It lies just off the mull me,
carpi radialis, located on the upper half of the toward the radial side of the forearm. This ten¬
forearm, is slightly flattened distal ly. Iis tendon, don is thicker than the tendon of the potmans
beginning one-third of the way down the fore¬ bngus, is directed toward the index finger
arm, is Hat, wide, ami pointed proximcdly and when the hand is straight), and passes out of
rounded d 1st ally. The muscle fibers of the belly view at rhe base of (he hand. In rhe anatomical
split and pass, down each *ide of she tendon for position (s li pm a ted forearm )f the entire flexor
a short distance. Because of this arrangement, carpi radial is lies oblique on the forearm, as it
when the muscle is tensed, the wide proximal passed from its origin to irs insertion.

SECTION B

SECTION C

SECTION D

J99
 The Forearm Muscles • FLEXOR CARPI ULNARIS

Art Aru tmcuf Ap Apontwosis & A Bicipital tiptmeurotig BV Basilic vdn ECU Ejct&mr&wpfithuim
11J Extensor dtgitorum FCU Firxnr farpi utaurm FDP Flexor digicommpnpfundus
H > S Flexo r digitorum superfidiilis H y E Hypothemr eminence M E Mediai epkattdylt O (Jletrmm
PaL Pullmans lonj*u$ R a Radius \J Ultu ■ Vttdet flexor ttrpi uhttiris
 The Forearm Muscles - FLEXOR CARPI ULNARJS

Flexor Carpi UJnarss with fat. When the wrist is extended, ihe ten¬
ORIGIN Humeral head: Medial cpicnnJylc of don approaches the bone, and the fat is
rht? humerus (hy Che common flexor tendon l squeezed out. The tendon directly creates the
Uinar head- Med i d I border id the olecranon, inner front comer of the box of the wrist (in
conuMumg down the upper two-thirds of the the anatomical position)*
posterior border of the ulna, The ulnar edge of the proximal two-thirds of
the belly of the flexor carpi li ln.iris thins into an
INSERTION Pisiform bone of the wrist,
aponeurosis which in turn passes m-yr the iur*
4ECTJ0N A AC T ION Flexion and ulnar deviation of the face of the flexor di giro rum profundus, to ulti¬
hand ar tlte wrist joint. mately attach along the posterior border of rite
STRUCTURE The humeral and ulnar heads qf ulna. In other words, the flexor digitorum pm-
the flexor carpi dfiaris combine to form a sin¬ fundus, is located in the interval between the
gle flat belly which is extremely difficult id iso¬ beity of the flexor carpi radial is and the poste¬
late on the surface. Basically, this muscle adds rior border of the ulna, covered only by the
hulk to the general form of the flexor muscle dun aponeurosis of the flexor carpi islnans
mass on the forearm. The belly of the flexor (which has no form of its own). The ulnar edge
carpi ulna ns tapers dssrally as its muscle fibers of the belly of the flexor carpi ulna ns may on
insert along the ulnar edge of its tendon, almost rare occasion show up as a furrow. The basilic
all the way down to the insertion. The tendon vein, is as limes located in the middle third of
5 E C T»C hi b
is relatively prominent on the dssEal quarter of this furrow.
the forearm, but less so than the tendons of the When the I i rile finger is abducted, the abduc¬
pal mans longus and flexor carpi radial is. At the tor digiti minimi pulls on the pisiform bone.
distal titrh of the forearm, when the wrisi |omt During dtis action, the flexor carpi ulnaris si¬
is straight nr Hexed, the tendon of the flexor multaneously contracts to stabilize the pisiform,
carpi ulnaris docs not lie m contact with she and its tendon then becomes more prominent.
ulna, Lind the interval between them is filled

CRO^S JELCTiQM OF WRIST

 Tfte Forearm Muscles • FLEXOR OIGITORUM SUPERFICIAUS

AdP Adductor patticit BA Bicipiidluponturom FCR ftexar curpt rjdutlis FCU Flexorcatpiultutrit
H OP Flexor digiturutu profundus F D S Flexor digiiomm wperjitMlts FPL Fte.xur potlias longus
I ^ f4lim-\or rfftfULtilurti UyE biypotfwtstt vntinctKC \1F. A1 ?itiiit£picomiytf PjL hwgtts
PrT ProMattiT rtttf RaRjJtus THE Thtnar eminence U Ulna * To ring finger

202,
 The Forearm Muscles - FLEXOR DIGITORUM SUPERFICIALIS

Flexor Digilorym Superficial On the distal quarter of the forearm, the suh-
(Flexor Digitorum Sublimis) cutaneous tendon nf the flexor digitorum super¬
ORIGIN Originates him all ihrec arm ficial] s to the ring finger is usually easily seen,
bants—humerus, ulna* and radium—as follows: lying between the tendons pf the pa I marts lon-
the me dial cpicondyk- ol the bium1 ms by the gus and flexor carpi ulnaris. Ins most readily
common Ilex or tendonl; the medial side of the seen when the hand is clenched into a hsi and
c orotund process of the ulna and the ulnar cub the wrist is slightly flexed. If tht hand is then
lateral ligament of the dhow join! (ihe ligament deviated toward the ulnar side, iFil- tendon of
SECT IQN fK Connects the comm ml process of the ulna to the the flexor digitorum superficial is to the middle
medial epicondyle of the h nine rusk and an linger slides laterally toward the ulna) out from
oblique lint on the anterior surface of the ra¬ under the tendon of the pa Im am long us.
dius, beginning at the radial (bicipital) tuberos¬ In the pal in, the tendons of the flexor di gun-
ity and ending halfway down the hone. rum $uperfirial*$ all lie on the same plane as
they pass distally to their respective fingers.
i N £ E fl T 1 0 N The edges of the palmar surfaces
When the palmar fat is thin, and the fingers are
of the middle phalanges of the index, middle,
partly flexed again si resistance, these tendons
ring, and little fingers (fingers two through five).
may be seen in relief on the palm, radiating
It has no attachment to the rhumb,
from the wrist toward the fingers.
ACTION Flexes the middle phalanges of lin¬ When ihe wrist is fixed in ilia straight posi¬
section a gers two through five, and hy continued action, tion and tht: fingers are repeatedly flexed and
Ilexes their proximal phalanges and then the extended, the belly of the flexor digitorum su-
wrist joint. It does not lies the distal phalanges. perfirialis can be seen sliding up and down the
STRUCTURE The flexor dftgj to rum superfici- lower portion of the forearm. Because the flexor
alis is a wide, I airly large muscle layer m the digitorum profundus is also working during
forearm, mostly deep hut partly superficial The these actions, both these finger flexors influence
superficial part comes to the surface at several the shape of the forearm—they thicken the up¬
jdaces, hut can only occasionally he seen db per mass of the forearm during linger flexion
riscily, when the list is clenched, m the long (they get shorter and thicker when they con¬
SECTION C
narrow intervals between ihe flexor carpi radt tract).
atis. pal mans longus, and flexor carpi ulnaris.

TEMOONS FPS

SECTION p MIODle *0 O-fc'KG

PALMAR

L AT. €-

OOR.5AL

CROSS SECTION of WRIST

203
 The Forearm Muscles * FLEXOR DIGITQRUM PROFUNDUS

An Anconeus BT Biceps tendon ECU Extensor carpiulmw EDM Extensor %jfr minimi
F CU Flexor carpi uhwris F D P Flexor dsgtiarutn profirrtdm FDS Flexor digitontm niperficiaHs
FPL Flexor poliicis lorigus ME Medial epicondyte O Olecranon Palmar is lotigus
PQ pronaio t quadraius R a R adius U Vina * Under flexor carpt ulnaris

104
 The Forearm Muscles * FLEXOR DIGITORUM PROFUNDUS

Flexor Dig riorum Profundus fundus belly may on occasion he distinctly seen
ORIGIN Extensive, amnnuous area on the on the surface as a narrow form, tapering infe-
ulna—from the mid tile (hirJ of ns posterior riorly, on the upper two thirds of the hack or
border, the upper three-fourths of its medial the forearm. Ie is located between the posterior
surface (exclusive of us uppermost one inch}, border of Hie ulna {and the medial side of die
and the noddle third of its anterior surface. If olecranon) ind the edge of the muscU fibers of
also originates from the adjacent ulnar half of the flexor carpi ulnar is. U is most likely to he
the stuemssemis membrane, Jr does not origi¬ seen when the forearm is pro rutted* the wrist
SECTION A nate from the radius or the humerus,) extended, and the fingers repeatedly Hexed and
extended. Whether or not this portion of the
INSERTION Palmar aspect of the base of the
ilexor digitomm profundus tv distinctly seen on
distal phalanges of the index, middle* ring, and
the surface, it, not the flexor carpi uln.iris* is
little fingers ;fingers two through five). It has no
responsible for directly creating the form of the
attachment to the thumb.
flexor mass immediately adjacent to the poste¬
ACT ION Powerfully Ilexes the distal phalanges rior border of the ulna.
of fingers two through five, and by continued In the middle thud of the forearm, the flexor
action. Ilexes the other finger loints, as well as muscles (specifically the flexor digiiurum pro¬
the wrist. fundus) arc separated from the extensor muscles
5TRUGTURF Situated lor ihe moat part deep ■ sptdfkally t h c exitnso r carpi id n .in s) by a fur-
SECTION fl
hi (he forearm* the flexor digiturum profundus row. At the bottom of which lies the posterior
is die Largest of the forearm muscles and adds border of the ulna.
substantially to the volume of the flexor muscle When the wrist tv fixed in the straight posi¬
mass. At the wrist, its four irttdutis lie deep to tion and The fingers are repeatedly flexed and
die other tendons of the forearm. A portion of extended, the bellies of the flexor digiturum
its belly lies just unJer the thin aponeurotic ex- profundus and superficial]* influence the shape
pension of die flexor carpi utnarist and actually of the forearm. When they contract to flex the
produces surface form along the llexor side of fingers, they enlarge the medial side of ihe
the posterior border of the ulna. proximal half of the forearm as they shorten
This superficial strip of flexor digiro rum pro¬ and thicken*

HB

SECTION p

105
 The Forearm Muscles * FLEXOR PQLLICIS LONGUS

Flexor Polltds Lo ng us pul lias fungus can be seen moving in tins area
as the distal phalanx of the thumb is flexed and
ORIGIN Middle halt of rhe anterior surface
extended. When the mterphaliingeal [otni of the
of the radius and the adjacent interosseous
thumb is Hexed, the belly shortens, and a slight
membrane.
depression forms a short distance proximal to
INSERTION Palmar aspect of the base of the the wrist as the distal end of the belly slides
distal phalanx of the thumb. upward. Also in this position, u will be noticed
ACTION Flexes the distal phalanx ol the that the thickness (dorsal to palmar) of the
SECT ION A
thumb. proximal phalanx of the rhumb has increased,
caused by the pulling away of the tendon of the
STRUCTURE The llexor pollicis fungus is sit¬
flexor poll iris lungus from (he phalanx.
uated for the most part deep in the forearm,
The flexor pollicis longus therefore very sub¬
where it adds some fulbess on the anterior sur¬
tly affects surface form in two areas: on the
face of die radius. It becomes partially superb-
front id the lower end of the forearm and on
da] on die front of the lower half of the fore¬
the proximal phalanx of the thumb.
arm. Never distinct, the belly of the flexor

BA Btaptliil apaneufoib Hrt Briidmmidnshs FCR ftexor atrpt radtuib ECU Flexor aifpt uhians
FOP Ftexw digiiurum profundus FITS Flexor digitorum Muperfidalb FPL Ffcxttr pallias fungus
FR Ffexor mittjculum H yE Hypothendr eminence M E Medial cptttmdyte Pa L Mmaris itutgus
 The Forearm Muscles * PALMARtS LONGUS

Palmar Is Long us the lower two-thirds of the anterior (Jlexor) as¬

ORIGIN Medial cpi condyle of the humerus (by pect of the forearm. It widens slightly just as it

the conunOfi fkxur Tendon). teaches the base of the hand. This tendon is the
most Conspicuous tendon at the wrist; it be¬
INSERTION Distill part of the flexor reftnacu-
comes especially proEiiincni when the wrist is
him of the wrist and the apex of the palmar
partial It flexed and [he hand is clawed.
aponeurosis,
The tendon frequently sends a tendinous slip
ACTION Flexes the hand .ie the wrist. to the surface of the muscles of the thumb,
STRUCTURE t he patmaris iongus consists of which creates a subtle raised ridge on the
a short, narrow* (uniform muscle belly proxi¬ thenar eminence (on the abductor pullicis
mal ly and its very bng, slender, sightly flat¬ brevis) when the thumb is abducted.
tened tendon> Its telly may he seen only rarely The palrnaris hmgus is reported to be ab¬
as a short elliptical- relief descending from the sent in approximately Twelve percent of [he
media! tpicondylt of the humerus. The tendon population.
can easily be seen passing down the middle of

PAp Pdhmr dpfmenrosts PQ Pronator quadratm Rn Radius ThE Thenar rmrntrnt* U INm
* To ring fitigrr

107
 I7?e Forearm Muscles • PRONATOR TERES

BA Bicipital aponeomsk UB Biceps btachu Br Rrachiatis Brr Sradbiorcd^Hs BI Btecps fmdim

C F Cubital fosse Ft R Flexor carpi radialis F DS Flexor digitomm superpaalis H Humerus
ME Medialepicondyk MJS MedialMtermwculjr septum FrT Pronator feres Ra Radios
TMe Triceps — medial head U Ulna

208
 The Forearm Muscles * PRONATOR TERES

Pronator Tores higher i ha n, and then contributes to, the Hex or

ORIGIN The medial epicondyle of the hume¬ mass on the forearm. The distal end of its belly,
rus and the adjacent a men or surface of (he covered h% the hrochioradialis, ends in a flat
hone, (Tie origin is located immediately proxi¬ tendon before inserting. Although rhe pronator
mal io lhe origin of the common Ilex or tendon teres is for the most pan superficial, it is diffi¬
of rhe forearm flexors, Ir also originates from cult to see its isolation; its oblique fnrm is most
rhe cQmmofl flexor tendon itself* as well as likely to be seen when rhe elbow is partially
from the medial intermuscular septum of rhe flexed, the forearm prorated, the wrist fully ex¬
upper arm. tended, and all the muscles tensed. It is sepa¬
rated from lhe brachioradialis by 4 small trian¬
INSERTION A short, rough, vertical fine lo
gular interval, rhe cubiial fora, best seen in the
cared halfway down rhe lateral surface of the
a foremen tioned p* n it u m.
radius (at its point of maximum convexity ).
The form of the pronator teres is not affected
ACTION Protiaics rhe forearm; assists in flex¬ by the constricting action of the bicipital apo¬
ing the elbow joint* neurosis. The ulnar head of this muscle is smalt
STRUCTURE The pro mil or feres is a short* and Jeep: it has no effect; «n surface form.
fleshy, cylindrical muscle which begins slightly
TlON &

WIDE

109
The Hand Muscles

3 TEARDROP MUSCLE MASSES OF HAND

(right hand)

thenar — TENDON OF PALMARIS LONGUS

EMINENCE FLEXOR RETINACULUM
PtSIFORM. BONE
PALMARIS BREVIS
HYPOTHENAR EMINENCE
PALMAR APONEUROSIS

flexor tendons

PALM VIE W - RIGHT HAND

 The Hand Muscles * FIRST DORSAL INTEROSSEOUS

Fir&l Dorsal Interosseous STRUCTURE The first dorsal interosseous is

(Abductor Indices) the largest of the four dorsal interosseous mus¬
O n i G i N Proximal half of rhc ulnar mdc of she cles and is [he nnly one that creates surface
shaft of the metacarpal of the rhumb and the form. It is located on the back of [hr hand in
the V-shaped interval between the metacarpal
proximo] three-fourths of the radial side of the
hones of the thumb and index finger (the dorsal
shaft of the metacarpal of the index finger fa V-
skaped origin), surfaces nf these banes remain subcutaneous!.
Its two heads, each coming from a metacarpal,
I USERTlQhr Radial side of the base of the
usually show up as a single bulging fewtn th.lt is
proximal phalanx of the index finger, with a either teardrop-shaped or oval, A slight separa¬
small! attachment to the dorsal extensor aponeu¬ tion between the heads may occasionally show
rosis nt the index finger, at the proximal end of the belly when the mus¬
ACTION Adducts the index finger away from cle is tensed. The muscle belly, and therefore iis
the middle finger; flexes its metacarpophalan¬ bulging form, tapers into a tendon before reach¬
geal ini nr; extends both inEcrphalangcal joints ing the level of the metacarpophalangeal joint.
via the dorsal extensor aponeurosis. It does not
adduce the metacarpal of the thumb.

A b P B Abductor poilii is brevis V d I1 Adductor fmWas EC R B Externor wrpi mJulis brevis

EC R L Extensor urpi radtaiis Um$m E P Extensor digrtorum BP t Extensor polticis fungus
HIM First dorsjl mlemssemts FJ>P Flexor digits rum profundus FPS Flexor digtioTvnt superficial^
\

112
The Hand Muscies - ADDUCTOR POLLIC1S—TRANSVERSE HEAD

Adductor Pol I ids—Transverse Head able in life* its palmar surface ami distal edge
ORIGIN Distill rwiMhirds of the palmar sur¬ are covered by a layer «! loose shin. A small
face of the metacarpal nf the middle linger, portion, however. ljis he .seen oil the dorsal
side of the hand between the fifsi dorsal inter¬
INSERTIQN Lflnar side of the base of the
osseous and the base of the proximal phalanx
proximal phalanx of the thumb.
of the thumb. The tendon of insertion of the
ACTION Adducts and Ilexes (he rhumb at the adductor poll ids contains the ulnar sesamoid
carpometacarpal joint; Daces its proximal pha- bone of the metacarpophalangeal joint of the
Lirtx jr the rnetaca rpnph a I ,i ngeal joint. thumb.
STRUCTURE The llat* triangular, transverse Ihe more proximal oblique head of the ad¬
head of the adductor pnllids passes from the ductor pollicis hex deep to the thenar eminence
middle of the palm to the rhumb. Barely notice¬ in the palm.

FPB fkxur poilitii brevis FPL Flexor pottjck hmgus FR Flexor reumiculum \M tntmssemts mu tele
M Meiiitarpal ThH Tftemr emiftert£e
 The Hand Muscles - ABDUCTOR POLLICiS BREVIS

Abdutlor Polttcis Brevis extensor pollicis longus, assisis m, extending; the

ORIGIN Anterior surface ol the lateral hall of imerphulangeal joint of the thumb,
the Ikxor retinaculum and the adjacent palmar STRUCTURE Largest ol the thenar musclei,
surface* of the trapezium (its tubercle) and sca¬ the abductor pollieis brevis is a Hat, elongated,
phoid. Ie also frequently originates m part iron triangular muscle. When she thumb is abducted,
the tendon nf the abductor poll lets longus and ilu- form of this muscle divides longitudinally
occasionally from the tendon of the pal in am into two narrow parallel forms: a more promi¬
tongus. nent Inlrml form that originates from the carpal
INSER ] ION Radial side of the base of the bones and tendon of insertion of the abductor
proximal phalanx nf the thumb and into the polticis longus and a mat ml farm that origi¬
nates fmm the flexor retinaculum. These forms
tendon of the extensor polltris longus.
are produced by the descent of tendinous slips
ACT ION Abducts the thumb away from (ante¬ fmm the [endunv of [he abductor pnl Licit lorigus
rior to) the palm (on a plane perpendicular to and palrriaris longus onto the surface of the
the palm} at the carpometacarpal |aim; it simul¬ belly of The abductor pdlicis brevis, When the
taneously rotates the thumb medtally at the thumb is abducted, numerous thin, transverse
same joint fa saddle joint); It assists m flexing skin wrinkles develop across the surface of this
[he metacarpophalangeal joint of the thumb, muscle.
and by its attachment into the tendon of the

FCR
AbPL
EPB

EPL

A b l* B A bduetor pailid* hm*ti A h PL Abductor poUkis longus A d P Adductor poUtcis

E PR ExteHSQt pollids frwis FPL Extensor pallid* longu s FCR flexor carpi mduhs
P L> S Ftexfj r digitomm superfiaalh FP R flexor pollicis brevis FPL Flexor polite t$ Imgm*
V

ZI4
 The Hand Musc/es * FLEXOR POLLICIS BREVIS

Flexor PolUds Brevis dial rotation of the metacarpal of the thumb at

ORIGIN P.i I mar surface of ihc trapezium <an the carpometacarpal joint,
area medial and distal to the origin of the ab¬ STRUCTURE The flexor pollicis brevis is a
ductor pol l ids brevis} and the distal border of small, narrow muscle, located medial to the ab¬
the flier a I ha] I of the llexnr retinaculum. ductor poll!tis brevis, which contributes to the
form of the thenar eminence. Although ie is for
INSERTION Radial and part of die palmar
the most part subcutaneous wuh its medial edge
side of the base of the proximal phalanx of the
at the medial border of the ihcnar eminence, its
thumb,
actual form is usual I v obscured by 3 layer of
ACTION Hexes the proximal phalanx ut die palmar fat. Its lendon of insertion coma ms the
thumb; assists in opposition of the thumb radial sesamoid bone of the metacarpophalan¬
against the other fingers, St also assists in mo geal joint of the thumb.

f Pa L
FPtK
AhPB AbPft
THE

HR flexor rttmaculum HyE Hyputhtnattnuucnct M Metacarpal OP Qpponempollidi

P*L Tihrunt hngus Th E Thenar eminence

«5
The Hand Muscles * ABDUCTOR DIGIT! MINIMI

Abductor Digiti Minimi the back of the proximal phalanx of rhe link
ORIGIN Tip of die pisiform bone and from finger) h
the anterior surface of the ligament connecting ACTION Abducts and flexes the hide finger at
the pisiform bone to the base of the fifth oieta- [he metacarpophalangeal joint; extends the in
caipah LerphalangeaJ joints (via us insertion into the
dorsal extensor aponeurosis^
INSE RTION Ulnar side of the base of the STRUCTURE The abductor digiti minimi is
proximal phalanx of [he hide finder (in com¬ the largest of the hypothetic muscles, It wraps
mon with the flexor digiri minimi brevis) and around the ulnar side of the hand up to the sidr
ulnar border of the dorsal extensor aponeurosis of the metacarpal of the little finger; therefore,
of the tendon of the extensor digits minimi (on it can he seen I mm the back view of the hjnd.

AbDM Abductor digiti minimi ECU Extensor carpi idmiris EDM Extensor digiti mmim
ECU flexor carp! tdrum E L> M B flexor digm minimi brevt* EDS Flexor digitontm superficial!*
The Hand Muscles * FLEXOR OIGITI MINIMI BREVIS

Flexor Dig it i Minimi Brevis ACTION i lexes the proximal phalanx of the
ORIGIN Medial surface oI the hook of the ha¬ little finger; assists in abducting it.
mate hone and anterior surjace of the medial
STRUCTURE The flexor digiEi minimi brevis
half of the flexor retinaculum.
is a very narrow muscle located between the
INSERTION Ulnar and part of the palmar abductor digiri minimi and opponent digiti min-
mJc of the base of the proximal phalanx of the uni, Contri bulling to the volume of the hypo th¬
little finger (in common with the abductor digiti enar eminence, tts actual form is obscured hy a
minimi)* layer of palmar fat;

FR Ftextir retinaculum Hy E Hyp&thenw tmitt&tee VI Mrfacxrpdi OD Qpponem Ji$iu minimi

PnL Paim&rii fwttgus Pi Pisiform htmc TfiE Thctijr emittfiner

II?
 The Hip Muscles

CR055 SECTION

f5ACRAL=N
TfcjAWGLk INGUINAL
j^U&AmenT
'VPUfliS^
GLUT£AL
CLEFT UNE**''
6LUTEAL OF THf&M
FOLD X

BACK VIEW FRONT VIEW SIDE VIEW

18
 The Hip Muscles ■ TENSOR FASCIA LATA

A 51S Anterior superior that spine ISFS Biceps fetmms— short hrjti Cl Crest of itimn Fc Femur
G\\a iifuteiisttuximtti GMc Cihittus medhts GT Grater trochanter ItT ihotibialtract Pa Patefb
QT Quadriceps tendon KF Rectus femoris Sa Sarivrms T Tibia TFL Tensor fascia lata
VL Vastus hteraiis * On vastus lateralis

120
 The Hip Muscles * TENSOR FASCIA LATA

Tensor Fascia Lata chanter. The tensor muscle is separated from

ORIGIN Anterior pari of the outer lip of the the greater trochanter by fleshy libers of the
iliac crest and a small area of the adjacent outer gluteus medium
surface of the ilium immediately posterior to The lower end of the tensor muscle is often
the anterior superior iliac spine* the widest point of the male hips.
rhe iliotihr.il tract is a King, wide, thin hand
INSERTION ITc upper pn rtion the il bt i bia I
final lies on the outer surface of the thigh. It
tract, which in turn inserts into the lateral con¬
begins superiorly at the level of the greater tro¬
dyle of the tibia,
chanter and ends interiorly where it distinctly
ACT SON Flexes* abducts. and medially rotates inserts into rhe lateral condyle of the tibia. This
the thigh. The tensor fascia lata pulling on the trad is a thickening of the normal fascia that
iliotibial tract stabilises the outside of the knee surrounds the entire leg. Both the tensor fascia
joint* laca and gluteus maxim us insert into its upper
STRUCTURE The tensor fascia lata is a short, end. and she tract functions as their tendon of
thick, teardrop-shaped muscle located on the insertiuri into the tibia below (it is technically
outer front corner of the pelvis. Its form begins fascia* not tendon). The iliotibial tract wraps
at lhe front point of [he hip and ends where the around the posterior surface of the vastus later¬
muscle attaches into the iliotibial band, at a alis and fuses with the lateral intermuscular sep¬
level |ust below and in front of ihr greater tum* which eventually attaches to the linca as-
trochanter of the femur (near the level of the pera on rhe back of the temur.
hi it mm of the buttocks). Fts wider, flattened, When the muscles of the leg are tensed, the
distal end lies on tup of the form of the vastus lower end of the iliotibial tract regularly shows
lateralis. up as a distinct* narrow, vertical form on the
In the standing position* the belly becomes outside of the extended knee (after it parses off
stretched into an elongated oval shape (some¬ the form ot the vastus lateralis). There are no
what punned interiorly;, but as the thigh is muscle fibers in this form. It* posterior edge
SECTION a continues downward from the posterior edge of
flexed* it changes into its characteristic teardrop
shape. As the thigh continues flexing, she distal the vastus lateralis {seen in side view). This
end widens (from to hack). At full hip flexion* form lies anterior 10 the belly of the short head
the belly is crossed transversely bv a deep skin of the biceps lemons and is in contact with it
fold. or is separated from it by a narrow interval.
When the thigh is partly flexed at the hip As it lies on the vastus lateralis* the thin ili¬
loint and then medially rotated* the tensor fas¬ otibial tract has no form of its own, Bui when
cia. lam partially or completely merges with the pulled taut by the two muscles that attach into
anterior portion nf the gluteus medius to pro¬ its upper end* the iliotibial tract creates numer¬
duce a single, oval* bulging form. When they ous long, vertical furrow* and ridges m rhe un¬
are distinct from each other* the gluteus mcdius derlying vjsius lateralis muscle mass* much like
extends ro rhe bottom of the front edge of the a pillowcase would do when pulled tight
greater trochanter, whereas the tensor descends agamst the surface of a soft pillow mstde ft see
lower and does noi attach to the greater tro¬ Vastus Lateralis).

Post.
j f CR935
** /SECTION OF
h / Pelvis
\aht

'outer FRQnT corner

£* TENDED
TEAftDftOP HIP

FLEXED
HIP

ZZ J
 The Hip Muscles * GLUTEUS MEDIUS
O o

cl CfCf f of ilium ep Extermt oblique FF Fhmk fat pad GMi Crtuteus maxintus
CMe Gluteus mcdntf UMi Gluteus mttitmus GT CiWfff Irochtmter t iliimt rl fliactts I Li Uuthnt
IcT iliotibial tract fon vastus lateralts} L Lautumm dors* I'SIS Fontenot superior iliac spine
Sa Sariorius Sac Sacrum TFL Tentor fascia lata VLV&stmlatmlit

ZZ1
ThB Hip Musc/as - GLUTEUS MEDSUS

Gluteus Medms glutens niedius continue down the front edge of

QRlGiN Outer surface of a portion of the it- the greater trochanter for a short distance; they
men - pelvis), up in the crest of the ilium. can bulge quite considerably during flexion and
medial rotation of the femur, This anterior
INSERTION A wide oblique line running
bulge, separate and distinct from the rest of the
downward and forward on the outer (lateral)
gluteus medium k$ often confused with rhe ten¬
surface of the greater trochanter of the femur.
sor t.ss^r.i |,it.i, hut die tensor muscle's form be¬
ACTION Abducts the thighs keeps the pelvis gins from a very small area of origin on the
horizontal during walking when the advancing outer front corner of the ilium and ends lower
leg is meji in contact with the ground. Posterior on die thigh than dues [he gluteus medium (the
libers extend and laterally rotate the thigh; an¬ tensor ends on the surface of the vastus later¬
terior fibers medially rotate rhe thigh* alis ). The anterior form of the gluteus tried i us is
STRUCTURE The glutens me Jins is a wide* pointed inferior!y.
chick, fan-shaped muscle that tapers interiorly The posterior edge of the posterior portion of
Info a strong flattened tendon at its insertion. the gluteus medio* t* covered by rhe gluteus
The mass of the muscle ends on top and in maximum The line between these muscles is oc¬
Imnt of rhe greater trochanter; Its tendon (not casionally visible, and then only subtly. The
visible) continues downward and posteriorly posterior portion of rhe gluteus medio* and the
over the surface of the greater trochanter to the anterior portion of the gluteus maximus usually
actual Tine of insertion. The form of the greater create a single, large, hemispherical form on rhe
trochanter is therefore not covered by muscle outer hack corner of the pelvic region when
fibers and is visible. The anterior fiber* of the both arc tensed.

POST*—*
SIDE VIEW

2 *3
 The Hip Muscles * GLUTEUS MAXIMUS

A &M Adductor magma B Ki Biceps femora - long head A IS Biceps femoris—skari bead
C* Carry* DM Deep muscle ES Errrfoj^pjftijr Fa Fat Fu Femur Ci Gracilis
CfC Gluteal cleft €Fa Gluteal fat pad GFo Gluieai fold GMj C Uuteus maximus
GMc Gluteus mcdius GT Greater trochanter Ham Hamstring muscles I ilium Is Ischium
ItT Iliotibial tract Mu Mufupdos PSiS ftisterwr sitperou iliac spine Sac Sacrum
5m Semimembranosus 5t Semttendmwu* TFL Tensor fascia lata VL Vastus lateralis
* On vastus btemhs + Under erector spmae

2X4
The Hip Muscles * GLUTEUS MAXIMUS

Gluteus Maximus jor volume of the buttock. It is directed down¬

ORIGIN Expanded and roughened posterior ward and outward from its origin and wraps
fourth or fifth of the crest of the ilium, includ¬ around the outer back corner of [he pelvis. It
ing the posterior superior iliac spine and the consist* tif coarse muscle fibers which may at
small area below it on the outer surface of the times form several wide, elongated bundles on
iliumi the posterior surfaces of the lateral edges the surface. The upper edge of the rmisde is
of the sacrum’s lower half and I he coccyx [nor faintly indicated by a slight furrow where it
from the last two coccygeal vertebrae.); the sac- overlaps the posterior portion of the gluteus
mmberous 11£3merit between the sacrum and as- mcdiuis. Its lower edge, passing from the bottom
chial tuberosity: the sacroiliac ligaments be¬ oi the coccyx down to the outside of the leg, is
tween the sacrum and ili 11111* die lateral surface concealed in the standing leg hy a crescent-
of the aponeurosis of the erector spinae (which shaped fat pad that lies on tbt lower inner cor¬
lies on the multifidus); and the surface of the ner of the muscle. When the hip joint is enm-
posterior portion of the gluteus medius. pleirly flexed* the lower edge of the muscle may
occasionally be seen in its entirety. The gluteus
INSERTION Upper half; Upper portion of the maxim us covers the back hut not the bottom of
iliotibial tract, which ultimately inserts into rhe the ischial tuberosity, even when rhe hip joint is
lateral condyle of (he tibia. Lower half: Superfi¬ flexed, which prevents musde fibers from get¬
cial fibers into the iliotibial tract, deep libers ting damaged in the sitting position.
into the gluteal tuberosity of the femur, which The gluteus maxi runs and the posterior halt
is a thickened vertical line (an upward rxten- of the gluteus mcdius create a somewhat
vion of the tinea aspera) on the back of the doughnut-shaped form on the outer back comer
femur. of the pclvts. Its hack profile (seen in side view)
ACTION Powerfully extends and laterally ro¬ is sometimes rounded almost into 3 pier feet arc
tate* rhe thigh at the hip joint; extends, rhe pd- of a circle. The lower half of the arc straightens
vie when it ts flexed forward. The upper fibers when the muscle is tensed (without the hip joint
assist in abducting the thigh; the lower fibers moving).
assist in adducting it. The inferior end of the form of the gluteus
maximum* on the outer hack comer of the thigh,
STRUCTURE The gluteus maximum is a thick* is directed between the forms of the vanus la¬
fleshy* quadrilateral muscle that forms the ma¬ teralis and the long head of the biceps femons

115
 The Hip Muscles * ILIOPSOAS

Iliopsoas psoas major. Considered as a single muscle

[Hiacus and Psoas Major) group, ir begins deep in the hack of the abdo¬
ORIG IN Itiaais: Upper two-thirds of the iliac men and converges toward its insertion oil the
loNsa and the base of the sacrum, Psoas major: inner hack comer of the femur. It passes down
Anterior surfaces and lower borders of the the bony notch on the from of the acetabulum
transverse processes of nil ihe lumbar vertebrae; of the pelvis (directly in front of (he hip joint),
b> five slips from the upper and lower mar^ns just below the anterior inferior iliac spine.
of the sides iif the bodies of the vertebrae and Coursing downward under the inguinal liga¬
the intervening intervertebral discs, beginning ment, the iliopsoas becomes partly subcuta¬
from the lower margin of the Iasi thoracic ver¬ neous as it leaves the abdomen, bur soon disap¬
tebra and ending at the upper margin of the pears as it dives deep,
fifth him bar vertebra. ITic iliopsoas is never prominent. It lies par¬
tially under the upper end of the sarturius,
SECTION A INSERTION tkacM: Lateral side of the ten¬ which it pushes slightly forward in the extended
don of insertion of the psoas major and onto hip. The superficial portion of the iliopsoas, pri¬
[he shaft of rhe lemur for an inch or so mimedi- marily the iltacus, is located just medial to the
aiely below and an tenor to lesser trochanter. superior end of the sartorius and immediately
Psoas major: Lesser trochanter of the femur. below the inguinal ligament. It bulges slightly
AC T ION Powerful flexor of the hip joint; ti when the hip is extended. This superficial por¬
Hexes the thigh (when kicking: or pelvic (and tion becomes slightly recessed from the surface
trunk—when doing a sir-up . It also laterally when the hip joint is flexed (as the sartorius is
rotates the thigh. The psoas nssisis in flexing raised forward). Its form may he seen when the
the lumbar vertebrae. leg is abducted toward the horizontal and lat¬
erally rotated, at which rime the superficial area
STRUCTURE l"he iliopioas is made up of the iv slightly recessed, but appears as a short,
large, fi.it, triangular tliacut and the fusiform downwardly pointed triangular form.

SECTION a

Ap Aponeurosis uf external oblique A SIS Anterior superior (tiacspmt Fa tat | e femur

GMe Gtutem media* 1 I hum IL htgi/wal ligamcm II Wants IQ Internal oblique Ip tifo§a&a&
Fe Peer writs VS Puhjc symphysis ?% Psoas major Pu Vidus RF Rtgirnfmam 5 a Sartorius

ZZJ
 The Upper Leg Muscles

Fon^s QUADRICEPS] forms HAMS7 KINGS ADDUCTORS

1 VASTUS METD,> hep. fj. semltend. \ fADPLCTOR LO NO.'S To
GROUP
2. ■ VASTUS LATT UtWuR ul* a.iSEMIMEMB. (rROM KWi. IaO DUC.TOR MASrtWffi
t ---.- f pelvis
(cE«f>) ' VASTUS INTER.) BICEPS FEM.' (GRACILIS
3- ^FCTUSfEM, I-AT. -LOMU
fj. - M£AP
©"OUPL _
SNORT HEAI>)^UR
JQOAREp-CJ=F
ATofti&iN OF
A&DUCTOft
UOnGIJ* \

SiN&LE-
OBuQuE
BELLY FORM OF
ADpU CTQRS_
AkP-
HArt5Yfl!N&$

COMPOUND
TENDON

AKE-S OF AVERTED CONE

Qua & ft i c i' p 5 fAUS CL£ H ASS&S OF ADDUCTOR MASS
MUSCLE MASS
FRONT VIEW FRQNT VIEW
CAT-4—

QUADRICEPS T&WDON OF
TENDONi CURVED RICTUS rCM, vast;
PROPER Va LAT
^vfl/cuRVtt? VAST-
MEP-
COMPOUND
TENCON
PATEL LA IMF RA- QUAD.
patella
PATELLAR Pat-
LiGAHENT PAD hea&t
shaped -or Ground
■ti&ial Ty&EROSiTY

3
UT^rih

LOM&US
ADDUCTOR

EXTENDED kNS£T

118
 The Upper Log Muscles - VASTUS LATERALIS

B F L Biceps ftmoris - long head R F S Biceps ftmtiris - short head Fc Frmn r G M j f p listens maximus
G\k Ctuteus medlm GT Greater trochanter IF Infrapatellar fat pad ItT Hmhlualtract Fa Patella
I1 Li Piitetfat ligament QT Quadriceps tendon KF Rectus femorts TFL Tensor fascia lata
TJu Tibtel tuberosity VI Vastus mtcrtwdtus VL Vast its lateralis VM Vast its nmiults
" Opr vastus lateralis

I32
 The Upper Leg Muscles - VASTUS LATERALIS

Vastus Lateralis vastus lateralis ends infcriorly a couple of

(Vastus Externum) inches above the top of the patella* at a level
ORIGIN A line that begins on the front of the lower than the bottom of the rectus femoris and
greater trochanter of the femur, curves around higher than the bottom of the vastus medial is.
[he outside of the lemur below the trochanter, The muscle fibers do nor reach the patelki> nor
rndi^ the tinea aspera on the midline ol the do they cover the lateral condyle of the femur.
buck of the femur* and descends along irs lat¬ When the knee is flexed, the vastus lateralis is
eral lip ecn end halfway down, or lower, on the stretched and become* thinner.
hone, ft also originates from the lateral inter¬ When the iliotibial tract, which lies on top of
muscular septum between thv vastus lateralis she vastus lateralis* is pulled taut, one or more
and short bend of the biceps femoris. long]ordinal furrows, elongated flattened planes,
ami-or raised ridges appear nn the outer surface
SECTION a INSERTION liy the quadriceps tendon imo
of the belly of the vastus lateralis. Various pat¬
the lateral border and upper outer turner of the
terns may emerge. Because the tensor fascia lata
patella. It ultimately inserts into the ribial tuber¬
and gluteus maximus in sen into the superior
osity via the patella r ligament.
end of the iliotibial tract* and because the tract
ACTION Extend* the lower legal cite knee ultimately inserts into the lateral condyle of the
joint (lifts the body from a squalling portion tibia, the tension furrows and flattenings are
by extending the knee fuim or lowers the body usually directed from various parts of these
against die pull of gravity by controlling the contracting muscle** above to the insertion point
rate of knee flexion). below..
STRUCTURE Largest of the quadriceps mus¬ An oblique furrow directed downward and
cles the vastus lateralis occupies the lateral side forward may develop from the bottom of the
of the thigh, yet also extends pa malty around tensor fascia lata Because it is not directed
5ECTION B to both the front ami hack of the thigh. Note toward the outside of the knee* n is nut caused
that the line of origin begins bn the front sur- by a tensed iliutthj.il tract* hut rather by a por¬
fate at the top of the femur* and it is here tion of the fascia of the leg anterior to the ac¬
where its muscle mass begins to bulge forward. tual tract. At the mit-side of the knee, the ilioti¬
The Upper portion of the muscle, lying on the bial tract is continued downward tram the
outer surface of the femur just below the posterior edge of the vastus lateralis. The tract
greater trochanter, begins quite thin, but thick¬ creates us own elongated surface form after it
ens as it descends. leaves the surface of the vastus lateralis.
The lower portion uf tlie posterior edge (in The vastus intermedia* is an extensive muscle
si Jr view) may be straight. It v outer surface i-^ that hes deep ru all the other quadriceps bellies,
somewhat flattened* The muscle mass of the adding muscular fullness under them.
SECTION C

*33
 The Upper Leg Muscles * VASTUS MED1AUS
INSIDE VIEW

A d L Adductor lattgta A d M A dductor m agm** Fe frvnzvr IF Infrapatellar fat pad Pa Ptitrlk

PLs PjtclLr ligament QT Quadriceps tendon RY Rectus fetmiris Sa.Sartorius TTu Tibialtubcrostiy
VJ Vastus mtermediw VL Vastm ktterdlk VM Vastus medmlis

234
The Upper leg Muscles * VASTUS MEDIALIS

Vastus Medians top of the shaft of the femur (deep to other

(Vasins Imamus) muscle* j and gets thicker as it descends. When
ORIGIN A line beginning on the frurit ot *he the lower leg ih flexed at the knee mint, the
femur At lbe level of the lesser trochanter winch media! side of [he bent knee appears smooth
curves around the inside id the shaft of the and rounded, because the fleshy vastus mediahs
bone to reach the line.a aspera on the hack of becomes stretched over and blankets the medial
the lemur, h descends along its medial Itp„ then condyle of the femur. The muscle, however,
veers medially into the upper part of the medial does not completely cuvet the medial condyle,
supracondylar line of the femur. The vjceu^ me¬ regardless of knee position. In the Hexed knee
dia lis also originates from die tendons of the position, a hollow may appear posterior to the
adductor longus and magmis and from the me¬ vastus medially located between the vastus and
dial inter muscular septum. Niinorius. A portion of the vastus mediahs lying
adjacent and paraIIft to the rectus femons occa^
INSERTION By the quadriceps tendon into sionally shows up as a separate, elongated, thin
die medial border of [he patella and by muscle form and is sometimes confused with the rectus
fibers directly into the patella's upper inner cor¬ fern on s.
ner. The vastus medial is ultimately inserts into line band of Richer is a thickening of the
the tibia I tuberosity via the patellar ligament, deep fascia of the leg into a nonelastic narrow
band. It descends obliquely from the outside to
AC I ION Extends the leg m the knee ioinr
the Inside of rhe leg across the front of the
Functionally* the vastus media lis can he di-
lower portion of the thigh and produces an
vtded into two portions. The upper portion, nr
oblique furrow across the soft muscular forms
vastus medially km pus, exrends the knee, The
deep to it. The hand technically begins at the
lower portion* nr vastus media I in oblique, dot's
iliotibial tract on the outside of the leg, three-
not extend the knee, bin rather pulls (he patella
fourths oi the way down the thigh, and ends on
medially and posteriorly Eo counteract rhe lat¬
the inside of the knee, inserting as tar down as
eral pull of the vastus lateralis. This keeps rhe
the medial surface of the shaft of the tibia.
patella tracking in its groove between the femo¬
Most noticeable m the straight leg across the
ral condyles.
lower end of she vastus media lis and sum grimes
STRUCTURE Lowest of the quadriceps mus¬ across the vastus lateralis (ie does not affect the
cles, l he vastus medial is is a bulging teardrop reetiis femoris), the furrow becomes pro¬
form located on the inner front comer of the nounced when the quadriceps is relaxed, and
lower two-thirds of the thigh. The very bottom usually, but not always, disappears when it is
of it* form ends on the wside of the knee tensed. The relaxed vastus medial is can bulge
(either founded nr pointed), ai [he level ot the considerably below the band. On the insLde of
Middle of the patella. Tts form touches the up¬ Ehe knee 'in front of the sartorius], (he band of
per inner corner of the patella, where an Richer can sometimes produce a Nile, vertical,
ohliquL1 skin told appears, especially when the cord I ike raised ridge as its medial end leaves the
muscle is tensed* form of the vastus mcdialix to insert into the
The form of ibis muscle thin at the very tibia*

23S
 The Upper Leg Muscles * RECTUS FEMORIS

¥c Femur 1F /trfntpd^lLir fyrpad \p Iliopsoas Pa Pateth PLi Bjtclbr ligjmwtt

QT Quadriceps teneitm RF R fetus femoris Sj Surt^rjus TFL Tensor fascia htj TTu Ttbmt tuberosity
VI Vastus mtvrtttediiis VL Va$tu$ latrraik VM VmtmmtdiaMs

136
 The Upper Leg Muscles * RECTUS FEMORIS

Rectus Femoris side of ir. The ribbanJike tendon of insertion

ORIGIN Anrerrior inferior Iliac. spine. {This is attaches to the iop of the patella. It lies on+ yet
the origin of the straight tendon. T he- reflected is independent of„ the quadriceps tendon, and
tendon, arising tram [he top of the acetabulum* may be seen during partial knee flexion when
is small and deep, with no effect on surface the quadriceps h contracted.
form.) The lower end of the muscular belly of the
rectus femoris ends approximately a hand's
INSERTION Top of the paid In: therefore, it breadth a hove the mp of the patella. It ends
ultimately inserts into she tibfol tuberosity via highest of all the quadriceps bellies; the vastus
the patdlar ligament. medial is ends the lowest, and the vastus Liter-
ACTION Extends the leg at the knee joint; alls ends at a level between them.
flexes the [high at the hip joint. A depression is present three finger widths
below the anterior superior iliac spine of the
STRUCTURE The rectus lemons is one of the pelvis; it ls especially evident when the thigh is
tour bellies of the quadriceps muscle group. It is flexed at the hip joint. This depression marks
the only twchjoint muscle in this group, cross¬ the point where the rectus femoris dives deep
ing both knee and hip joints. Its belly is long, between the sartorius and tensor fa^un lam,
tlanentJ, and fust torn, sometimes showing a toward its insertion on the anterior inferior iliac
furrow down the middle of its upper hall in spine. The upper end of rhe rectus femoris is
well-developed individuals. The furrow is covered by the sartor ms. When looking at the
caused by the bipen note arrangement of the figure from The side view wuh the thigh flexed
muscle fibers inserting ituu its median tendon las in ihe sitting position), rhe top (anterior)
and therefore divides the belly into lateral and surface of the rhigh is directed toward rhe ante-
medial forms. The lateral form 15 larger, higher, rior inferior iliac spine, the origin of the rectus
section B
and more prominent than the medial form. The femoris, nor the anterior superior iliac spine.
lower lateral edge of the belly can be either I "he rectus femoris sits in a muscular groove
convex or concave (looking at in front view). on the front of the thigh. The vastus initrme-
The inferior end of the belly can be quite dius creates the floor of the groove, and the
tapered and pointed, and also slightly de¬ vasti media I is and lateralis form the sides {see
pressed, as rhe vastt muscles bulge on either cross section)*

SECTION c

237
 The Upper Leg Muscles * BICEPS FEMORIS

.'V J M Adductor mjgttui BI L Bktps femutii—fang head BHS Biceps ferntins—short brad Va Fat
Fc Femur CL Gastrocnemius—lateral head GMa Gluteusttutxirnus HF Headuffibula
JiT Ihatihijl trai t PI Fiantam 5 m Semirnemhraitasus SqSoIcm St Hemitertdmosus T tibia
Tu tendon VL V+isfw* lateralis

1^8
 The Upper Leg Muscles • BICEPS FEMORIS

Biceps Femoris ally passes downward on the outside of the

ORIGIN Lang head: Ischial tuberosity of the knee ro the head of the fibula, sometimes ap¬
pelvis and lhe adjacent lower part of the Mtm- pearing quite wide and bulging prominently. Its
tubemus ligament. Shari head: A line on ihe form may end a short distance above the head
of the hbuia.
middle third of the back of the femur.
In the extended knee, the medial (posterior)
INSERTION Outer surface of the head of ihe edge of the common tendon often produces a
fibula (with .1 tendinous slip 10 the lateral con¬
vertical furrow on the lateral side of the hack of
dyle of ihe tibia).
[he knee, defining the lateral limit of the poplit¬
ACTION Both heads ilex the lower leg at the eal bulge.
knee fuint and then rotate the tibia laterally; the The lower end of the belly of the long head
SECTION a long head also ex lends and assists in lateral ro¬ ends approximately three-fourths of the way
ot is in of the thigh al the hip joint, The long down the [high. Its fibers continue inserting hit
head is a two-joint muscle, while the short head a distance down the medial edge of the com¬
is a one-point muscle. mon tendon. When [he biceps lemons contracts
STRUCTURE ITic biceps fern oris is comprised during flexion of (he knee, the long head be¬
of two heads, 0 tong and a short, and then comes shorter, wider, rounder* conspicuous,
single tendon of insertion. This common ten¬ and separate from the form of the short head.
don* located on the outer back corner of the The form of the Jong head, especially its lower
knee and shared by both heads, begins aponeu- end, now lies medial to the now prominent
mueaSiy on the lower posterior surface of the short head, whose posterior edge (and overlying
belly of lhe long head, leaves the belly, and tendon) has been raised into a ridge. The over¬
then tapers into a strong, wide, flat tendon, The lying tendon now" curves around the short
tendon descends over the posterior portion of head's posterior surface* and the lower end of
the short head. Tile fibers of the short head the long head appears to insert into the medial
insert into the deep aspect of this tendon all the side of the form of the short head. The axes of
way down to the head of the fibula. the forms of the long and short heads are no
In the straight leg, the two heads generally longer in line with each other in the flexed
produce a single elongated fusiform shape knee—the long head is oblique, while the short
(hardy separable from [he scmitendinoiLLS, bui head is vertical (seen Irani the back view ), in
very distinct from the vastus lateral is), and the this position, the lower half of the short head
tendtrn is nor seen. The two heads may, how¬ pit Ik away from the femur, and a depression
forms between this portion of the short head
iECTiON c ever, bu discernible in the straight leg. The
fleshy muscular form of the short head eventu¬ and the vastus lateralis (seen in side view).

139
 Tiie Upper Leg Muscles * SEMIMEMBRANOSUS

INSJDE VIEW

A d M A ditiictur magiws JJ FL Bicep* femork—long head B F5 Bicep* femori*—short head Fa hat

Fe Femur C Gradii* GM Gastrocnemius—medial head G M a Gluteus maxtmus Sa Sartoms
Srn Semimembranosus Sr Semitendmosus

Z40
 The Upper Leg Muscles - SEMIMEMBRANOSUS

Semim em b ranosus form lies just medial to the miJIine of the hack
OR IGIN Upper lateral facet of the ischial tub¬ of the thigh. The lower lateral portion bulges
erosity of the pelvis (kinder and lateral to the during lull knee extension, although it is par¬
origin of the long Head of the biceps femorisj. tially nr completely covered by the popliteal fat
pad. When the fat is thin* this portion of the
INSERTION A htirizontd) groove on the pos¬ semimembranosus contributes directly to the
teromedial surface of tht- medial condyle of the popliteal bulge that develops lateral to the fur¬
tibia (not onto the shaft)* row caused by the Semitetidinosus tendon (only
ACTION Flexes the lower leg ai the knee joint in the extended knee).
and thru medially rotates it; extends the thigh The medial portion of the semimembranosus
SECTION A
.IE the hip joint, does not extend all the way up to the gluteus
maxi mu s» but ends in a puinl where the semi-
STRUCTURE The semimembranosus consists Eendsnosus and adductor nugnns bellies meet.
of a fleshy muscle belly with a cendrm 31 each An oblique tendinous intersection, directed
end* Ir begins superiorly as a wide h+membra- downward and medially and parallel to the me¬
nous"p tendon that is curved side id side to form dial edge of the adductor magmis, is located
a longitudinal channel. The channel extends across the upper part of this medial form. It
down into its lleshy muscle belly, and the belly sometimes separate the portion of the semi-
of rhe semitendinusus lies in tht-n gully. The membraiioMis above ie into an independent
sen t ini rmbranosus ends in a strong, I lac rent'd form*
tendon [has arises from tht- medial side of its When the thigh is completely flexed at the
Hillock- belly. This tendon iv located between the hip joint and the knee is extended, the semi¬
tendons of the serniiunditiosus and gracilis on membranosus Is stretched light. It becomes
SECTION a
the inner hack comer of the knee, but is never thinner and the width of the medial portion of
visible on the surface- The muscle fibers of the its belly forms a wide* depressed furrow be¬
fleshy helly extend downward to the level of The tween rhe bellies ai the semitendmosus laterally
middle of the medial condyle of the lemur, and adductor magnus and gracilis medially+
which brings these fleshy fibers m contact with As the knee jouiE is fully flexed, more of rhe
the fleshy fibers of the medial head of the gas¬ belly of the semimembranosus is revealed on
trocnemius. the hack of the thigh as the sttmitcndifia$u$
The muscle helly of the semimembranosus h belly shortens and slides upward. Much of the
partly superficial on either side of the semirendi- belly of the semimembranosus now lies against
itusus—medial to it as an elongated form cm the belly of the biceps femoris on the lower
SECTION C almost the entire length of rhe inner back cor¬ two-thirds of Ehe back ai the thigh. The upper
ner nf the thigh and latrrdt to the lower portion portion of the scmircndmnstis tendon forms a
of its belly arid tendon. The lower lateral por¬ furrow in the now-exposed upper portion of
tion kes [list above the back of the knee* where the belly of the semimembranosus. At the back
it fills most of the popliteal space and butts up of the flexed knee, the semitenJtnosus tendon
against the biceps femoris. This portion can be moves posteriorly .may from the knee, pulling
thought of as a downward extension of the the skin with it. The lower end of the belly of
elongated form of the sc mi tend i nos us belly situ¬ the semimembranosus is then nu longer sect! on
ated immediately superior to iti the combined the surfacf-

mCDlAL
PORTJdN ON
INNER flACH
CfrltNta OF
TWS&H

241
 The Upper Leg Muscles * SEMITENDINOSUS

M3l/\ 3<]!SW1

■V d M AtUwfa Jr B Ft j3fakpj /twjrjrtf—fewig /wdi/ H F5 ttrtfp* /G-mi ms —$hart fwJ Fa fdf

Fc J G Grtf^/is GM GastrtKiiemius^medialfwtid GM.i Glttitiu nwxiwfis Sj Sartartus
Sm Si Srfwuffl^wojuj T

141
 The Upper Leg Muscles • SEMITENDINOSUS

Semiiendinosus a narrow vertical furrow on the hack of the

ORIGIN Nchi.il tuberosity of the pelvis (in kncet medial to the popliteal bulge (made up of
common with the long head of ihr biceps the bulging popliteal fat and the underlying pan
femora)* of the semimembranosus). The furrow is more
pronounced in the female.
INSE R MON Upper parr of the mcdi.il surface
When I he knee is extended and the pelvis is
of the shall of the tibia* below the medial con¬
flexed forward at the hip joint* stretching the
dyle, in common with the sartorius and gracilis.
hamstring muscles, rhe musdc belly of the semi-
ACTION Flexes the lower [eg am! ihen medi¬ Tendinosis and the lower lateral portion of rhe
ally rotates *t; extends the thigh at the htp joint. semimembranosus immediately below it to¬
STRUCTURE rFhe lung* narrow, fleshy belly gether produce an elongated raised form down
5ECTJ0N A
of the wmhendinosirt ends two-thirds of the the back of the thigh |ust medial to the midline.
way down the thigh at its tendon and sirs in the When the knee is flexed, the inferior end of the
shallow, longitudinal muscular groove formed belly of the semitendinosus rises considerably
in the semimembranosus muscle. It is located (exposing more of the belly of the semi membra-
I use medial to the midline of the hack of the nostis). The upper portion of its long tendon of
ihigh. Its tong, cord!ike tendon of insertion be¬ insertion then becomes a furrow, and the lower
gins on the itu'didl side of its hdly, passes down portion of the tendon becomes a very promi¬
on the middle of the lower half of the belly of nent raised ridge. In this position, the semiten¬
the semimembranosus, continues behind the dinosus tendon on the medial side of the back
medial condyles of the femur and ubia, and fi¬ of the knee projects further posteriorly than
SECTION. &
nally curves forward lying against the medial does [he biceps fern oris tendon on the lateral
head of the gastrocnemius) to reach its inser¬ side of [he back of the knee.
tion- This tendon becomes very prominent dur¬ The superior end of the belly of the semiten-
ing knee 11 ex ion as it moves away from the dinosus maintains its width as is puses under
back of the upper leg (it al$o moves away from rhe lower edge of the gluteus maximum At this
[he sentiment bra n< wus). When the knee joint is point, it is m contact with the adductor magnus
extended, she tendon is pulled tight, producing medially, nor the semimembranosus

SECTiDM C

ANt<-rohX

EXTENDED FLEXED
KNEE

243
 The Upper Leg Musctes * ADDUCTOR LONG US

BACK VIEW

AdB Adductor brei'is AdL Adductor fangus Fai-Ji Fc l emur FT femoral tmnflc fal GGradiis
IL Inguinal ligament P* Pectin*#* ?S hibk symphysis Pti Pubis &.P Rectus fiemoris S■ Sartonus
VM mrdialis

144
 1 The Upper Leg Muscles * ADDUCTOR LONGUS

Adductor Longus mAgnus. The adductor longus passes from the

ORIGIN Small round area on the outer surface front of the pelvis to the hwk of the femur. Et
of the anterior portion of the pubic bone of the lies on the front of the mass of the adductor
pelvis, just below the pubic tubercle and fust group, medial to the fat and neurovascular bun¬
lateral to rhe pubic symphysis dle of the tcmoral mangle. Interiorly, it dlsap^
pears under rhe sarrurius. It is usually not de¬
INSERTION A vertical line on the middle
li ned on the surface since the adductor muscles
third of rhe hack of the lemur {on the medial
usually appear as a single mass rather than as
lip Ei| she linca asperaj,
individual musd.es. However, when it does
ACTION Adduct*, tlesrv, and medially rotates show up, is is seen a* an oval or triangular
the rhigji. swelling on the medial portion of the front of
STRUCTURE The adductor longus is a long* the upper hall of she thigh. This form narrows
SECTION A.
triangular muscle, originating with both fleshy as if nears its origin on the pelvis.
fibers and a strong tendon. The tendinous por¬ When both tendons of origin of the adductor
tion is often conspicuous in the groin when rhe longus and gracilis arc wen in the groin, the
legs are apart. Dis tally, the fleshy belly thins rounder (more cylindrical) adductor longus ten¬
into a wide, Hat tendon where is inserts into the don is located anterior and lateral to the flat
femur between rhe vastus media lis and adductor gracilis tendon.

SECTION &
 The Upper Leg Muscles * ADDUCTOR MAGNUS

A d B Adductor brevis Ad L Adductor tongas A d M A dductar magitus B F L Biceps fvmom — tong bead
BPS ftkepf femoTis—short bead F afar Fc Femur G Granin GFo Cluteat fold
Ci M.i if lu tern maxim us Pc PetitwitL Sin m imem b tj Si Semitcndinosm

2,46
The Upper Leg Muscles • ADDUCTOR MAGNUS

Adductor Magnus to attach to its bug line of insertion cm rhe

ORIGIN A line begin fling on the lower lateral back of the femur* Two-thirds of the way down
portion of the ischial tuberosity* extending the thigh, the inverted conical form of the ad¬
along the inferior edge of the lateral surface uf ductor magnus differentiates into a rounded
tendon (not visible), which inserts into the ad¬
the ram Lis of the ischium, and then continuing
ductor tubercle on the top of the medial con¬
forward along, the posterior part of the ramus
dyle of the femur.
of the pubis {|ust above its inferior edge}.
Only a small triangular area of the muscle is
MM SECTION A line down [he middle of the
actually superficial. In low-fat individuals* at*
hack of the femur, beginning at die level of rhe superficial part can he distinctly seen on the in¬
lesser Trochanter, lending to mid passing down ner back comer of the upper end of the thigh
the luiea as pent, and the adductor tubercle of when the pelvis is completely flexed forward at
rhe femur, just above rhe medial condyle. the hip joint and the knee remains extended. In
ACTION Powerfully adducts the thigh* Grav¬ this position she separation between the adduc¬
ity, however, usually adducts ihe thigh in the tor magnus and (he adjacent semitetidinosTj*
standing position, with [he adductor magnus re¬ and semimembranosus is clearly seen. It is only
maining relaxed. The oblique anterior fibers occasionally distinguishable from the overlying
hippet or obturator portion) assist in Ilex ion of gracilis. In this same position of full hip ilex ion,
the thigh* while the long* vertical, posterior por¬ the adductor inagnuv m clearly wen emerging
tion (lower portion or ischial head) assists ui from under cover of the gluteus maximus. h
extension of die thigh, especially if the hip joint disappears from view almost halfway down
has already been flexed (it functions like a rhe thigh between the gracilis and semimem¬
hamstring hip joint extensor). branosus.
When the thigh is first toitiplecely Hexed .it
STRUCTURE The adductor magnus is a large
the hip joint and the knee is then extended as
powerful muscle located an rhe inside of ihe
thigh. Its inferiorly pointed, somewhat conical far as possible, the semimembranosus is
stretched tight and creates a wide, depressed
form contributes substantially to rhe mass of
[he adductor group, which in turn blende with furrow; the soft form of the adductor magnus
[he hamstring group to create the large oblique bulges medial to this furrow.
The small uppermost portion of the adductor
form on the back of the thigh (directed upward,
magnus is called the adductor minimus. It is not
medially^ and forward). The long internal edge
visible on the surface,
of the adductor m.ignus passes between the
masses of the hamstring and quadriceps groups

z4?
 The Upper Leg Muscles * GRACILIS

inside view

AdB Addurtur breva AdL Adductor longas AdM.Adductor magniii Fc Femur GGratiiii
CM GttstrtKnemius—medial head GMft Glutens rmticimus PS Pubic symphysis Pii Pubis
Sj Sart&rivs Sm fkrnimmbrmQttts Si StmUmdinasus T Tibiti VM \ jstu$ mtdlahs

2.48
 The Upper Leg Muscles * GRACILIS

Gracilis straight teg. Only rarely is it seen on the inside

back corner of rhe knee when the lower leg is
ORIGIN Inferior edge of the midseeuon of die
flexed at the knee and medially rotated. When
puhlc arch between the pubic symphysis and
visible in rhis position, the gracilis tendon is
ischial tuberosity,
directed along the inside of rhe thigh toward
INSERTION Superior part of the medial sur- the mi dime of the base of the pelvis, whereas
face of the shaft of the tibia, below the medial the more proniment semi tend intis us tendon is
condyle, in common with the insertions of she direeted obliquely toward the ischial tuberosity
sartorius ami setnitendinctsus. of the pelvis and is situated more laterally. Both
ACTION Adducts the thigh at the hip joint; tendons arc easily pal pa red an the Hexed knee
Ilexes the lower leg at the knee joint and then when the muscles are tensed.
assists in medial rotation of the lower leg. Although the thin muscular form of the gra¬
STRUCTURE The gracilis is a thin, wide, cilis for the most pan blends wjih the mass of
the other adductor muscles, it can often be seen
bandlike muscle. Its flattened belly is wider
prominently at its tendinous origin at the pelvis
above and tapers infcriorly. Silting on the inside
when the legs are apart, just posterior and me¬
of lhe thigh, this muscle is the most superficial
dial to (he rounded tendon of origin of the ad¬
and medial of the adductors. Beginning from its
ductor longus. The belly of the gracilis may oc¬
thmN tendinous upper end (approximately two
casionally become defined on the surface*
inches wide), irs belly passes down the inner
ln the front view, the gracilis disappears be¬
surface of the thigh and develops into a
hind the vastus mediahs two-thirds of the way
rounded tendon two-thirds of the way down
down the thigh.
the thigh. I he lower tendon is never seen in the

5 ECTFON B

SECTION C

SECTION D

M9
 The Upper Leg Muscles * SARTORfUS

Add Adductors A djL Adductor iortgm A d M Adductor magma A SIS ArttttiQ? superior ili&c $pint
F a Taf Ft Femttr GGradlh GM Gastruiftrrmwi— trutdinf he&d GMt Glnteui meJins
1L Inguinal ligament ip Itbpsoas Pq Ritrifa Fc Pfctmew PLi fitullat ligament
RF Recta* femoHs Sn Sarlnnus Sm Scmimcmbram>sus St T 1'ihu
TFL Tensor fascia lata VM Vastus mediplh

5
- °
 The Upper Leg Muscles * SARTORIUS

Sartorius jo ini on the surface of the medial condyle of (he

QfiiGl N Just Wow the tip of the anterior su¬ tibia, and (he muscle continues via its flat ten¬
perior iliac spine (““from point of the pelvis*')* don eli its insertion on the shaft of the tibia.
in the upper hah of the notch between the ante¬ This [endon is not visible. The distal fleshy por¬
rior superior and anterior ulterior iliac spines. tion of the sartorius adds a muscular fullness to
the inside of the knee. From the front view of
INSERTION Superior part oi the medial sur¬
the thigh, the sartorius is usually nor visible ns
face of the shaft of the tibia, below the medial
it hooks behind the vastus medial is, bui re¬
condyle, in common with the insertions of the
appears below it on the inside of the knee.
gracilis and semuendmosu*.
When looking at the inside (medial) view of the
AC T I ON Strongly flexes, weakly abducts and knee, rhe anterior edge of the sartorius is on or
laterally rotates the thigh at the hip fotni, flexes lust posterior 10 the midline (front the front
the lower leg and then minimally rotates it me* profile ro the back profile of the knee).
dially. It is a powerful flexor of iht tlngh, even As the knee ioint is flexed, the sartorius gets
though it is narrow, because it lies some dis¬ shorter and thicker. When the knee is cora-
tance in front of the hip joint. pleteJy hexed, it either merge* with the bulging
STRUCTURE The sartorius is a long, narrow, form ol rhe adductor muscles or creates its own
thick, rihbonlike muscle that spirals down the wide form on rhe medial surface of die thigh. In
thigh, Ee begins on the from of the hip and ends this position* a skin flexion fold develops on the
on the inside of the knee region. It usually mis back of the knee and cuts across the distal end
inconspicuously between the masses of The of the sartorius. Also during knee flexion, the
quadriceps and adductors when rhe leg is at lower porrion of the belly of the sartorius
rest. When the thigh is flexed and laterally ro¬ moves posteriorly and away from the distal end
CTION El tated at the hip joint, and the knee is also ex¬ of the vastus media I is h and a slight depression
tended k the sartorius becomes prominent as it forms between the two muscle* on the inside
lifts utit or the valley between these bordering surface of [he knee region.
muscle masse*. Its upper portion lies on the The upper end of rhe sartorius, located he-
belly of she rectus lemons and is in contact tween the anterior superior iliac spine and ihe
laterally with the tensor fascia lata for a short line of the thigh (genital fold), joins with the fat
distance below its origin. The very superior ex¬ of this region to form a short, narrow, indepen¬
tremity of the sartorius tapers slightly before dent form in the extended hip joint.
attaching to the pelvis. The pcs anscrinus is a flattened aponeurosis
From rrs origin on the front point of ihc pel¬ made up of the combined inserting distal ends
vis, the sartorius passes downward and inward of the tends ms of the sartorius, scmiicndinosus,
SECTION C
lo the medial surface of the (high. It then de¬ and gracilis, h does not create any form on the
scends vertically, hooking behind the vastus me* surface, -in J the form of the libia predominates.
dsnjisp The fleshy fibers end fust below the knee

SECTION 0

SECTION E

i 5
* *
 The Lower Leg Muscles

(ArC-HFLLE 5
TEnjON

DOU&LE,-CuFAv£C>
SURFACE

POST
WOSCLE \
MASS ^
INT£ftqSSEOUJ
CA&lES QPi- TP
EJEHrNft QP6 O
ANALL
<
ul
TJD.JA
&
iZ

CROSS SECTION
THROUGH ANKlE

F0fttt5 \ i H
ON £\ -*\
OUTSIDE Vs'
O.F x T
LOWER
Ufi
COfAFART METNT 6 &
1
O
J

L tc

&A5TR0C o.

L
A
'-Li

cJ
t le- Aj 5 FORMS
an t. 1
♦ t }-■ T- OUTSIDE VIE*/-UPPER CALF
V&IG-'f-
\LON-

GA5TR.

pEtf *SXT HaEU- LONG

iUPERf3S
RtTiHAt,
TF& Pair.
L, UPPER
inferior JNF^EftiOR [ &AND
EXTENSOR
RETINACULUM RflTlKiAC.
FLtXOft k LOW Eft
ALTtNAC- , SAND CAlCAn.

INSIDE VIEW front VJkW OUTS JOE VJ EW

AT Achiihs tendon EDB Extensor tiigit&rutrt brevis EDL Extensor digit orum k\ ngus
E H L Extensor halfueis longus F Fibula FDL flexor digttorum longus PB Pe rone us brevis
PL Petotteus htngus PT PerQttfHS tertius T Tibia TA Tibialis anterior TP Tibialis posterior
 Th& Lower Leg Muscles s PLANTARI3

AT Achillas tendon BFL Biceps femom -hug head BF$ Biceps ferncris—short head Fa bat
F c Femur G L Cast rocnmhi$ - lateral head G M Gastnnnemms—medial head VI Planmm
Sm 5rmpwieffitrjifojwi Tn

*54 I
The Lower Leg Muscles * PLANTARIS

Plantar is slightly to the muscular column of the lateral

ORIGIN Lower end of the Literal suprauoudy- head of the gastrocnemius. Its extremely long,
Lvr rfdge of the femur, just above the lateral thin tendon at hrst lies deep between the sole us
condyle 'immediately above the origin of the and gastrocnemius and then emerges on the me¬
I ate nil head of the gastrocnemius]. dial side of the Achilles tendon. This tendon is
too thin to he seen on the surface, but when thr
INSERTION Very small area on the posterior
knee is partly flexed, the foot plantar flexed,
surface of the calcaneus, mediaF to rhe insertion
and pressure is placed against the heeh pan of
of the Achilles tendon,
the muscle belly of the plarttaris may be seen on
ACTION Weak action of flexion of the knee the back oi the bent knee, fust lateral to the
Joint and plantar flexion of the foot, midi ine.
STRUCTURE The belly of the planrans is
slender, short, and fusiform; it contributes only
The Lower Leg Muscles • GASTROCNEMIUS

AT AdtHfas U'rtJt.m BHL fismorrt—hng hrjd BF S Bu r+ps femora -- a hurt fuad !■' Fibula
Fa }:dt FDL Flexor digtiarum fongus GL Ciistmcuvmttn —f&ttral ht&d
C M liastrQntcmiui—mediat bead G Te Cosfret titmtm tmdrut H F ! f. ,id uf fibula
LM Lateral mulktrfnf MM Medial malleolus PB Penmens kwh PL Pcronem longwt PJ Phw&ms
Pa Popliteus Sm Semimembranosus So Sulem St Semite rid mosus T Tibia
TF Tem/mews expamir>n " On soleus
 The Lower Leg Muscles * GASTROCNEMIUS

Gastrocnemius rounded* muscular column* separated from its

ORIGIN Lateral head: A fact! on the hicnl fellow al the back of the knee. Tliey soon come
side the Jateril condyle of she femur and the together* with a cleft between them that usually
posterior surface of she shiift immediately above disappears at the middle of the belly. When the
this area. Medial head: A beer on the upper muscle is tensed, the columns separate from the
pan of the medL.it condyle of the femur and the rest of the head. Togerher they form a raised,
adjacent roughened area above it* thick, Heshy V on the back of the calf. The me¬
dial column is mote vertical, the lateral more
INSERTION Middle pan of the posterior sur-
oblique and sometimes larger.
face of the caJcaneu*, in common wirh the *t*-
The separation of the muscular column from
SECT f OM ^ leus (the insertion of the Achilla tendon),
the rest of the head us caused by an aponeurotic
ACTION foui free: Plantar Ilexes the him sheet of tendon that begins at the origin of each
{points the foot). Foot on ground: lenses the head at the femur and expands downward onto
heel which lifts the body. The psrrucncmiiis the posterior surface of the upper portion of
may assist minimally in Hexing the knee joint, k each head. This nonelastic tendinous sheer does
will not plantar Ilex the foot when the knee is not cover the column, and when the gastrocnc^
completely flexed (because it is then actively in¬ mins: contracts, it prevents the fleshy muscle
sufficient). mass immediately deep to it from expanding,
STRUCTURE t he gastrocnemius is made up but allows the exposed muscular column to
of a lateral head, a medial head, and their sin¬ bulge, tli c a re a o f mu sc le resir i cred by the apo¬
gle tendon of insertion. The medial head is neurosis appears flat and planar in the con¬
SECTiOH 6 larger, descends lower* and wraps around the tracted muscle. A sharp furrow may separate
leg more toward the front than dtws die lateral the column from the flat, tendon-covered area.
head. The lower lateral edge of the lateral head Prom the side view (medial or lateral), the
may be an oblique straight line* rather than 4 posterior profile of the gastrocnemius is seen as
rounded teardrop. The muscular heads end at. a convex double curve—the muscular columns
or slightly above, the middle of the leg, where bulging above* the remainder of the heads be¬
they attach to their tendon. The tendon is wide low. in irom view, the inside profile of the me¬
and thin at its upper end and: becomes narrower dial head is directed toward the center of the
and thicker as it descends. It fuses with the ten- patella. From the inside view, the lower edge of
dun of the sulcus lying immediately deep to it, the medial head ranges from a simple down¬
SECTION C ward curve or a straight line to an S curve.
forming the Achilles tendon (see Soteus),
From irs origin, each head begins as a thick.

257
t
 The Lower Leg Muscles - SQLEUS

AT Achilla tendon IJFS Bleeps femoris-fhort bead Y fibula Fa Fa: FDL Flexor digttorum iwgus
T H L Flexor halloas fartgus C L Gastmcnemha - lateral head GM Gastrocnemius - medial head
C Tc Gastrocnemius tendon on soleus HF Head of fibula t. M Lateral malleolus \1 M Medial malleulut
PB Pcrsmcui brevii PL Pmantio lortgus PI Ptantarif So SoUus 1 Tibia

I58
I
 The Lower Leg Muscles * SOLEUS

Soieus downward is called the: Achilles tendon (tendo

ORIGIN Posterior surfaces of the head and up¬ calcaneus). Ibis flattened tendon is narrowest
per third of the shaft of the fibula; from a ten¬ (about three-fourths of an inch) and most
dinous arch connecting the head of the fihuh 10 prominent (most defined* at the level of the lat¬
the tibia- and from tlu- rained sulcal tme on the eral malleolus. U widens slightly before h in¬
hack of the tibia. Thu tendinous arch is contin¬ serts* There is a fat-filled interval between the
uous with the soIcnt line. Achilles tendon and the back of the .inkle
bones. The medial and lateral edges of the com¬
INSERTION Middle part of the posterior sur- bined tendons of the so leu s and gastrocnemius
face of the calcaneus* in common with the gas¬ lying on the helly of the sotcus, may compress
SECTION A trocnemius (the insertion of the Achilles ten¬ the soleus and create two vertical furrows when
don h the calf muscles are contracted. The form of the
nolens is then divided into three vertical muscu¬
ACTION Foot free: Plantar flexes the fnor
lar columns: two narrow columns on either side
[points the foot). Foot oft fh? ground: Raises
of the edges of the tendon and a wide* raised
the heel, which lifts the body* and by contimi-
relic! up the middle of die muscle between the
mis contraction* prevents the body from falling
edges.
forward in the standing position.
In side view, the back profile of the muscular
STRUCTURE The toleut is j thick muscle lo¬ belly of the coleus is either straight or only
cated on the hack of the lower leg; it joins the slightly convex. It meets the Achilles Tendon at
SECTION &
gastrocnemius to form the gall muscle group. U a slight angle, and below thi* angle the profile
is thickest at its middle, where itv flattened form appears as a straight line when the calf is tensed
curves around the deep flexor muscles of the or as a sLabile concave line when relaxed (usu¬
toot ;ind toes. The medial side of the belly pro¬ ally with the foot partly plantar flexed). After
jects more anteriorly [on the inside of the lower rhe tendon inserts, ihe bony calcaneus of the
leg) than docs the lateral side. Its upper portion heel bulges posteriorly, and a second bulge be¬
is covered by the heads of the gastrocnemius. low the calcaneus is created by the far pad un¬
The muscle m.iss of the sulcus tapers interi¬ der rhe heel. In the front or rear view, the so-
5 E C T J 0 ft C
orly and descends quite low, reaching a level leus often forms the profile on the outer side of
|Usl above the ankles. Itv tendon, which con tin the upper half of the lower leg (the pemneus
Lies on ten its insertion on the heel, begins quite brevis forms the profile on the lower half ). The
high on the posterior surface of the belly. It medial side of the helly can be seen on the
soon fuses with the overlying gastrocnemius middle third of the lower leg from the from
tendon* and this combined tendon from mid-leg view.

section u

< i£
CL

PIED *-y LflT

CROSS 5ECTIQN
 7>e Lower Leg Muscles * TIBIALIS ANTERIOR

E D L Extensor digrtontm lottgus EH L Extensor haljkat longiis F FHmta 11T iliotibial tract
M M MeJwl malieatks l*L Firemens longtit PLj Fate liar ligament T Tibia TA Tibialis anterior
r 1’ TitnaUsposterior TTu Tibiai tuberosity

160
 The Lower Leg Muscles * TIBIALIS ANTERIOR

Tibialis Anterior eversion of the foot (as they bulge}. During full
ORfGl fci Lateral condyle of the tibia, lateral plantar lie\ion of the font, the very top ends of
surface of the upper half of the shaft of the these muscles form a depression just below the
tibia> adjacent interosseous membrane, and the lateral condyle of the tibia (because they have
intermuscular septum between ihis muscle and been stretched mill, while the superior end of
the extensor digirnrum fungus. the peroneus bngus bulges (became it has been
shortened, thus becoming thicker).
INSERTION The h(ittom of the medial arch of
Hie muscle fibers of the lower end of the
tin: foot, midway from the from to the bach of
tibialis anterior belly continue insert mg for j
the foot; specifically, into the medial and bot¬
considerable distance onto the deep aspect of its
scctiqn A tom surfaces of the media I cuneiform hone and
tendon* This produces the elongated taper at
into ihe ba.se of the first metatarsal bone*
the inferior end of the belly. The tendon is wide
ACTION Doiflexes and inverts the toot. Dur^ and flattened where it begins at ihe lower end
ing walking, it Controls the descent of the foot of the belly; it gradually rounds off and be¬
after the heel strikes the ground. comes quite prominent as it descends. On the
STRUCTURE Thick and fleshy above, the tibi¬ trout of the ankle, rhe tendon is located medial
alis anterior tapers into its long, prominent ten¬ to the midline, If widens again pist before ii
don two-thirds of the way down the lower leg. inserts At the ankle |oint* ir is held in plate by
The muscle belly is rhr first form lateral to the the inferior extensor retinaculum, which may
tibia l tuhcmviiy and an tenor edge (the shin) of occasionally be seen stretched between this ten¬
the tibia, Fhc sharp edge of die shin is not cov¬ don and the medial malleolus of the tihi,s when
ered by this muscle belly, hi side view* the muv the fool is inverted.
ele belly bulges forwardp .interior to the *,hnnB to With ihe fool and big toe flu on the floor*
form the front profile of the top hiilf uf the the tendon of die tibialis anterior is the most
k>wl-r leg. It runs down the Outside of the shaft anterior tendon at the from of the ankle. It
iit the tibia. Its tendon then crosses diagonally spans the gap between the lower end of the
medially i in front of the ankle joint toward its ohia and the foot bones (over the ankle joint).
insertion into the medial arch of the foot- The I he entire tendon can occasionally form .1 con¬
tibialis anterior therefore subtly spirals down cave curve affing the front profile of the lower
the lower leg, passing from the outside of the half of [fir lower leg seen m side view). This
knee in the inside of the foot. concavity is the inferior continuation of the
The lateral fibers of the upper portion of the convex profile of the belly above. Careful exam¬
belly thin out and partially cover the upper end ination of the lower half of the lower leg will
of the extensor digicomm longus, obscuring the show that ihe Front profile is often made up of
separation between the muscles and creating a series of straight lines. This is caused by the
one wide form (set cross sect ion), The extreme l miM net ion of the tendon at several points by
SECTION D upper ends of these two muscles can at tunes be bauds of the extensor retinacula, separating the
seen separately during strong dorsi flexion and tendon into short, straight portions*

SIDE VIEW POSTMAN T.

i
l6t
 The Lower Leg Muscles * EXTENSOR DIGITORUM LONGUS

E11B f-.vttmttr digit* ttuin brei/ts KI > L Extensor digitnru m fcwgus E H H Extent&r hjliuca hrevti
EHL fLvimsnT haUuds hngus H Hbub HE Head nf fibula (Co Intermediate cuneiform
11T flmtihidt tract LCu Lateral cuneiform L M lateral malleolus M \ \rtatatsat
PB AmJfKti* bmtis PI. PetQfitm langus FT Perntteits icrims T Tibia T\ Tibialk anterior

i6l
I
 The Lower Leg Muscles * EXTENSOR DIGITORUM LONGUS

Exlensor Digitorum Longus oi the peroneus remits, which although a sepa¬

ORIGIN The outer side of the Litir.it condyle rate muscle, is somewhat attached.
u| the tibia; the upper three-fourths of the .infe¬ On the lower portion of the lower leg, the
rior surface (or front edge} of the fibula; the muscle belly narrows, and the kmr tendons re¬
adjacent interosseous membranes and the inter¬ main close together. They appear in he a single
muscular sepia between this muscle and the ti¬ combined tendon, or wide "cable, * as they pass
bialis anterior on one side and the peroneal dow n the tronI i>f the ankle, lateral to the mid-
muscles on the other side. line- Ibis cable becomes most prominent when
the h.H.it is everted. When the combined tendon
INSERTION Top surfaces of die middle and
reaches the dorsum of the foot, us four tendons
distal phalanges of tm^ two through five (to the
separate and diverge; they may deafly he seen
lateral four toes; the extensor digitorum longus
on the top of the foot when the toes arc ex¬
SECTION A does not go to the big rne)+
tended. Distal I yf the tendons disappear from
ACTION Extends toes two through five; Jorsi- sight on top of the middle of the proximal pha¬
flexes [he foot at the ankle joint (raises foot) langes, as they widen into a tendinous expan¬
and weakly evens it (faces sole outward). The sion, 1 he digital extensor hood* which continues
toes separate when they are extended (they onward to the insert km, The visible tendon of
come together when they are lfe*cd)+ the little toe is directed toward the head ot its
STRUCTURE The Jong, thin extensor digito- metatarsal, riot toward the tip of the toe. The
rum longus actually consists of four combined others are directed straight toward the ends of
bellies and their tendons (one to each of the the toes.
lateral lour toes}. ITie upper portion of the On occasion, the very superior up of the
muscle is usu.ilk not seen, as it is partly cov¬ fleshy belly of the extensor digicomm longus, ar
SECTl&N a
ered bv the tibialis anterior,, which usually its origin on the lateral condyle of rhe tibia (be¬
blends with it (dense fascia covering the bellies tween the tibialis anterior and peroneus longusL
akn obscures their separation). Hie extensor may he seen. It will appear as a short, raised,
digiunrum longus is lipii peri rate—it develops its linear form when the muscle is contracted to
tendons along the anterior edge of its belly, be extend the toes (the entire muscle gets shorter
ginning |lisi above the midpoint of the lower and thicker]. If the toes are flexed, the extensor
leg. The belly itself ends approximately three- digitorum longus will become stretched, and
fourths of the w ay down the lower leg. Its elon¬ this same area will show up as a narrow, verti¬
gated form is continued inferior]y by the belly cal depression.
SECTJDN C

BEi.LV
SECTJON D

single
■ CABLE
AT ANKLE

SECTION E.

14 T£NB0N5
u M FOOT

SECTION F

163
i
 The Lower Leg Muscles * PERONEUS TERTIUS

Peroneus Tertius ward alongside the tendons of the extensor digb

(HbuTaris Teriius) torum longus, These tendons all pass down the
front of the ankle together (lateral to the mtd-
QRI G I N Lower rlnrd of the anterior surface of
hnc) and then separate on the dorsum of the
the shall of the fibula not including the lateral
foot. The flattened tendon of the peroneus ter-
malleolus), the adjacent miems&eous membrane*
tins then passes over rhe belly of the extensor
and the intermuscular septum between it and
Jjgitnrijiti brevis and widens |ust More it fi¬
the pcroncus brevis,
nally inserts. This subtle tendon is seen only
INSERTION Variably into the dorsal surface occasionally* cither as a raised tendon or as a
5£CT\QH A of the fifth metatarsal bone <of the little toe) at furrow on the belly of rhe extensor digitnrum
its base or slightly forward of it* brevis.
ACTION DorsifleXrt (lifts) and everts the font, Superiorly* the peruneus itrtius lies against
the peroneus brevis, but the forms of these two
STRUCTURE The belly of the pemneus ter-
musdes usually blend together. The pemneus
rius can he visualized as a downward oontinua-
ten ins then passes downward and slightly for¬
ciuu of the form of the belly of the extensor
ward, separating from the peruneus brevis and
dipttorum longus. Its fleshy belly descends as
exposing the lower portion of the shaft of the
tow as the lateral malleolus. Its tendon begins
fibula.
on the front edge of its belly and passe:s down¬
section 6

DM Deep muscle EDB Extensor digitorum brei'is EDL lixtensor diRttorym h*tgu$
F H B Bxtenwr hdtv&s brevis LHL Extensor hixtiueb tmgm ? fibula L M Lateral malleolus

164
1
 The Lower Leg Muscles * EXTENSOR HALLUCIS LONGUS

exsensor Hallucis Long us quite prominently as it descends along the up¬

ORIGIN Middle half nf the medial surf a or of per surface of the foot on top of the metatarsal
the fibula (medial to the origin of the extensor of the hig foe. It finally disappears fust before
digitoruin hingus) and iht- adjacent mtemsscum reaching the in nr phalangeal joint of the big toe.
membrane. In the side profile view of the ankle, with the
foot standing fiat on die floor, Ehe most anterior
INSERTION Tlic repp of the base of she distal
tendon is that of the tibialis anterior. When the
phalanx of the big roe.
big toe is raised (extended), the tendon of rhe
SECTION A ACTION Extends the big roc? assists m dorse- extensor hallucis longus becomes the most ante¬
tics ion nf the foot. rior tendon.
STRUCTURE The belly of the extensor halite- With the fixkt dorssflexed and the big toe al¬
cis longus for the must pan lies deep in ihc ternately flexing and extending* the low er end
lower leg. I is tendon, beginning on the ante nor of the belly of the extensor hallucis longus. can
border of its muscle bdly, emerges from be¬ be seen sliding up and down at the poim where
tween The extensor digitorum lungus and tibialis it emerges on the front of the lower leg—it ap¬
SECTION B pears as .i depression when the toe is extended
anterior roughly two-thirds of the wray down
the lower leg* but is usually not dearly seen at (the belly shortens and its lower end slide* up
this point. When the hig toe is extended* the and disappears) and as a small* elongated bulge
tendon becomes visible as it posses down the when the toe is llexed (the ten Jon pulls the
in id line of the front of the ankle and shows up belly down, exposing it).
FRO NT
view

TdfUAUJ
GlGiTMutt ^.rJ T£ KiCH
L0W&U&

H*-CUUS LO*i&V$

M MeUtarsal PB Feroimtf brews PL Pcmneut tongus FT Peraneus itrtiu$ T Tibia

TA Tibialis artlermr
 The Lower Leg Muscles ■ PERONEUS BREVIS

A I Achilles tendon EDB ExtenstJt digifortmt hr<m* EDL Extensor digitant m Umgtts h Fibula
l a Fjj PHL Ht'xtrr kjiiucin lutigus LM tttfltitoins PB Peroue.its hrei'js IJL. Ftroneuslongu$
PT Frtmwus tertian Sn Srlien s T Tihht

2,66
 The Lower Leg Muscles * PERONEUS BREVIS

Perooeus Brevis posterior form is sometimes joined by those fi¬

bers of the pemneus longus that travel down
ORIG IN Lower two-Thirds of the lateral stir-
the back edge of its tendon. The lit*shy fibers of
Lice of I he shaft of the fibula (except the very
the pemneus brevis continue all the way down
distal end of the shaft) and the intermuscular
to the bottom of the hack of die lateral matko-
septa on both the anterior and posterior titles
hiv After us tendon passes down the groove on
of its belly.
the hack of [he lateral malleolus, deep to (ante¬
INSERTfDN Enlarged base of thu metatarsal rior to) ihe tendon af the peroneus Ion guv ic
SECTION A
bone of the Kittle .tilth] foe, on its dorsolateral sharply turns diagonally forward at the bottom
surface, of the mallcobs and heads toward its insertion
ACTION E verts an id plantar Hexes t he loot. on the middle of the outside of the foot, It fans
out as it inserts.
STRUCTURE TTie peroneu* brevis is an elon¬
The tendon of the pemueus bngui is usually
gated^ Hastened muscle located on she outside of
more prominent for a shun distance immedi¬
the lower half of the lower leg. The belly of the
ately below the lateral malleolus, bm then the
larger peroneus lungus covers the upper portion
tendon of the brevis often becomes more promi¬
section a of the belly of the penmens brevis, while the
nent a little further along on the outside of the
tendon of the former lies on the outer surface
foot.
of the latter. When the pert metis bngiis and
The belly of the pemneus brevis forms the
h rev is muscles are relaxed, they create a single
outer profile of the lower half of the lower leg
elongated form on the outside of the lower leg.
Iroin the front view, Lip to the point at which
When they are tensed, the tendon of the Imigus
the inferior portion of the tendon of the pem¬
presses into the belly of the brevis* dividing it
neus longus becomes raised arid visible [above
mtn vertical anterior and posterior forms. The
the ankle}.
SECTION c anterior form i^ often more prominent. The

.TENDON OF
PCftONLUS
LOND-U3

BEll y AN TEA |0 R +■
POSTERIOR
&VL&KS OF
PE RPNEy-5
PKEVJ5

LATERAL
MALLG0LU5
(riflULAJ
TENpON
POSH ANT.

SIDE VIEW
 The Lower Leg Muscles ■ PERONEUS LONGUS

AT AMiles tendon R F$ Hh:eps fetmms — thorl head L: DB Extensor digit* trnm brevis
EDL Extensor digitorutu hngus F Fihufj FHL Fkx or haliucis longn* H F Head of fibula
JtT ihutihui trait LM Literal tmlUalm E*B Pertmem brevis VL Ferorteus hnigus FT Feroneus Urtius
So Salens T Tibia TA Td*ulis anterior

168
*
 The Lower Leg Muscles * PERQNEUS LONGUS

Peroneus Longus attach into it, The upper portion of the tendon
ORIGIN Lateral surface* uf the head and up¬ then registers as a vertical furrow separating the
per two-thirds uf ihf shalr of the fibula, a small belly of the peroneus brevis into narrow ante¬
area un the lateral condyle of the tthias and thu rior larger: and posterior (smaller) vertical
intermuscular septa on both sides of the muscle, bulges. The lower port ion of the peroneus Ion-
gus tendon becomes a prominent vertical raised
•INSERTION Under ihc foot into she base of
ridge passing downward behind the lateral mal¬
the metatarsal bone of the big um and into the
leolus of the fibula. At the ankle, she tendon
medial cuneiform (tarsall bone.
remains visible as it passes down the bony
ACTION Everts and plantar flexes the foot. groove on the back uf the lateral malleolus,
SECTION A Important in maintaining the arches of the foot. posterior and superficial to the tendon of the
STRUCTURE The flattened, elongated, ovoid peroneus brevis. It hooks forward on the out¬
muscle belly of the penmens longus sirs on the side of the foot below the la serai malleolus,
upper hah of rhe outside of the lower leg, white running parallel yet Heading deeper than the
its tendon lies on top of the peroneus brevis on peroneus brevis tendon, le finally disappears as
the lower halt of the leg. The tendon begins it curves under the outside of the skeleton of
approximately at the middle ol the outside of the foot to head toward its insertion* Except for
the lower leg. "Hie anterior fibers of the belly a short distance immediately below the lateral
insert into the tendon's anterior edge for a short malleolus* the tendon of the penmens longus is
SECTION 0 distance at the Upper end of the tendon, usually less prominent on the outside of the
whereas the posterior fibers, continue further* toot than is the tendon of the peroneus brevis.
inserting into the posterior edge of the tendon Tiie outside profile of the upper half of the
at a level two-thirds to three-quarters of the lower leg (from the front view) is usually
way down the lower leg [sometimes they coti- caused by the suleus, not the penmens longus.
tin He all the way to the lateral malleolus). The simiJl portion of the peroneus longus ihat
When relaxed* the peronrus longus and attaches to The lateral condyle of the tibia may
brevis combine to create a single elongated show up as a distinct thm form when the mus¬
SECTION C
form on the outside of the lower leg, directed cle is contracted. Also, the anterior one-fourth
downward behind the Literal malleolus. When of the muscle belly and its tendon may occa¬
tensed, the two muscle* differentiate, and the sionally separate into what appears to be a dis¬
superior end of the tendon csf the peroneus lon- tinct* thin muscle.
gus becomes depressed where its muscle fiber*

SECTION P

A P
FROM
i ft U U A
-f- ,4-f HOW
! i I
TIB-A

&CLLY

post:#—^ ANT
^ l —D E.fRLSSiOn'\

f SfP£ VIEW \
F UptftOW
> PON
fWHEN
TtNSCD

T £m(j0N
Lateral
r“\ ^auccol.
nAU-C0UJ5

NC "TCi rN5£Rl
fNSEATlDN
nwnc'o FOOT
UNOEft.
 The Lower Leg Muscles • TIBIALIS POSTERIOR

AbH Abductor haUucu AT Achilles tendon F HbuU FDL Flexor digiiurttitt bogus
F H L Ftemr hjlhtas tongas MM Medial nuttfeolm So Salens T Tibia TA Tibialis anterior
TP Trbitflts posterior

1JO
1
 The Lower Leg Muscles * TIBIALIS POSTERIOR

Tibialis Posterior STRUCTURE Beginning Jeep at the upper end

ORIGIN Late ra I hill t trt t he post mi i r sn rtace of the hack of the lower (eg* only the tendon of
fif the tchi.i, from hd-nw the lateral condyle to a the tibialis posterior is superficial and visible lor
point two-thirds ol the way down the hone; the a short distance above* behind (lying in it> bony
upper two-thirds of the medial surface of the groove), and below the medial malleolus. Its
fibula; and [lu* interosseous membrane between deep muscle belly and tendon run diagonally
these two bony origins- downward and medially, deep to the more ver¬
SECTION A
tical flexor digiumirn Inngus. Just above the an¬
INSERTION Deep, into the bottom (plantar kle, the oblique tendon of the tibialis posterior
surface] of ihe middle of ihe foot skeleton— emerges superficially on the medial side of the
variously into six tarsal hones (navicular, three vertical flexor digicomm knigtis. It is most
cuneiforms, cuboid, ami talus and the bases of
prominent from where it angles forward below
the second, rhird, ami fourth metatarsals* The the medial malLeulus to where it disappears un¬
visible tendon k on the inside of the ankle, is der the prominence of the tuberosity of the na¬
seen directed to its insertion on the navicular vicular bone, on the medial side of the foot.
Kune jusi below the prominent navicular tuber*
Deep under the fool ihe tendon fans out as it
SECTION B osity. the tendon then continues onward to ex¬
inserts,
pand under the foot, out of view.
When the foot is inverted, the tendons of [he
ACTION Plantar ilexes and inverts the Font. It tibialis anterior ami posterior can be seen con¬
is the strongest support of the longitudinal arch verging distally. A depression forms between
of the foot; them in front of the medial malleolus.

ME.J3JAL
BELLY or PiALL£CLLL5
FL£*QR
Pl£l TORUM
LONGUS T t& iA L * 5
AN T£FHDft>,
DEPRESSION
TJUPAs_I 3 peJTCMOR

*EPIAL NAVICULAR
/MALLE.OLU5 . TU&EfiOSl Ty
(TIBIA) JT\tENOON of
$-'■ “NELLIS
NAVICULAR _ POSTERIOR
■U9ERP5ITY AWT ROST
Inside view

17}
4
 The Lower Leg Muscles * FLEXOR OIGITORUM LONGUS

AbH Abduninr hallucis AT Achilles ten doit F Fibula Fa Fat FPL Flexor digitornm longns
F H L Flexor balhtris hngus MM. Medial Malleolus So St thus T Tibia TA TibUlis anterior
TP Tibiafis posterior

7
* 3-
 The Lower Leg Muscles - FLEXOR DIGITOHUM LONGUS

Flexor Digitorum Longus don of the flexor digiromm longus then curves
behind the pulley of rhe medial malleolus (in
ORIGIN Middle half of the bock surf Lice eiC she
of the till Li, beginning (List below the su- the same bony compartment as the tibialis pos-
tenor tendon) and divides into the four tendons
teal line,
heading to the lateral fuur toes. All hough the
INSERT LON lia tats t i f she d tstal ph al anges of tendon of the flexor digitonini longus lies adja¬
toes two Through five on their plantar surfaces cent to but on a slightly deeper plane than the
(not into die big toe)* conspicuous tendon of the tibialis posterior* is is
SECTION A
ACTION Flexes the distnl phalanges ul the tat- nor seen.
era] four uks, especially for the final push-off in The Ilex or digicom m longus is attached to the
walking and running- Fly continued action, ii deep flexor haltucis longus muscle (flexor of the
plantar flexes and inverts the foot, big me) under the font hy a tendinous shp.

STRUCTURE Beginning deep in the lower leg When rhe toes arc alternately flexed and ex¬
on she back of the tibia* and ending deep under tended together, the inferior ends of the bellies
of both these muscles can be seen rising and
the fool, only a small portion of the belly of rhe
section a descending pusE behind and below the medial
llexot digitorum longus is subcutaneous on the
malleolus. A noticeable depression is created be¬
lower third of the inside of the lower leg, just
posterior to the medial surface of the shaft of tween the medial malleolus and Achilles tendon
the tibia. It is not distinct, hut rather fills a when (he toes arc fully Hexed, Even though the
EDL
small area between the tibia and lower anterior flexor hdElucm longus is deep, rhe ascent of she
inferior end of its belly affects surface form.
edge of the sole us. The exposed muscle fibers
taper into a tendon that becomes concealed as Because of the tendinous connecnon herween
i[ shifts away from the surface. Literal to the them, the flexor hallucis longus and flexor digi-
SECTION C torum longus must he flexed together to achieve
tendon of ilie tibialis posterior, which has now
emerged from between the tibia and flexor digb full flexion of ,ifl the toes.
torum longus and become superficial The ten¬

“73
 The Foot Muscle$

RELATIONSHIP OF FOOT VOLUME

TO LOWER LEG + GROUND

DOftSl FLEXION NEUTRAl. PLANTAR FLEXION NEUTRAL DOR5JFLEXION NEUTRAL PLANTAR FLEXIONS
(Ht£L STR:Ke) (FOOTFALLS) *-LOWER LEG ADVANCES-? (TOES KVP£R- (POSH-OFF)
FOOT FLAT ON GROUND EXTENDED)
WALKING-* FORWARD LOCOMOTION - *
SIDE. VIEW

SIDE-TO-SI0E MOVEMENT OF LOWER LEG

FRONT VIEW

2-74
 The Foot Muscles * EXTENSOR DIGITORUM BREVIS

enb

AbDM Ahdurtar digit* minimi AhH Abductor h$Uua& Cu i'ubotd PM Deep muscle
EDB External digitontm hrmris EDL Extensa* digitomm hngjts EHB Extensor halluas hrti*t&
EHL Extern*** halhrtte iimgtti LCv Literal cuneiform I M l Jimd m,dk'ohi> M MetdipTsal
PB fbrorwts brevis PL Fbrvntus lirngut PT Ftim&eus ferihtf TA Tihialii antthor

176
 The Foot Muscles * EXTENSOR DlGiTQRUM BREVIS

Exlonsor DigitOfum Brevis medially, is always present; hut the individual

(including Extensor Halluds Brevis) bellies and their tendons iire only occasionally
ORIGIN Entire muscle: The upper surface of visible.
Hie front end of the calcaneus, the inferior ex¬ ITe most medial portion of the extensor digi-
tensor retinaculum, and the lateral taloealearural torum brevis, inserting into the big toe, is also
lip mem. referred to as the extensor hallucis brevis. It
diffcr> from the other bellies of this muscle hy
INSERTION To the medial four roes as fol¬
inserting into bone* rather than imo the sides of
lows: Extensor hallucis brevis (m she big, toe):
tendons. When the big toe iv flexed, the narrow,
rnta bone; ir inserts imo the upper surface of
flat be lly of the extensor hallucis brevis may be
the base of the proximal phalanx of the big roe.
seen on the dorsum of the foot, between the
Extensor digitomm brevis <to the middle three
tendons of the extensor hallucis lougus and ex¬
toes): mio tendon; its tendons join the lateral
tensor digifumm longus of the second roe. Al¬
sides ol the tendons of the extensor decorum
though flexing the big me will stretch the belly
fongus heading to the second, third* and fourth
ol the extensor hallucis brevis and make n thin¬
tors. It therefore ultimately inserts into the
ner, it also pulls the belly disnlly, so it can he
middle and distal phalanges of the middle three
seen in rhe interval between the tendons that
toes. These tendon-to-ten don fusions occur on
border it on the dorsum of the foot.
SECTION B the top of ihe proximal phalanges,
The tendons to the middle three toes can oc¬
ACTION Extensor halluds brevis: extends rhe casionally be seen on top of the distal half of
proximal phalanx of the big ten:. Extensor dtgi- the metatarsus* in the three spaces between the
torum brevis: extends the phalanges of rhe sec¬ four long tendons of the extensor digitonim
ond, third, and fourth toes ar the imerphnl.m- longuv 111 esc tendons of the extensor digicom in
geal and metatarsophalangeal joints; pulls these brevis are directed posteriorly toward the literal
toes laterally ar the metatarsophalangeal joints, malleolus, whereas the tendons of the extensor
STRUCTURE The overall extensor digirnmm digitoniin longus arc directed toward the
brevis muscle is made up of four slender. Hat middle of the front of the ankle.
bellies that pass forward and medially over rhe
top of the foot. These bellies develop into ten¬
dons distally. The combined bellies create an Note: The extensor digimmm brevis (including
oval bulge on the outside of the top of the foot, rhe extensor hallucis brevis 1 does not insert into
located below and in Irnnt of rhe lateral malleo¬ the hide roc; it inserts mto the medial four toes
lus. I he bulge* directed forward, upward, and only.

277
 The Foot Muscles - ABDUCTOR HALLUCIS

AbH Abductor h&Huas DM Deep nm&ck EHL Extensor hatluds tongas

FDL Fkxur digitomm fang*# FHB Ft&or Mum brevis FHL Flexor baihtds hngus M Mt'Utfawf
MCti Medial aamform MM Medial malleolus PA Pfarttar apnnenrosis SB Sesamoid bone
TA Tibialis anterior T P Tibialis posterior

178
The Foot Muscles - ABDUCTOR HALLUCES

Abductor Halluds mside of the foot. Its postenor two-thirds is

fleshy muscle belly; the anterior third is tendon.
ORIGIN Med 1.11 process on the bottom of the
Muscle fibers continue to insert along the top
cakaneust the anterior edge of the flexor ferina-
edge of the tendon for a variable distance. The
culuru of the ankle (stretching between she heel
abductor halluris combines with the flexor hah
ami medial malleolus), and the plantar □poncu-
luos brevis which is located anteriorly under
ruSts.
its tendon, to create a slight raised relict along
INSERT ION Medial side of the base of the the medial border of the foot. This form lies on
proximal phalanx of the big toe. the a Li ter arch of the foot, below the tuberosity
of rhe navicular boncT and curves upward at its
ACTION Hexes more than it actually abducts
center to conform to the rounded medial arch.
the metatarsophalangeal joint uf the big toe.
Its efungated oblong form stretches from the
STRUCTURE The abductor halluds begins heel to the metatarsophalangeal joint of the big
from a wide origin near the posterior end ol the toe.

&5TLLY OF BELLY QF
MAfIROw fh& AfeH
^AL- Affc

temrgw of
AkH
IIM5IDE VIEW ANTM-*Posr

2-79
 The Foot Muscles • ABDUCTOR OIGlTI MINIMI

AtsDiM Ahdtttfar digits minimi EDS Extensor digitorimt brevis EDL Ext&uor digttonitH
hDL biexor dtgitvrum fottgm FDMB Flexor ihgiii mtniim forei ii LM l Metif l malleolus M Mennnjl
PA Pbtiteraponeurosis FS Ferotivm breva PL Penmens lottos PT Ferotmts rertius

i8o
 The Foot Muscles * ABDUCTOR DIGIT! MINIMI

Abductor Digit Minimi of the fifth metatarsal. At the midpoint of the

ORIGIN Both the medial and latrral processes foul, the tendon glides over the smooth under¬
and the intervening bone between these areas. surface of the expanded base of the fifth meta¬
«n the bottom of the calcaneus* and from the tarsal.
plantar aponeurosis* Passing anteriorly from the origin of the ab¬
ductor digiti minimi, some fibers insert into the
IIMSERl ION Literal aspect nf the base of the
base of the fifih metatarsal, while some new
pmximl phalanx of the little Toe.
fibers rake origin from it.
SECTION A ACTION AhdueiJi and assists in flexing the lit1 This muscle ts for the most part concealed by
tie toe, the dense, fibrous fat pad of the sole of the
STRUCTURE TTtis muscle ties under the lit' foot. However, the anterior portion of the belly
era I border of the foot. In side view* n appears located between the base of the fifth metatarsal
to have two bellies, one anterior and otic poste¬ and the metatarsophalangeal joint can occasion¬
rior to the expanded base of she filth metatarsal ally be seen on the surface lying lateral to rhe
hone. Its Tendon develops on the deep (superior) shaft of the fifth metatarsal. Its form is very
aspect of the belly before reaching the level of subtle. The posterior portion is concealed by
the base of the fifth metatarsal, but its fleshy the plantar fat,
fibers, usually continue anteriorly up to the head
SECTION B
 overhang the lower eyelid slightly. The inner on nearer and nearer objects, ihe axes converge*
and utiEer corners usually lie on a horizontal ultimately assuming a cross-eyed position at
line or else the miter corner si is at a level their greatest convergence. The axes never db
slightly higher than the inner corner. The inner verge (become “wall-eyed") in normal eyes.
comer is located more anteriorly, white the The eye cover fold is the skin flap below the
outer corner sits more posteriorly toward the lateral portion of the eyebrow and above the
s/de of the eyeball; the avis through the corners lateral portion of the upper eyelid. It is seen as
of the eye therefore passes laterally and posteri¬ a bulging* oblique skin form (somewhat tear-
orly. A depression is located above the inner drop-shaped) when the eye is in the normal
corner of the eye. open position. It conceals the upper and outer
The front surface of the open eye (eyeball edges of the bony orbit. Laterally, the wide end
and lids) can be simplified into a plane that is of this form ends past the outer comer of the
curved side to side «litd directed forward and eye. It is sometimes more flat than round, and
dowmvard. The side-to-sidc curvature is ac^ creates a down plane under the eyebrow. When
counted for by the mundness of the eyeball the eyebrows are raised, this form disappears as
I"he plane faces downward because the edge of the skin is stretched* revealing the shape of the
the upper eyelid projects more anteriorly (it is bony orbit.
near the equator) than the edge of the lower Ihe lower border of the lower eyelid meets
eyelid. In other words* the plane of the front of the upper portion of the front of the check at a
the eye is created by the lower half of the front definite line, or change of plane. The crescent¬
of the eyeball and the eyelids. shaped tear bag is located below this line. It
When the eye is focused at infinity* the axes becomes more prominent as a person ages.
of both eyeballs are parallel. As the eyes focus

OARUNCOLA
U CftWALIS

2.84
 Nose

The NOSE is mftdc up of bone, cartilage, and pointed at the tip of the nose (a short distance
fatty tissue. It is pyramidal in shape* consisting on either side of the midline). The bottom of
of a long narrow plane on its front edge, two the ovoid lateral wall may develop a distinct*
inclined side planes, and a triangular bottom narrow, sharp plane. The medial wall forms the
plane. movable nasal septum, located at the midline
The bridge of the nose is formed by the two on the bottom of the nose between the nostril
nasal bones. The junction of these bones with This septum is visible from the side view be¬
the frontal bone at the xiasion is called the root cause it descends lower than the wing of the
of the nose. The middle section of the nose is nose. The plane of the opening of each nostril is
made up of the flat* paired lateral cartilages therefore directed downward and slightly out¬
(upper cartilages), each triangular in shape. The ward* permitting the opening of the nostril to
junction on the front edge tif the nose between be seen partially from the side view. From be¬
the nasal bones and lateral cartilages is the wid¬ low, the entire greater alar cartilage (both lat¬
est part of the bridge. In side view, the nasal eral and medial walls) is seen bordering the an¬
hones meet the lateral cartilages at an angle, terior half of the nostril.
forming the "bump13 of the nose. The maxilla Two to four lesser alar cartilages (small, or
bone, located posterior to the nasal bone and sesamoid, cartilages) are found on each side of
nasal cartilages, contribuies to the formation of the nose at the posterior end of the lateral wall
the side plane of the nose. of the greater alar cartilage. They are not seen
The tip or apex of the nose is made up of the in life. The rounded wing of the nose, or alae
paired greater alar cartilages (lower or rip carti¬ nasi, made up of dense, fibrous, fatty connective
lages). Each greater alar cartilage is somewhat tissue, surrounds the nostrils, or nates. These
U-shaped, but is better visualized as having a oval apertures taper anteriorly and are directed
larger, flattened* ovoid portion* the lateral wall anteriorly and medially when seen from belowr
(lateral crush and an inferior extension or tail, The rigid, vertical septal cartilage lies inconspic¬
the medial wall (medial crus). The lateral wall uously between the paired cartilages, on the
forms the tip of the nose and then extends to midline of the nose. It does not participate in
the side of the nose between the lateral cartilage the formation of the movable nasal septum.
and wing of the nose. The greater alar carti¬ The nasal bones are completely rigid, the lat¬
lages may inconspicuously blend into the rest of eral cartilages semirigid, the greater alar carti¬
the nose, or they may be clearly defined all lages slightly flexible, and the fatty wing<; soft
around and separated by a vertical groove or and flexible. The nose is therefore harder and
notch where the two meet in front. They also strongly attached superiorly and softer and
range from being rounded 10 exceedingly more movable interiorly.

ROOT Of N

NASAL BONE -

MAXILLA GREATER alar cartilage

LATERAL LATERAL WALL

cartilage
MEDIAL WA
LESSER
CARTILAGES LATERAL WALL

GREATER GREATER
ALAR -ALAR
CARTILAGE ' CARTILAGE

NG
ttLPIAL WALL

FROISTT VIEW SIDE VIEW BOTTOM VIEW

285
Mouth

The MOUTH consists of the muscular, highly The lower lip is made up of two elongated,
movable upper Lind lower lips* or labia. The horizontal forms that meet at the midhne. It is
mouth region includes more chan just the red heavier and fuller than the upper lip, and its
portion of the lips; it technically extends from lower edge is more squared-off. It has a raised
the base of the nose down to the fleshy pro mi - edge along its border where the red pan meets
nance of the chin (to the mentolabial sulcus}. the skin. This border may not appear at the
The red color of the lips is caused by blood middle of the lower lip* but it does develop
capillaries lying close to the surface. The lips laterally. It is especially prominent at the angle
arc normally dryr They curve around the cylin¬ of the mouth, where there is a strong separation
der of the teeth. between this ridge and the large form of the red
The tipper lip is made up of three forms: a part nf the lower lip. The surface of the lower
small rounded form located on the midline. The lip may be continuous with the skin below (no
tubercle, and two elongated forms on either edge), and the lip proper is distinguished by
side. The upper lip is flatter overall (more color change alone. Averaged out, the red part
planar) than the lower lip, and because it is a of the lower lip is an ^up” plane, and usually
"down1" plane, it usually appears darker. Its up¬ receives direct light, making it appear lighter
per edge forms a continuous, upwardly curving than the upper Lip,
arch, interrupted in the middle by a wide V- or The lower lip region is separated from the
U-shaped notch where the base of the phi It rum chin by the horizontal mentolabial sulcus. Col¬
meets the tubercle. The tubercle is non muscular, umnar forms passing downward and outward
whereas the test of the bps is made up of the from below each half of the red part of the
orbicularis oris muscle. The edge of the upper low!er lip are referred to as the pillars of the
lip where the red part meets the skin may de¬ mouth.
velop into a ridge, and a narrow top plane may When the mouth is closed, the forms of both
develop across the upper surface of this ridge. lips touch at the mouth line* with the convexi¬
Because this top plane may catch direct light ties of one lip lodging in the hollows of the
rays, it is often conspicuous. other. The mouth line is therefore multiply
The nasolabial furrow or sulcus, passing curved—from the mid line outward, this line in¬
downward and outward from the tqp of the clines upward for a short distance, downward
wing of the nose to the outside of the angle of for a longer distance, and then upward again
the mouth, technically delineates the upper lip for a very short distance. It lies at The level of
region from the cheek. The vertical, wide, me¬ the middle of the upper front teeth.
dian furrow or depression located between The In the front view, the angle of the mouth
upper lip and base of the nose is called the approximately aligns with a line dropped from
phi It rum. It is bordered by a vertical ridge nn the pupil of the eye. In side view, the angle
cither side. The oblique, oval muscular form lo¬ aligns with a line dropped from the front of the
cated immediately lateral to the angle of the eyeball.
mouth is called the node or modiolus (see Fa-
dal Muscles).

FRONT VIEW ■5LDE VIEW

Ear

The external EAR consists of the aw-ide and tragus is a double-pointed cartilaginous projec¬
external auditory meatus. The auricle, or pinna tion located above the ear notch. It lies just
(the outer ear proper), is a complex, ovoid, car¬ posterior to the condyle of the mandible at the
tilaginous funnel, larger above, that directs posterior end of the zygomatic arch. The anti¬
sound into the ear hole, or external auditory tragus—projecting opposite the tragus—is lo¬
(acoustic) meatus# The auricle is made up of a cated above the lobe. The tragus and amiiragus
single complex cartilage, as well as fatty skin. partially project over the openings of the con¬
The concha is the deep, howl-shaped part of cha and car hole. The tragus is separated from
the cartilage that attaches directly to the side of the helix by a notch. The earlobe, or lobule, is
the head at the front of the mastoid process of a softy, fatty skin form that hangs off the bot¬
the skull. The ear hole is located in the lower tom of the ear. It is usually independent of the
front corner of the concha. The helix rings the side of the jaw, but is sometimes attached.
uppermost portion of the ear. It begins deep on From the front view, the ear is widest at the
the floor of the concha as the crus of the helix, top (at the helix). The antihelix projects Lat¬
dividing the concha into a smaller upper por¬ erally at its midpoint, receding inward toward
tion and a Larger lower one. It passes forward, the head both superiorly and inferiorly. From
outward, and upward and then curves down the side view, the cat appears oblique, its long
the posterior edge of the ear, to finally end axis directed downward and forward. This axis,
when it reaches (blends into) the earlobe. For as well as the front edge of the ear, is roughly
the most part, the helix is cartilaginous, but its parallel to both the back of she ramus of the
lower hack portion is formed by skin. Its inner lower jaw and the profile of the nose. From the
edge on the upper half of the ear is sharp. An back view, the outer edge of the helix makes an
anteriorly pointing tubercle is often seen on S curveh while the bowl-shaped concha attaches
the inner edge of the upper back comer of the to the side of the head. The concavities seen in
helix. the side (outer) view nf the ear become convexi¬
The anrihelix roughly parallels the helix, ties on the cranial (medial) side.
lying internal to it. It also borders the back and The top of the car is approximately in line
top of the concha. U splits superiorly (ante¬ with the brow, while the bottom of the lobe
riorly) into a U-shaped fork having a rounded usually coincides with the level of the base of
and large upper Leg and a narrow and sharp the nose. These alignments do vary quite a bit,
lower leg. The legs are separated by a depres¬ though. The straight front edge of the car is
sion called the fossa triangularis. The anti helix located approximately midway between the
ends interiorly just before reaching the earlobe front and back of the head; the ear hole is lo¬
and antitragus. The elongated, curving furrow cated just posterior to the midline. The auricle
between the helix and anti helix is the scapha. of the ear sits on the side of the base of the
The obLique car notch, or intertragic notch, is cranium. The overall plane of the ear is directed
located on the front edge of the ear just above outward, slightly forward, and slightly down¬
the earlobe. It is bordered by cartilage. The ward.

\
■FOSSA TRIANGULARIS /

SCAPHA

TAR hole:

TRA&US
ANTIHELIX
EAR NOTCH

CONCHA'

ANT1TRA GLkS
LOBE

FRONT VIEW

z87
 Male Fat Pads

pectoral
VFAT
X PAD
PECTORAL
FAT PAD

FORM OF ERECTOR SPINAE

EXTERNAL DBLrQUE MUSCLE

FILLER
flank fat pad

ILIAC LINE

PUBIC
gluteus medius
FAT PAD
PUBIC
FEMORAL
GLUTEUS MAXIMUS FAT
TRIANGLE
GLUTEAL PAD
CLEFT
posterior gluteal_
FAT PAD
GLUTEAL
5K1N
INFERIOR GLUTEAL
FOLD
FAT EXTENSION

SEMIMEMBRANOSUS

POPLITEAL FAT PAD,

TENDON
PATELLA
OF SEMI-'"'
tenbinosus
TENDON OF
INFRAPATELLAR
BICEPS FEMORIS
FAT PAD INFRAPATELLAR
PATELLAR
FAT PAD
ligament
gastrocnemius

FRONT VIEW BACH VIEW side view

2.91
 Female Fat Pads

BREAST
FAT
BREAST
FAT

external ABDOM.
OBLIQUE MUSCLE FAT PAD

FLANK __ DIMPLE LATERAL GLUTEAL

FAT PAD OF / FAT PAD \
POSTER
SUPER.
lateral POSTERIOR GLUTEAL
ILIAC
GLUTEAL ^ FAT PAD Nj PUBIC
spine
FAT PAD FAT PAD

GREATER _
PUBIC
femoral TROCHANTER
FAT PAD
triangle

INFERIOR GLUTEAL
GLUTEAL
OUTER FAT EXTENSION-
FOLD '''
THIGH ^
FAT PAD
OUTER THIGH FAT PAD
INNER/
THIGH
FAT PAD
LOWER
LOWER
ANTERIOR
ANTERIOR
THIGH -
THIGH
FAT PAD
POPLITEAL PAT PAD FAT PAD

infrapatellar infrapatellar
FAT PAD FAT PAD

FRONT VIEW BACK VIEW SIDE VIEW

193
 Skin Hand and Foot

Top of foot Sole of foot

-94
 Breasts, Genitafs

Female breasts

Female breasts—lop view

Rl!GHT FEMALE BREAST RfOHT MALE NIPPLE

YA«EOLA
lAT, ■ MEP.
( O J- papula

MALE NAVEL
*-. DEPRESSION

U ^9-SWELLING
TAPILLA FLU 5 H RAISED
X - p£ PASSION
FRONT VIEW AREOLA AREOlA
SIDE VIEW FRONT VIEW

300
 Veins

SUPERFICIAL
TEMPORAL V'
S OPR ATSDCM LEAR V.
SUPERFICIAL-
TEMPORAL
BRANCH TO
ARTERY
external
JUGULAFL V.
EXTERNAL.
JUGULAR V,.
7/ ANTERIOR
JUGULAR V.
CEPHALIC V

ACCESSORY
CEPHALIC V.'
thoracoepigastric v,
MEDIAN
CU0JTAL V. ACCESSORY
BASILIC V,
CEPHALIC V.
MEDIAN
SUPERFICIAL
ANTEBRACHIAL V. B ASILIC V
CIRCUMFLEX V

CEPHALIC V.
SUPERFICIAL
EPIGASTRIC V.
DORSAL
DIGITAL V
OF thumb
GREAT
SAPHENOUS V dorsal
VENOUS
NETWORK

DORSAL
DIGITAL V.

GREAT
SAPHENOUS V

GREAT
SMALL
SAPHENOUS V.
SAPHENOUS V

DORSAL VENOUS ARCH DORSAL VENOUS ARCH

FRONT VIEW
3C
BACK VIEW
 Veins

SUPRATROCHLEAR V
SUPERFICIAL
TEMPORAL V,
^SUPERFICIAL TEMPORAL
’artery (frontal branch)
EXTERNAL
JUGULAR V- -anterior jugular v.

.BRANCH TO
External jugular v

• CEPHALIC V

-TH0RACC£PrGA5TFtlC V

MEDIAN fiASlLiC V. LACCESSORY CEPHALIC V

CuerTAL
V. ^SUPERFICIAL JLJAC CIRCUMFLEX V

CEPHALIC SUPERFICIAL
ME Dr AN
V. EPICA5TRIC V.
ANTEBRACHIAL V

'CEPHALfC V.
BAS rue v.
DORSAL DIGITAL
DORSAL V OF THUMB
VENOUS
NETWORK DORSAL VENOUS
'NETWORK.

[NS IDE VIEW

great
SAPHENOUS V

SMALL
SAPHENOUS V-

D0R5AL
VENOUS

OUTSiDE VIEW INSIDE VIEW

 Proportion

PROPORTION is the most subjective aspect of etc, A common unit of measurement for the
the study of human structure. Our understand¬ body is a head length (head height)* which can*
ing of proportion is baited on a combination of for example* be divided into the figure six*
Severn I factors; historical conceptions of the fig¬ seven* seven and one-half, eight* or even more
ure throughout art history jit also varied in dif¬ times* each having very different results.
ferent geographical regions during the same I"he body can be measured from irs bony
rime period, e.g,, German and Italian Renais¬ landmarks (top and bottom of the sternum, me¬
sance)* society's present standard of beauty, our dial epi condyle of the humerus* front point of
own particular sensibilities as an artist* and, the pelvis, patella, etc.) and from its fleshy land
when working from the live model, the particu¬ marks (nipple, navel* horizontal gluteal fold,
lar set of proportions of that individual. etc.}. Fleshy landmarks are more variable
Proportion deals with eampansons—a height among individuals, and tend to shift when the
to another height* a height to a width* a height figure changes pose.
to a depth* a width to a depth* etc. Useful Finally, and obviously* proportions vary ac¬
lengths are those that are equal to another cording to age* sex, and race.
length or are multiples of that length (twice as fhc following iNustrations present some ira¬
long* three and a half rimes as long, etc )- The dio nna I systems of proportion developed by
figure* or its components* can also be divided well-known artist/anatomists.
into equal units* such as halves* thirds, fourths,

FiG. Comparative ProporiiOb™,

■ ■ / Fiom Finih TO epp^f Fairil*. 5. From Acmp4«l ro bad <jf Clfta Mr brad
i. \ I'ranTi ffgH fff Plttiliia Eii*t ind 1 tiilt
5, \ Fr.m hn* I" of SLcrnun. 6. From hc-jd I'lcjt It? irk I irl ii.uLLiu.-s df
T>-r« Throe propoisrofii art- illy *hfSf« Hihi hriil aifol -a hair.
The Aim. Front Plinth to top of Pair I.a two beards.
4- Tlttf* aft IftiEih from A rromwfl, la From tenue of FautIUl sl? Uiu prirfm \w&
SKOFuknO>h ftl WALL A M'D FiliU.l PiaLTJlF.it IS lllATi* A F I. IIA LF T1 Pi Pf f\nm, An ifY-lal irm flf anJ^-i fcn^r. btiidik

Arthur Thomson — 1896 Edouard Lanieri— i 922

W9
VOLUME RELATIONSHIPS Mass Conceptions of the Figure

ERECT TILTED TIP PED

O
SHARP
K
EDGES

L_ ROUNDED
Ld
Ck
LOW RELIEF
FILLED
QL FORM DEFINITION
o PROJECTION BETWEEN
FORMS
SURFACES

NO CURVATURE single curvature DOUBLE CURVATURE DOUBLE CURVATURE DOUBLE CURVATURE

STRAIGHT-STRAIGHT CONVEX-STRAIGHT CONVEX'CONVEX CONVEX - CONCAVE CONCAVE'CONCAVE
(FLAT PLANE) (cylinder) (sphere) (donut) (bowl)
Mass Conceptions of the Figure

RELATIONSHIP BETWEEN FORMS All contraction of the muscles. The contact between
form in the figure is produced by anatomy— forms can be sharp (deft, cleavage), rounded
boric, cartilage, muscle, tendon, fat, skin, veins, (furrow, groove), or obscured (filled—continu¬
etc. Besides the usual geometric shapes, forms ous surface between forms). On close examina¬
in the figure are often teardrop or fusiform (ta¬ tion of the figure, its individual forms can be
pering toward each end). Forms can be con¬ isolated and their borders defined. Capturing
sidered in high or low relief depending on their this extensive network of interrelated surface
projection from the surrounding surface, inde¬ forms, or surface modeling, in an accurate way
pendent of the definition between them. Defini- gives artwork great fidelity to nature, vitality*
lion between forms varies, depending on the de* and realism.
grec of subcutaneous fat and the amount of
Mass Conceptions of the Figure

3*3
 Mass Conceptions of the Figure

Blocks

Continuous
planes

3*4
Mass Concept tons of the Figure

315
 Mass Conceptions of the Figure

Tapered
cylinders
(coties)
Mass Conceptions of the Figure

317
 Mass Conceptions of the Figure

Male—life

Female—life

318
Mass Conceptions of the Figure

3i 9
 Mass Conceptions of the Head

rounded

Underlying
volumes
Mass Conceptions of the Head

3i3
 Mass Conceptions of the Head

Simplified
planes

Male—life

52,4