Transcript 1) Upper

Functional anatomy of the muscles
of the limbs
1.
2.
3.
4.
Development of the limb muscles
Peculiarities of the limb muscles
Auxiliary apparatus of the limb muscles
Differences of the upper and lower limb
muscles
5. Topography of the upper limb
6. Topography of the lower limb
7. Weak places of the pelvis and hernias
Development of the limb muscles
• It is supposed that muscles of the limbs are developed from the
cells of the ventral myotomes which migrate into the
mesenchyme bud of the limb.
• Muscles which are inserted to the bones of free limb with both
ends form the Autochthonous group of the muscles.
• Some muscles which are derivatives of migrated cells move
one its end to the trunk and become inserted to it. Such muscles
form the Trunkopetal group of the muscles (e.g. pectoral major
and minor muscles, latissimus dorsi muscle).
• The third group is developed from the myotomes of the trunk
and is inserted with one end to the bones of the limb forming
the Trunkofugal muscles ( trapesium m., rhomboid mm., levator
scapulae m., anterior serrate m).
• At the lower limbs trunkofugal muscles are absent.
• Trunkopetal muscles of the lower limb: greater psoas m.,
quadratus lumborum m..
Peculiarities of the limb muscles
•Big amount of the long
muscles
•Presence of big
amount of muscular
annexions:
- retinaculi,
- synovial vagines,
- synovial bursae,
- tendinous vinculae,
- fibromuscular canals.
Localization of the
limb muscles
•Muscles have perpendicular
direction to the axis of
movement at the joint.
•Minimum one pair of muscles
/one by one for opposite
movements/ exist for each axis.
•Function of each muscle
depends on the its position to
the axis of movement.
Retinaculi of the upper limb
Retinaculum flexorum
Canalis carpi radialis:
•tendon m. flexor carpi radialis.
Canalis carpalis:
•Synovial vagines of tendons of muscles
flexor digitorum,
•tendon of m.flexoris pollicis longus,
•nervus medianus.
Canalis carpi ulnaris:
•Arteria ulnaris
•Vena ulnaris
•Nervus ulnaris
Retinaculi of the upper limb
Retinaculum extensorum
/6 canals transmitting tendons/
I - m.abductor pollicis longus
m.extensor pollicis brevis
II - m.extensor carpi radialis longus
m.extensor carpi radialis brevis
III - m.extensor pillicis longus
IV – m.extensor digitorum
m. extensor indicis
V - m. extensor digiti minimi
VI – m.extensor carpi ulnaris
Synovial sheaths of the palmar and dorsal surface of the hand
Retinaculi and synovial sheaths of the lower limb
Retinaculum extensorum
• It presses the tendons of the anterior leg muscles to
the bones
• It has 2 parts:
1. Upper /between the leg bones above the malleoli/
2. Lower /distally in front of the ankle joint, Y-shaped/
- originates from the lateral surface of the calcaneus
and tarsal sinus
- separates into two bands:
a) superior - passes to the medial malleolus;
b) inferior – to the navicular and medial cuneiform
bones
•It splits into a superficial and deep layers the
extensor tendons forming four fibrous canals
I – synovial vagine of the extensor digitorum longus
andperoneus tertius m
II - synovial vagine of the extensor hallucis longus
III- synovial vagine of the tibialis anterior muscle
IV – blood vessels and nerve
Retinaculi and synovial sheaths of the lower limb
Retinaculum flexorum
•Passes from the calcaneus
to the medial malleolus
•Forms 4 osteofibrous
canals:
I – synovial vagine of the
tibialis posterior,
II - synovial vagine of the
flexor digitorum longus,
III – synovial vagine of the
flexor hallucis longus,
IV – posterior tibial artery
and tibial nerve.
Retinaculi and synovial sheaths of the lower limb
Retinaculum
peroneorum
It has 2 parts:
1) Upper
- from the lateral malleolus to
the calcaneus,
- transmits the common synovial
vagine of the peroneus longus and
brevis muscles
2)
Lower
- located on the lateral surface of
he calcaneum,
- transmits separated synovial
vagines of the peroneus longus
and brevis muscles.
Synovial vagines and the grooves of the
plantar surface
Differences of the muscles of the upper and
lower limbs
• Amounts of the muscles of upper limbs is bigger
• Volum and weight of the muscles is bigger at the lower limbs
• Lower limbs haven’t group of the muscles pronators
• Pelvic girdle doesn’t have proper muscles, these muscles are
well developed at the shoulder girdle
• Flexors prevail at the upper limbs, extensors – at the lower
limbs.
• Lower limbs have well developed group of adductors.
• Muscles of the upper limbs have small surface of attachment
to the bones.
• At the upper limb point of effort is placed closely to the
fulcrum than at the lower limb.
Topography of the upper limb
1.
Axillary fossa
•
It is seen in abduction
•
It is bounded: inferiorly by the greater pectoral m. in front;
by the latissimus dorsi and teres major m. – behind;
medially – by an imaginary line between borders of these mm. on
the chest
laterally – by a connecting line on the inner surface of the upper
arm.
2.
Axillary cavity
Anterior wall – major and minor pectoral muscles:
3 triangles
clavipectoral
pectoral
infrapectoral;
Posterior wall – subscapular m.
teres major m.
latissimus dorsi m.;
2 oppenings
trilaterum = triangular
quadrilaterum = quadrangular;
Medial wall – serratus anterior m.
Lateral wall – humarus + muscles.
Topography of the shoulder girdle
1.
2.
Deltoideopectoral triangle
(groove) - a
Lateral and medial
bicipital grooves – b, c
Topography of the upper limb
1. Canal of the radial
nerve = canalis
spiralis = canalis
humeromuscularis:
•
between the humerus and
triceps muscle
2. Fossa of beauty:
•
on the posterior surface of
the elbow joint
3. Gluter’s triangle and
line:
•
connect the epicondyles and
apex of the olecranon
Topography of the forearm
1.
2.
3.
Canal of the ulnar nerve:
between the medial
epicondyle, proximal ulna
and origin of the forearm
flexors
Canalis supinatorius:
between the supinatorius
muscle and radius
Pirogov’s space: between
the third and fourth
layers of the forearm
muscles at its distal part.
Topography of the forearm
and hand
Elbow fossa:
laterally – brachioradial m.,
medially – pronator teres m.,
superiorly – brachial m..
Antebrachial grooves:
Lateral = radial: between
brachioradial and flexor carpi
radialis mm;
Median: between flexor carpi
radialis and flexor digitorum
superficialis mm ;
Medial = ulnar: between flexor
digitorum superficialis and flexor
carpi ulnaris mm .
Anatomical snuff-box
Suprapirifom and
infrapiriform
oppenings
The piriform foramen passes
through the greater sciatic foramen,
above and below which narrow
openings remain and transmit the
gluteal vessels and nerves.
Lacuna musculorum:
Above – inghinal lig,; laterally – sartorius m.; medially – arcus ileopectineus.
Lacuna vasorum:
Above – inghinal lig,; laterally – arcus ileopubicus; medially – lig. lacunare;
behind – arcus ileopectineus.
Femoral triangle:
Laterally – sartorius m.;
Above – inghinal ligament;
Medially – adductor
longus m.
Canalis adductorius:
Laterally – medial belly
of cvadriceps m.;
Medially – adductor
magnus m.;
Anteriorly - membrana
vastoadductoria.
•Under normal conditions doesn’t
exist.
•Walls:
Lateral – femoral vein;
Posterior – deep layer of fascia lata
femoris;
Anterior – inghinal ligament and
superior horn of the crescent-shaped
margin of fascia lata.
•There is a narrow opening in the
medial corner of lacuna vasorum – the
femoral ring = inlet
Laterally – femoral vein;
Anterior and superior – Poupart’s
ligament;
Medially – lacunar ligament;
Posterior – pectineal ligament.
• Outlet – chiatus saphenus.
Femoral canal
Canals of the leg
•Grouber’s canal =
canalis cruropopliteus
• Extends between the
superficial and deep mm. of
the leg.
• It gives a branch – canalis
musculoperoneus inferior
formed by the middle third
of the fibula and the flexor
hallucis longus.
• Canalis musculoperoneus
superior – it is placed in the
upper third of the leg,
between the fibula and
peroneus longus muscle.
• Pirogov’s canal – it is a
fascial canal located
between two heads of the
gastrocnemius muscle.
Weak places of the
pelvis
1. Obturator canal
2. Suprapirifom foramen
3. Infrapiriform foramen
Obturator Hernia: This extremely
rare abdominal hernia develops mostly
in women. This hernia protrudes from
the pelvic cavity through an opening
in the pelvic bone (obturator foramen).
This will not show any bulge but can
act like a bowel obstruction and cause
nausea and vomiting.
Ischiatic and obturator hernias
Ischiatic hernias:
1. Suprapiriform hernia;
2. Infrapiriform hernia;
3. Hernia of the lesser piriform
foramen
Perineal hernias
2 – anterior
peroneal
hernia;
7 - posterior
peroneal
hernia.
Femoral hernias
Femoral Hernia: It occurs when the intestine enters
the canal carrying the femoral artery into the upper
thigh.
Femoral hernias are most common in women, especially
those who are pregnant or obese.
End