Prepared by Patty Bostwick-Taylor, Florence-Darlington ...€¦ · © 2012 Pearson Education, Inc....

© 2012 Pearson Education, Inc.

PowerPoint® Lecture Slides Prepared by Patty Bostwick-Taylor, Florence-Darlington Technical College

C H A P T E R 6The Muscular System


The Muscular System

•Muscles are responsible for all types of body movement

•Three basic muscle types are found in the body •Skeletal muscle •Cardiac muscle •Smooth muscle


Characteristics of Muscles

•Skeletal and smooth muscle cells are elongated (muscle cell = muscle fiber)

•Contraction and shortening of muscles is due to the movement of microfilaments

•All muscles share some terminology •Prefixes myo and mys refer to “muscle” •Prefix sarco refers to “flesh”


Comparison of Skeletal, Cardiac, and Smooth Muscles

Characteristic Skeletal Cardiac Smooth

Body location Attached to bone or skin (for some facial muscles)

Walls of the heart Mostly in walls of visceral organs (other than the heart)

Cell shape and appearance

Single, very long, cylindrical, multinucleate cells with very obvious striations

Branching chains of cells, uninucleate, striations, intercalated discs

Single, fusiform, uninucleate, no striations

Connective tissue components

Endomysium, perimysium, and epimysium

Endomysium Endomysium


Comparison of Skeletal, Cardiac, and Smooth Muscles

Characteristic Skeletal Cardiac Smooth

Regulation of contraction

Voluntary Involuntary Involuntary

Speed of contraction

Slow to fast Slow Very slow

Rhythmic contractions

No Yes Yes, in some


Skeletal Muscle Characteristics

•Most are attached by tendons to bones •Cells are multinucleate •Striated—have visible banding •Voluntary—subject to conscious control


Connective Tissue Wrappings of Skeletal Muscle

•Cells are surrounded and bundled by connective tissue •Endomysium—encloses a single muscle fiber

•Perimysium—wraps around a fascicle (bundle) of muscle fibers

•Epimysium—covers the entire skeletal muscle

•Fascia—on the outside of the epimysium

© 2012 Pearson Education, Inc. Figure 6.1

Blood vessel

Perimysium

Epimysium (wraps entire muscle)

Muscle fiber (cell)

Fascicle (wrapped by perimysium)

Endomysium (betweenfibers)

Tendon

Bone


Skeletal Muscle Attachments

•Epimysium blends into a connective tissue attachment •Tendons—cord-like structures

•Mostly collagen fibers •Often cross a joint due to toughness and small size

•Aponeuroses—sheet-like structures •Attach muscles indirectly to bones, cartilages, or connective tissue coverings


Skeletal Muscle Attachments

•Sites of muscle attachment •Bones •Cartilages •Connective tissue coverings


Smooth Muscle Characteristics

•Lacks striations •Spindle-shaped cells •Single nucleus •Involuntary—no conscious control •Found mainly in the walls of hollow organs

© 2012 Pearson Education, Inc. Figure 6.2a

Circular layer of smooth muscle (longitudinal view of cells)Mucosa

Longitudinal layer of smooth muscle (cross-sectionalview of cells)

Submucosa

(a)


Cardiac Muscle Characteristics

•Striations •Usually has a single nucleus •Branching cells •Joined to another muscle cell at an intercalated disc

•Involuntary •Found only in the walls of the heart

© 2012 Pearson Education, Inc. Figure 6.2b

Cardiacmusclebundles

(b)


Skeletal Muscle Functions

•Produce movement •Maintain posture •Stabilize joints •Generate heat


Microscopic Anatomy of Skeletal Muscle

•Sarcolemma—specialized plasma membrane •Myofibrils—long organelles inside muscle cell •Sarcoplasmic reticulum—specialized smooth endoplasmic reticulum


Sarcolemma

Myofibril

Dark (A) band

Light (I) band

Nucleus

(a) Segment of a muscle fiber (cell)



•Myofibrils are aligned to give distinct bands •I band = light band

•Contains only thin filaments •A band = dark band

•Contains the entire length of the thick filaments


(b) Myofibril or fibril (complex organelle composed of bundles of myofilaments)

Z disc H zone Z disc

I band A band I band M line

Thin (actin) filamentThick (myosin) filament



•Sarcomere—contractile unit of a muscle fiber •Organization of the sarcomere

•Myofilaments •Thick filaments = myosin filaments •Thin filaments = actin filaments



•Thick filaments = myosin filaments •Composed of the protein myosin •Has ATPase enzymes •Myosin filaments have heads (extensions, or cross bridges)

•Myosin and actin overlap somewhat •Thin filaments = actin filaments

•Composed of the protein actin •Anchored to the Z disc

© 2012 Pearson Education, Inc. Figure 6.3c

Z disc

Sarcomere

M lineZ disc

Thin (actin) filament

Thick (myosin) filament

(c) Sarcomere (segment of a myofibril)



•At rest, within the A band there is a zone that lacks actin filaments •Called either the H zone or bare zone

•Sarcoplasmic reticulum (SR) •Stores and releases calcium •Surrounds the myofibril

© 2012 Pearson Education, Inc. Figure 6.3d

Thick filament Bare zone Thin filament

(d) Myofilament structure (within one sarcomere)


Stimulation and Contraction of Single Skeletal Muscle Cells

•Excitability (also called responsiveness or irritability)—ability to receive and respond to a stimulus

•Contractility—ability to shorten when an adequate stimulus is received

•Extensibility—ability of muscle cells to be stretched

•Elasticity—ability to recoil and resume resting length after stretching


The Nerve Stimulus and Action Potential

•Skeletal muscles must be stimulated by a motor neuron (nerve cell) to contract

•Motor unit—one motor neuron and all the skeletal muscle cells stimulated by that neuron

© 2012 Pearson Education, Inc. Figure 6.4a(a)

Spinal cord

Motor unit 1

Motor unit 2

Axon terminals at neuromuscular junctions

Nerve

Axon ofmotor neuron

Motor neuroncell bodies

Muscle Muscle fibers


Axon terminals at neuromuscular junctions Muscle fibers

Branching axonto motor unit

(b)


•Neuromuscular junction •Association site of axon terminal of the motor neuron and muscle


PLAY A&P Flix™: Events at the Neuromuscular Junction



•Synaptic cleft •Gap between nerve and muscle •Nerve and muscle do not make contact •Area between nerve and muscle is filled with interstitial fluid

•Action potential reaches the axon terminal of the motor neuron

•Calcium channels open and calcium ions enter the axon terminal


Transmission of Nerve Impulse to Muscle

•Calcium ion entry causes some synaptic vesicles to release their contents (acetylcholine, a neurotransmitter) by exocytosis

•Neurotransmitter—chemical released by nerve upon arrival of nerve impulse in the axon terminal •The neurotransmitter for skeletal muscle is acetylcholine (ACh)


Transmission of Nerve Impulse to Muscle

•Acetylcholine attaches to receptors on the sarcolemma of the muscle cell

•In response to the binding of ACh to a receptor, the sarcolemma becomes permeable to sodium (Na+)

•Sodium rushes into the cell generating an action potential and potassium leaves the cell

•Once started, muscle contraction cannot be stopped

© 2012 Pearson Education, Inc. Figure 6.5, step 1

Synaptic vesicle containing ACh

Axon terminal of motor neuronMitochondrion

Ca2+

Synaptic cleft Sarcolemma

Fusing synaptic vesicleSarcoplasm of muscle fiberFolds of sarcolemma

Ca2+

AChreceptor

ACh

Action potential reaches axonterminal of motor neuron.

1




Ca2+


Ca2+

AChreceptor

ACh

SarcolemmaSynaptic cleft


Calcium (Ca2+) channels open and Ca2+ enters the axon terminal.

1

2




Ca2+


Ca2+

AChreceptor

ACh




Ca2+ entry causes somesynaptic vesicles to release theircontents (acetylcholine, a neurotransmitter) by exocytosis.

1

2

3




Ca2+ entry causes somesynaptic vesicles to release theircontents (acetylcholine, a neurotransmitter) by exocytosis.

Acetylcholine diffuses across the synaptic cleft and binds to receptors in the sarcolemma.



Ca2+


Ca2+

AChreceptor

ACh

1

2

3

4



ACh binds and channels open that allow simultaneous passage of Na+ into the muscle fiber and K+ out of the muscle fiber. More Na+ ions enter than K+ ions leave and this produces a local change in the electrical conditions of the membrane (depolarization), which eventually leads to an action potential.

5Ion channel in sarcolemma opens;ions pass.

Na+ K+


ACh effects are ended by its breakdown in the synaptic cleft by the enzyme acetylcholinesterase.

6

Ion channel closed; ions cannot pass.

Acetylcholinesterase

Na+Degraded AChACh

K+

© 2012 Pearson Education, Inc. Figure 6.6a-b

Small twig

Matchflame

Flame ignites the twig.

Flame spreads rapidly along the twig.

Neuromuscular junction

Nervefiber Striations

Muscle cellor fiber

Na+ diffuses into the cell. Action potential spreads

rapidly along the sarcolemma.

(b)

1 21

2

(a)


The Sliding Filament Theory of Muscle Contraction

•Activation by nerve causes myosin heads (cross bridges) to attach to binding sites on the thin filament

•Myosin heads then bind to the next site of the thin filament and pull them toward the center of the sarcomere

•This continued action causes a sliding of the myosin along the actin

•The result is that the muscle is shortened (contracted)

© 2012 Pearson Education, Inc. Figure 6.7a–b

Myosin Actin

Z HI

ZA I

(a)

(b)

ZI A I

Z


Protein complex

Myosinmyofilament

Actinmyofilament(a)

In a relaxed muscle cell, the regulatory proteins formingpart of the actin myofilaments prevent myosin binding (see a). When an action potential (AP) sweeps along its sarcolemma and a muscle cell is excited, calcium ions(Ca2+) are released from intracellular storage areas (thesacs of the sarcoplasmic reticulum).


Myosin-binding site Ca2+

Upper part of thick filament only(b)

The flood of calcium acts as the final trigger for contraction, because as calcium binds to the regulatory proteins on the actin filaments, the proteins undergo a change in both their shape and their position on the thin filaments. This action exposes myosin-binding sites on the actin, to which the myosin heads can attach (see b), and the myosin heads immediately begin seeking out binding sites.


PLAY A&P Flix™: The Cross Bridge Cycle


Contraction of Skeletal Muscle

•Muscle fiber contraction is “all or none” •Within a skeletal muscle, not all fibers may be stimulated during the same interval

•Different combinations of muscle fiber contractions may give differing responses

•Graded responses—different degrees of skeletal muscle shortening


Contraction of Skeletal Muscle

•Graded responses can be produced by changing: •The frequency of muscle stimulation •The number of muscle cells being stimulated at one time


Types of Graded Responses

•Twitch •Single, brief contraction •Not a normal muscle function



•Summing of contractions •One contraction is immediately followed by another

•The muscle does not completely return to a resting state due to more frequent stimulations

•The effects are added



•Unfused (incomplete) tetanus •Some relaxation occurs between contractions but nerve stimuli arrive at an even faster rate than during summing of contractions

•Unless the muscle contraction is smooth and sustained, it is said to be in unfused tetanus



•Fused (complete) tetanus •No evidence of relaxation before the following contractions

•Frequency of stimulations does not allow for relaxation between contractions

•The result is a smooth and sustained muscle contraction


Muscle Response to Strong Stimuli

•Muscle force depends upon the number of fibers stimulated

•More fibers contracting results in greater muscle tension

•Muscles can continue to contract unless they run out of energy


Energy for Muscle Contraction

•Initially, muscles use stored ATP for energy •ATP bonds are broken to release energy •Only 4–6 seconds worth of ATP is stored by muscles

•After this initial time, other pathways must be utilized to produce ATP



•Direct phosphorylation of ADP by creatine phosphate (CP) •Muscle cells store CP

•CP is a high-energy molecule •After ATP is depleted, ADP is left •CP transfers a phosphate group to ADP, to regenerate ATP

•CP supplies are exhausted in less than 15 seconds

•About 1 ATP is created per CP molecule



•Aerobic respiration •Glucose is broken down to carbon dioxide and water, releasing energy (about 32 ATP)

•A series of metabolic pathways occur in the mitochondria

•This is a slower reaction that requires continuous oxygen

•Carbon dioxide and water are produced



•Anaerobic glycolysis and lactic acid formation •Reaction that breaks down glucose without oxygen

•Glucose is broken down to pyruvic acid to produce about 2 ATP

•Pyruvic acid is converted to lactic acid •This reaction is not as efficient, but is fast

•Huge amounts of glucose are needed •Lactic acid produces muscle fatigue


Muscle Fatigue and Oxygen Deficit

•When a muscle is fatigued, it is unable to contract even with a stimulus

•Common cause for muscle fatigue is oxygen debt •Oxygen must be “repaid” to tissue to remove oxygen deficit

•Oxygen is required to get rid of accumulated lactic acid

•Increasing acidity (from lactic acid) and lack of ATP causes the muscle to contract less


Types of Muscle Contractions

•Isotonic contractions •Myofilaments are able to slide past each other during contractions

•The muscle shortens and movement occurs •Example: bending the knee; rotating the arm

•Isometric contractions •Tension in the muscles increases •The muscle is unable to shorten or produce movement

•Example: push against a wall with bent elbows


Muscle Tone

•Some fibers are contracted even in a relaxed muscle

•Different fibers contract at different times to provide muscle tone and to be constantly ready


Effect of Exercise on Muscles

•Exercise increases muscle size, strength, and endurance •Aerobic (endurance) exercise (biking, jogging) results in stronger, more flexible muscles with greater resistance to fatigue •Makes body metabolism more efficient •Improves digestion, coordination

•Resistance (isometric) exercise (weight lifting) increases muscle size and strength


Five Golden Rules of Skeletal Muscle Activity1. With a few exceptions, all skeletal muscles

cross at least one joint. 2. Typically, the bulk of a skeletal muscle lies

proximal to the joint crossed. 3. All skeletal muscles have at least two

attachments: the origin and the insertion. 4. Skeletal muscles can only pull; they never

push. 5. During contraction, a skeletal muscle

insertion moves toward the origin.


Muscles and Body Movements

•Movement is attained due to a muscle moving an attached bone

•Muscles are attached to at least two points •Origin

•Attachment to a moveable bone •Insertion

•Attachment to an immovable bone


Tendon

Insertion

Brachialis

Origin

Muscle contracting


Types of Body Movements•Flexion

•Decreases the angle of the joint •Brings two bones closer together •Typical of bending hinge joints like knee and elbow or ball-and-socket joints like the hip

•Extension •Opposite of flexion •Increases angle between two bones •Typical of straightening the elbow or knee •Extension beyond 180° is hypertension


Types of Body Movements

•Rotation •Movement of a bone around its longitudinal axis

•Common in ball-and-socket joints •Example is when you move atlas around the dens of axis (shake your head “no”)



•Abduction •Movement of a limb away from the midline

•Adduction •Opposite of abduction •Movement of a limb toward the midline



•Circumduction •Combination of flexion, extension, abduction, and adduction

•Common in ball-and-socket joints


Special Movements

•Dorsiflexion •Lifting the foot so that the superior surface approaches the shin (toward the dorsum)

•Plantar flexion •Depressing the foot (pointing the toes) •“Planting” the foot toward the sole


Special Movements

•Inversion •Turn sole of foot medially

•Eversion •Turn sole of foot laterally


Special Movements

•Supination •Forearm rotates laterally so palm faces anteriorly

•Radius and ulna are parallel •Pronation

•Forearm rotates medially so palm faces posteriorly

•Radius and ulna cross each other like an X


Special Movements

•Opposition •Move thumb to touch the tips of other fingers on the same hand


Types of Muscles

•Prime mover—muscle with the major responsibility for a certain movement

•Antagonist—muscle that opposes or reverses a prime mover

•Synergist—muscle that aids a prime mover in a movement and helps prevent rotation

•Fixator—stabilizes the origin of a prime mover


Example:Pectoralis major(anterior view)

(a) A muscle that crosses on the anterior side of a joint produces flexion


Example:Latissimus dorsi (posterior view)

(b) A muscle that crosses on the posterior side of a joint produces extension


Example:Medial deltoid(anterolateralview)

(c) A muscle that crosses on the lateral side of a joint produces abduction


Example:Teres major(posterolateralview)

(d) A muscle that crosses on the medial side of a joint produces adduction


Naming Skeletal Muscles

•By direction of muscle fibers •Example: Rectus (straight)

•By relative size of the muscle •Example: Maximus (largest)



•By location of the muscle •Example: Temporalis (temporal bone)

•By number of origins •Example: Triceps (three heads)



•By location of the muscle’s origin and insertion •Example: Sterno (on the sternum)

•By shape of the muscle •Example: Deltoid (triangular)

•By action of the muscle •Example: Flexor and extensor (flexes or extends a bone)

© 2012 Pearson Education, Inc. Figure 6.15(g) Unipennate

(f) Bipennate

Orbicularis orisDeltoid

(d) Circular

(a) Convergent

Biceps brachii

(a)

(c)(b) Fusiform

Sartorius

(g)

(c) Parallel

(d)(e) Multipennate

(e)

(b)

(f) Extensor digitorum longus

Rectus femoris

Pectoralis major


Head and Neck Muscles

•Facial muscles •Frontalis—raises eyebrows •Orbicularis oculi—closes eyes, squints, blinks, winks

•Orbicularis oris—closes mouth and protrudes the lips

•Buccinator—flattens the cheek, chews •Zygomaticus—raises corners of the mouth

•Chewing muscles •Masseter—closes the jaw and elevates mandible

•Temporalis—synergist of the masseter, closes jaw


Head and Neck Muscles

•Neck muscles •Platysma—pulls the corners of the mouth inferiorly

•Sternocleidomastoid—flexes the neck, rotates the head


Cranial aponeurosis

Orbicularis oris

Orbicularis oculi

Frontalis

Zygomaticus

Buccinator

Platysma

Temporalis

Occipitalis

Masseter

Sternocleidomastoid

Trapezius


Muscles of Trunk, Shoulder, Arm

•Anterior muscles •Pectoralis major—adducts and flexes the humerus

•Intercostal muscles •External intercostals—raise rib cage during inhalation

•Internal intercostals—depress the rib cage to move air out of the lungs when you exhale forcibly


Deltoid

Sternum

Pectoralis major

Bicepsbrachii

Brachialis

Brachio-radialis

Clavicle

(a)



•Muscles of the abdominal girdle •Rectus abdominis—flexes vertebral column and compresses abdominal contents (defecation, childbirth, forced breathing)

•External oblique—flex vertebral column; rotate trunk and bend it laterally

•Internal oblique—flex vertebral column; rotate trunk and bend it laterally

•Transversus abdominis—compresses abdominal contents


Pectoralis major

Rectus abdominis

TransversusabdominisInternaloblique

ExternalobliqueAponeurosis

(b)



•Posterior muscles •Trapezius—elevates, depresses, adducts, and stabilizes the scapula

•Latissimus dorsi—extends and adducts the humerus

•Erector spinae—back extension •Quadratus lumborum—flexes the spine laterally

•Deltoid—arm abduction



•Muscles that arise from the shoulder girdle and cross the shoulder joint to insert into the humerus include: •Pectoralis major •Latissimus dorsi •Deltoid

PLAY A&P Flix™: Movement at the glenohumeral joint: An overview.

PLAY A&P Flix™: Muscles that cross the glenohumeral joint.

PLAY A&P Flix™: Muscles of the pectoral girdle.

PLAY A&P Flix™: Muscles that act on the shoulder joint and humerus: An overview.


Olecranon process of ulna (deep to tendon)

Triceps brachiiLatissimus dorsi

Occipital bone

Sternocleidomastoid

Trapezius

Deltoid

(a)

Spine of scapulaDeltoid (cut)

Humerus


C7T1

Erector spinae• Iliocostalis• Longissimus• Spinalis

Quadratus Iumborum

(b)


Muscles of the Upper Limb

•Biceps brachii—supinates forearm, flexes elbow

•Brachialis—elbow flexion •Brachioradialis—weak muscle; elbow flexion •Triceps brachii—elbow extension (antagonist to biceps brachii)

PLAY A&P Flix™: Movement at the elbow joint.

PLAY A&P Flix™: Muscles of the elbow joint.

PLAY A&P Flix™: The elbow joint and forearm: An overview.


Deltoid

Sternum

Pectoralis major

Bicepsbrachii

Brachialis

Brachio-radialis

Clavicle

(a)


Olecranon process of ulna (deep to tendon)

Triceps brachiiLatissimus dorsi

Occipital bone

Sternocleidomastoid

Trapezius

Deltoid

(a)

Spine of scapulaDeltoid (cut)

Humerus


Muscles of the Upper Limb

•Muscles of the forearm, which insert on the hand bones and cause their movement include:

•Flexor carpi—wrist flexion •Flexor digitorum—finger flexion •Extensor carpi—wrist extension •Extensor digitorum—finger extension

PLAY A&P Flix™: Movements of the wrist and fingers (b).

PLAY A&P Flix™: Movements of the wrist and fingers (a).

PLAY A&P Flix™: Muscles that act on the wrist and fingers: An overview.


Muscles of the Lower Limb

•Muscles causing movement at the hip joint include: •Gluteus maximus—hip extension •Gluteus medius—hip abduction, steadies pelvis when walking

•Iliopsoas—hip flexion, keeps the upper body from falling backward when standing erect

•Adductor muscles—adduct the thighs

PLAY A&P Flix™: Movement at the hip joint: An overview.

PLAY A&P Flix™: Muscles that act on the hip joint and femur: An overview.


Gluteus medius

Gluteus maximus

Adductor magnus

Iliotibial tract

Biceps femoris

SemitendinosusSemimembranosus

Gastrocnemius

(a)

Hamstring group


Sciatic nerve

Gluteus maximus

Safe area ingluteus medius

IIiac crest

Posterior superior iliac spine

(b)


12th rib

Iliac crestlliopsoas Psoas major

lliacus

Anterior superior iliac spine

Sartorius

Rectus femoris

Vastus lateralis

Vastus medialisQua

dric

eps

Patellar ligament

(c)

Patella

Adductor group

5thlumbar vertebra

12ththoracic vertebra



•Muscles causing movement at the knee joint •Hamstring group—thigh extension and knee flexion •Biceps femoris •Semimembranosus •Semitendinosus


Gluteus medius

Gluteus maximus

Adductor magnus

Iliotibial tract

Biceps femoris

SemitendinosusSemimembranosus

Gastrocnemius

(a)

Hamstring group



•Muscles causing movement at the knee joint •Sartorius—flexes the thigh •Quadriceps group—extends the knee

•Rectus femoris •Vastus muscles (three)

PLAY A&P Flix™: Muscles that cross the knee joint: An overview.


12th rib

Iliac crestlliopsoas Psoas major

lliacus

Anterior superior iliac spine

Sartorius

Rectus femoris

Vastus lateralis

Vastus medialisQua

dric

eps

Patellar ligament

(c)

Patella

Adductor group

5thlumbar vertebra

12ththoracic vertebra


Vastus lateralis

(d)

Sartorius

Adductor muscles

Inguinal ligament


Muscles of the Lower Limb•Muscles causing movement at ankle and foot

•Tibialis anterior—dorsiflexion, foot inversion •Extensor digitorum longus—toe extension and dorsiflexion of the foot

•Fibularis muscles—plantar flexion, foot eversion

•Soleus—plantar flexion

PLAY A&P Flix™: Movements of the ankle and foot.

PLAY A&P Flix™: Posterior muscles that act on the ankle and foot.

PLAY A&P Flix™: Muscles that act on the ankle and foot: An overview.


Fibularis longus

Fibularis tertius

Tibialis anteriorExtensor digitorum longus

TibiaSoleus

(a)

Fibularis brevis


Gastrocnemius

Soleus

Calcaneal (Achilles)tendon

Medial malleolusLateralmalleolus

(b)


Facial• Temporalis

• Masseter

Shoulder• Trapezius

• Deltoid

Arm• Triceps brachii• Biceps brachii• Brachialis

Forearm• Brachioradialis• Flexor carpi radialis

Pelvis/thigh• lliopsoas

Thigh (Quadriceps)• Rectus femoris• Vastus lateralis• Vastus medialis

Leg• Fibularis longus

• Extensor digitorum longus

• Tibialis anterior

Facial• Frontalis• Orbicularis oculi• Zygomaticus

• Orbicularis orisNeck• Platysma• SternocleidomastoidThorax• Pectoralis minor• Pectoralis major• Serratus anterior

• Intercostals

Abdomen• Rectus abdominis• External oblique• Internal oblique• Transversus abdominis

Thigh• Sartorius• Adductor muscle

• Gracilis

Leg• Gastrocnemius

• Soleus


Arm• Triceps brachii• BrachialisForearm• Brachioradialis• Extensor carpi radialis longus• Flexor carpi ulnaris• Extensor carpi ulnaris• Extensor digitorum

lliotibial tract

Leg• Gastrocnemius

• Soleus

• Fibularis longus

Calcaneal(Achilles)tendon

Neck• Occipitalis

• Sternocleidomastoid

• Trapezius

Shoulder/Back• Deltoid

• Latissimus dorsi

Hip• Gluteus medius

• Gluteus maximus

Thigh• Adductor muscle• Hamstrings:

Biceps femorisSemitendinosusSemimembranosus


Deltoidmuscle

Humerus


Sciatic nerve

Gluteus maximus

Safe area ingluteus medius

IIiac crest

Posterior superior iliac spine

(b)


Vastus lateralis

(d)

Sartorius

Adductor muscles

Inguinal ligament

Prepared by Patty Bostwick-Taylor, Florence-Darlington ...€¦ · © 2012 Pearson Education, Inc....

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