The Muscular System
‫سیستم عضلی‬
EDO 001.10
AFAMS
07/05/2012
The Muscular System
‫سیستم عضلی‬
Learning Objective: The
Physical Therapy Technician will
gain an understanding of the
anatomy and physiology of the
muscular system and its purpose
within the body.
Estimated Time to Complete:
140 minutes.
‫زمان تعین شده برای تکمیل این‬
‫ دقیقه‬140 :‫لکچر‬
AFAMS
Teaching Points
‫نکات تدریس‬
1. How skeletal muscle produce
movement.
2. How skeletal muscle are
named.
3. Principal skeletal muscles.
4. Homeostatic imbalances related
to the muscular system.
5. Surface Anatomy.
6. Questions.
7. In-class assignment.
AFAMS
The Muscular System Movement
‫سیستم عضالت‬
• Skeletal muscle major groupings
‫• گروپهای بزرگ عضالت اسکلیتی‬
• How movements occur at
specific joints
‫• حرکات در مفاصل مخصوص چطور واقع‬
• Learn the origin, insertion,
function and innervation of
major muscles
‫ و تعصیب‬،‫ وظایف‬،‫ ارتکاز و دخول‬،‫• منشآ‬
• Important to allied health care
and physical rehabilitation
students
.‫میگردد‬
.‫تمام عضالت بزرگ را بیاموزید‬
‫• برای تداوم مراقبت های صحی و توانایی‬
.‫فزیکی محصلین مهم میباشد‬
AFAMS
Muscle Attachment Sites: Origin and Insertion
‫ منشاء و دخول‬:‫محالت اتصال عضله‬
• Skeletal muscles shorten & pull on the bones they are attached to
• Origin is the bone that does not move when muscle shortens
(normally proximal)
• Insertion is the movable bone (some 2 joint muscles)
• Fleshy portion of the muscle in between attachment sites = belly
AFAMS
‫• عضله اسکلیتی به عظام که آنها وصل است باعث کوتا و کش شدن آنها میگردد‪.‬‬
‫• زمانیکه عضله کوتاه میگردد منشاء در حقیقت عظم است که حرکت نمی کند‬
‫(بشکل نارمل قریبه)‬
‫• دخول در حقیقت عظم قابل حرکت است (بعضی ها دو مفصل عضلی است)‬
‫• قسمت فربه عضله در حقیقت بین ناحیه اتصالی میباشد= بطن‬
‫‪AFAMS‬‬
Muscles that Move the Head
‫عضالت که باعث حرکت رأس میگردد‬
• Sternocleidomastoid muscle:
– arises from sternum & clavicle & inserts onto mastoid process of skull
– innervated by cranial nerve XI (spinal accessory)
– contraction of both flexes the cervical vertebrae & extends the head
– contraction of one laterally flexes the neck and rotates the face in opposite
direction
AFAMS
‫• عضله عنق یا سترنو کلیدو ماستوید‬
‫– این عضله در حقیقت از عظم قص و ترقوه منشاء گرفته و از قسمت بارزه ماستوید‬
‫داخل جمجمه میگردد‪.‬‬
‫– توسط عصب قحفی یازدهم (نخاعی فرعی) تعصیب شده است‪.‬‬
‫– تقبض این هر دو عضله باعث قبض فقرات رقبی و بسط رأس میگردد‪.‬‬
‫– و تقبض یکی از آنها عنق را بطرف وحشی قبض نموده و وجه را به جانب مخالف‬
‫تدور میدهد‪.‬‬
‫‪AFAMS‬‬
Surface Anatomy
• A branch of gross anatomy that examines shapes
and markings on the surface of the body as they
relate to deeper structures.
• Essential in locating and identifying anatomic
structures prior to studying internal gross
anatomy.
• Health-care personnel use surface anatomy to help
diagnose medical conditions and to treat patients.
13-9
AFAMS
Surface Anatomy
• four techniques when examining surface anatomy
• visual inspection
– directly observe the structure and markings of surface features
• palpation
– feeling with firm pressure or perceiving by the sense of touch)
– precisely locate and identify anatomic features under the skin
• percussion
– tap sharply on specific body sites to detect resonating vibrations
• auscultation
– listen to sounds emitted from organs
13-10
AFAMS
Triangles of the Neck
• Neck/cervical region/cervix is a complex region that connects the head
to the trunk.
• Spinal cord, nerves, trachea, esophagus, and major vessels traverse this
highly flexible area.
• Neck contains other organs and several important glands.
• Neck can be subdivided into anterior, posterior, and lateral regions.
13-11
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The Anterior Region of the Neck
• Has several palpable landmarks, including the larynx, trachea, and
sternal notch.
• The larynx.
– found in the middle of the neck
– composed of multiple cartilages
– thyroid cartilage
• “Adam’s apple”
• Inferior to the larynx are the cricoid cartilage and trachea.
• Terminates at the sternal (jugular) notch of the manubrium and the left
and right clavicles.
13-12
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13
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The Clavicles
• Paired clavicles and the sternal (jugular) notch represent the border
between the thorax and the neck.
• On the superior anterior surface where they extend between the base of
the neck on the right and left sides laterally to the shoulders.
• Left and right costal margins of the rib cage form the inferior boundary
of the thorax.
• Costal angle (costal arch) is where the costal margins join to form an
inverted V at the xiphoid process.
• On a thin person, many of the ribs can be seen.
• Most of the ribs (with the exception of the first one) can be palpated.
13-14
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Muscles of Abdominal Wall
‫عضالت جدار بطن‬
• Notice 4 layers of muscle in the abdominal wall
AFAMS
‫• شناخت چهار طبقه عضلی در جدار بطن‪.‬‬
‫‪AFAMS‬‬
Muscles of Abdominal Wall
‫عضالت جدار بطن‬
‫ جوره عضالت ورق یا شیت مانند‬4
• 4 pairs of sheet like muscles
.‫– رکتوس ابدومین= تمایل به عمود دارد‬
– rectus abdominis = vertically oriented
‫– عضالت مایل داخلی و خارجی و بطنی‬
– external & internal obliques and
‫مستعرض‬
transverses abdominis
‫• تدور بدون پیچیده شده تا جدار قدامی بدن‬
• wrap around body to form
anterior body wall
.‫را بسازد‬
• form rectus sheath and linea alba
‫• پوش عضله رکتوس و لینا البا را‬
• Inguinal ligament from anterior superior
.‫میسازد‬
iliac spine to upper surface of body of
‫اربطه مغبنی از قسمت قدامی علوی برامده گی‬
pubis
.‫حرقفی شروع و به جانب جسم عانه میرود‬
• Inguinal canal = passageway from pelvis
‫کانال مغبنی= یک راه عبوری از حوصله تا به‬
through body wall musculature opening
‫جسم جدار عضلی باز بوده که بشکل یک حلقه‬
seen as superficial inguinal ring
.‫مغبنی سطحی دیده میشود‬
• Inguinal hernia = rupture or separation of
‫فتق مغبنی= پاره گی یا تجرید جدار بطن اجازه‬
abdominal wall allowing protrusion of
part of the small intestine (more common ‫میدهد تا بخشی از امعأی رقیقه خارج گردد (که‬
in males)
).‫نزد مردها معمول است‬
‫بیشتر‬
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•
•
•
•
Transverse Section of Body Wall
‫بخشی مستعرض جدار بدن‬
• Rectus sheath formed from connective tissue aponeuroses of other
abdominal muscles as they insert in the midline connective tissue
called the linea alba
AFAMS
‫• پوش ریکتوس از انساج منظم ترکیب یافته و پوش وتری دیگر عضالت بطن به‬
‫مجرد که داخل خط متوسط انساج منظم میگردد بنام لینا البا یاد میگردد‪.‬‬
‫‪AFAMS‬‬
Muscles Used in Breathing
‫عضالت که در فعل تنفس استعمال میگردد‬
•
•
•
•
Breathing requires a change in size of ‫در هنگام فعل تنفس ضرور است تا اندازه قفس صدری‬
the thorax
.‫تغیر نماید‬
During inspiration, thoracic cavity
‫ جوف صدر از نظر اندازه بزرگ‬،‫در زمان شقیق‬
increases in size
.‫میگردد‬
– external intercostal lift the ribs
.‫– عضله خارج بین الضلعی اضالع را بلند مینماید‬
– diaphragm contracts & dome is
‫– حجاب عاجز تقلص نموده و شکل گنبد مانند آن‬
flattened
.‫هموار میگردد‬
During expiration, thoracic cavity
‫ جوف صدر از نظر اندازه کوچک‬،‫در زمان زفیر‬
decreases in size
.‫میگردد‬
– internal intercostal mm used in
forced expiration
‫– عضله داخل بین الضلعی در جریان زفیر جبری‬
Diaphragm is innervated by phrenic
.‫استعمال میگردد‬
nerve (C3-C5) but intercostals
)‫حجاب عاجز توسط عصب فرینیک (حجاب حاجزی‬
innervated by thoracic spinal nerves
‫) تعصیب شده اما بین اضالع توسط اعصاب‬C3-C5(
(T2-T12)
.‫) تعصیب شده است‬T2-T12( ‫صدری نخاعی‬
AFAMS
•
•
•
•
‫‪Muscles Used in Breathing‬‬
‫عضالت که در فعل تنفس استعمال میگردد‬
‫‪AFAMS‬‬
AFAMS
SURFACE ANATOMY OF THE
LUNGS
Where to stick your stethoscope.
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Surface anatomy of the lungs
• Apices: 2.5cm above the medial 1/3rd of clavicle.
• Medial border: pass behind the sternoclavicular joint and down
to the sternal angle. On left the border deviates to the left 3cm
at 4th costal cartilage, then continues down to the 6th.
• The lower borders of the lung are:
– T6 - mid-clavicular line (anterior)
– T8 - mid-axillary line (Lateral)
– T10 - posteriorly
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Surface anatomy (cont)
• The lower borders of the pleura are:
– T8 - mid-clavicular line
– T10 - mid-axillary line
– T12 - posteriorly
• Lung Fissures:
– Oblique fissure runs from the spinal process of T3 posteriorly to the
level of T6 anteriorly;
– The transverse fissure is on the right at T4.
• Lobes: Lobes are created by the fissures.
– Right lung: upper, middle and lower lobe
– Left lung: upper and lower lobe.
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Surface anatomy (cont)
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Surface anatomy (cont)
•
The anterior aspect of the chest wall:
– Upper lobe – right and left.
– T4-T6 is the middle lobe – right only.
•
The axilla and lateral aspect of the chest wall:
– upper, middle (right) and lower lobes.
•
The posterior aspect of the chest wall:
– Lower lobes – right and left.
AFAMS
Surface anatomy of the lungs
Front of thorax, showing surface
relations of bones, lungs (purple),
pleura (blue), and heart (red
outline).
Side of thorax, showing surface
markings for bones, lungs
(purple), pleura (blue), and
spleen (green).
AFAMS
Surface anatomy of the lungs
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Thorax
• The superior portion of the trunk sandwiched between the
neck superiorly and the abdomen inferiorly.
• Consists of the chest and the “upper back.”
• On the anterior surface of the chest are the two dominating
surface features of the thorax.
– the clavicles and the sternun
13-30
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The Sternum
• Palpated readily as the midline bony structure in the
thorax.
• The manubrium, the body, and the xiphoid process may
also be palpated.
• Sternal angle can be felt as an elevation between the
manubrium and the body.
• Sternal angle is clinically important because it is at the
level of the costal cartilage of the second rib.
– it is often used as a landmark for counting the ribs
13-31
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The Abdomen
• On the anterior surface of the abdomen, the umbilicus (navel) is the
prominent depression or projection in the midline of the abdominal
wall.
• In the midline of the abdominal anterior surface is the linea alba, a
tendinous structure that extends inferiorly from the xiphoid process to
the pubic symphysis.
• The left and right rectus abdominis muscles and their tendinous
insertions are referred to as “six-pack abs.”
• The superior aspect of the ilium (iliac crest) terminates anteriorly at the
anterior superior iliac spine.
• Attached to the anterior superior iliac spine is the inguinal ligament,
which forms the lower boundary of the abdominal wall.
13-32
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33
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The Inguinal Ligament
• Terminates on a little anterior bump on the pubis
called the pubic tubercle.
• Superior to the medial portion of the inguinal
ligament is the superficial inguinal ring.
– a superficial opening in the lower anterior abdominal
wall
– represents a weak spot in the wall
– can be palpated to detect an inguinal hernia
13-34
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Lever Systems and Leverage
‫سیستم اهرمی و شیوه بکار برده اهرمی‬
• Muscle acts on rigid rod (bone)
that moves around a
fixed point called a fulcrum
• Resistance is weight of body
part & perhaps an object
• Effort or load is work done
by muscle contraction
• Mechanical advantage
– the muscle whose attachment is farther from the joint will
produce the most force
– the muscle attaching closer to the joint has the greater
range of motion and the faster the speed it can produce
AFAMS
‫• عضله باالی یک میله (عظم) عمل مینماید که بدور یک نکته ثابت حرکت مینماید و‬
‫بنام ‪ fulcrum‬یا نقطه اتکاه یاد میگردد‪.‬‬
‫• در مقابل بخشی از وزن بدن مقاومت نموده و ممکن است هم یک هدف باشد‪.‬‬
‫• کوشش یا فشار در حقیقت کاری انجام شده توسط تقلص عضلی میباشد‪.‬‬
‫• فواید میخانیکی‬
‫– عضله که اتصال آن از مفصل دورتر واقع شده در حقیقت نیروی بیشتری را تولید‬
‫خواهد کرد‪.‬‬
‫– عضله که اتصال آن به مفصل نزدیکتر است دارای دامنه حرکت بزرگ و میتواند‬
‫سرعت سریعتر را تولید نماید‪.‬‬
‫‪AFAMS‬‬
•
First - Class Lever
‫اهرم درجه اول‬
Can produce mechanical
advantage or not depending
on location of effort &
resistance
– if effort is further from
fulcrum than resistance,
then a strong resistance
can be moved
•
Head resting on vertebral
column
‫میتواند فواید میخانکی را تولید نماید یا‬
‫ننماید که این خود وابسته به موقعیت‬
.‫کوشش و مقاومت است‬
•
‫– اگر کوشش نظر به مقاومت از نقطه‬
‫ پس در‬،‫اتکاه دورتر باشد‬
‫اینصورت مقاومت قوی میتواند‬
.‫حرکت داده شود‬
‫رأس باالی ستون فقرات استاده شده‬
.‫است‬
– weight of face is the
resistance
.‫– وزن وجه در حقیقت مقاومت است‬
– joint between skull &
atlas is fulcrum
‫– مفصل بین جمجمه و فقره اطلس در‬
.‫حقیقت نقطه اتکاه است‬
– posterior neck muscles
provide effort
‫– عضله خلفی عنق کوشش را فراهم‬
.‫مینماید‬
AFAMS
•
Second - Class Lever
‫اهرم درجه دوم‬
•
Similar to a wheelbarrow
•
Always produce mechanical
advantage
– resistance is always
closer to fulcrum than
the effort
•
Sacrifice of speed for force
•
Raising up on your toes
– resistance is body
weight
– fulcrum is ball of foot
– effort is contraction of
calf muscles which pull
heel up off of floor
.‫مشابه به یک چرخ دستی است‬
•
.‫همیشه فواید میخانیکی را تولید مینماید‬
•
‫– مقاومت هیمشه نزدیک به اتکاه بوده‬
‫نظر به کوشش‬
.‫فدا کاری سرعت برای فشار‬
•
.‫انگشتان شما را بلند مینماید‬
•
.‫– وزن بدن را مقاومت مینماید‬
‫– نقطه اتکاه در حقیقت گوشت زیر‬
.‫پنجه پا است‬
‫– کوشش در حقیقت تقلص عضله ساق‬
‫پا بوده که کری پا را از زمین بلند‬
.‫مینماید‬
AFAMS
Third - Class Lever
‫اهرم درجه سوم‬
•
Most common levers in the
body
•
Always produce a mechanical
disadvantage
– effort is always closer to
fulcrum than resistance
•
Favors speed and range of
motion over force
•
Flexor muscles at the elbow
– resistance is weight in
hand
– fulcrum is elbow joint
– effort is contraction of
biceps brachii muscle
‫یکی از معمولترین اهرم‬
•
‫همیشه فواید میخانیکی را تولید‬
.‫مینماید‬
•
‫– کوشش همیشه نظر به مقاومت به‬
.‫نقطه اتکاه نزدیک است‬
‫طرفداری سرعت و دامنه حرکت‬
.‫باالتر از قوه است‬
•
‫عضله قبض کننده در آرنج‬
•
‫– مقاومت در حقیقت وزن دست‬
.‫است‬
‫– نقطه اتکاه در حقیقت مفصل‬
.‫آرنج است‬
‫– کوشش تقلص عضله بای سپس‬
.‫براخی میباشد‬
AFAMS
Fascicle Arrangements
• A contracting muscle shortens to about 70% of its length
– muscles with longer fibers have a greater range of motion
– a short fiber can contract as forcefully as a long one.
AFAMS
‫تنظیم الیاف عضالتی‬
‫• یک تقلص در حقیقت طول عضله در حدود ‪ %70‬کاهش میدهد‪.‬‬
‫– عضالت که الیاف طویل دارد در حقیقت دامنه حرکت طوالنیتر دارند‪.‬‬
‫– الیاف کوتا میتواند مانند الیاف طویل تقلص نمایند‪.‬‬
‫‪AFAMS‬‬
Coordination Within Muscle Groups
‫هماهنگی در بین گروپهای عضلی‬
• Most movement is the result of
several muscle working at the same
time
• Most muscles are arranged in
opposing pairs at joints
‫• اکثریت حرکات در نتیجه کارکرد چندین عضله‬
.‫در عین زمان است‬
‫• اکثریت عضالت در ناحیه مفصل بشکل مخالف‬
.‫باهمدیگر تنظیم شده اند‬
– prime mover or agonist contracts
to cause the desired action
‫– عامل محرک یا تقلص مضطرب سبب یک‬
.‫عمل قابل میل میگردد‬
– antagonist stretches and yields to
prime mover
‫– کشش مخالف و محصول سبب عامل‬
.‫محرک میگردد‬
– synergists contract to stabilize
nearby joints
– fixators stabilize the origin of the
prime mover
.‫– تقلص کمکی تا مفصل نزدیک را ثبات دهد‬
‫– تثبیت کننده منشاءعامل محرک را ثبات‬
.‫میبخشد‬
‫• کتف بشکل همنواخت عضله دلتوید را‬
• scapula held steady so deltoid .‫نگهداشته تا بتواند بازو را بلند نماید‬
can raise arm
AFAMS
Muscles that Move the Arm
• Deltoid arises from acromion & spine of scapula & inserts on arm
– abducts, flexes & extends arm
• Rotator cuff muscles extend from scapula posterior to shoulder joint to attach to
the humerus
– supraspinatus & infraspinatus : above & below spine of scapula
– subscapularis on inner surface of scapula
AFAMS
‫عضله که بازو را حرکت میدهد‬
‫• عضله دلتوید از قلعه و برامده گی کتف منشاءگرفته و داخل بازو میگردد‪.‬‬
‫– بازو را تبعد‪ ،‬قبض و بسط میدهد‪.‬‬
‫• عضالت تدور دهنده از قسمت خلفی کتف تا به مفصل شانه وسعت یافته و با عضد اتصال‬
‫میابد‪.‬‬
‫– سوپراسپیناتوس و انفراسپیناتوس‪ :‬از قسمت برامده کتف باال و پاین‬
‫– عضله تحت الکتفی یا ‪subscapularis‬در سطح داخل کتف موقعیت داخل‪.‬‬
‫‪AFAMS‬‬
Shoulder and Upper Limb Region
•
Clinically important because of frequent trauma to these body regions.
•
Vessels of the upper limb are often used as pressure sites and as sites for
drawing blood, providing nutrients and fluids, and administering medicine.
13-45
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Shoulder
• The scapula, clavicle, and proximal part of the
humerus collectively form the shoulder. The
acromion is the bump on your anterior shoulder.
• The rounded curve of the shoulder is formed by
the thick deltoid muscle, which is a frequent site
for intramuscular injections.
13-46
AFAMS
Axilla
• Commonly called the armpit, is clinically important
because of the nerves, axillary blood vessels, and lymph
nodes located there.
• The pectoralis major forms the fleshy anterior axillary fold,
which acts as the anterior border of the axilla.
• The latissimus dorsi and teres major muscles form the
fleshy posterior axillary fold, which is the posterior border
of the axilla.
13-47
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48
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49
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Flexors of the Forearm (elbow)
•
Cross anterior surface of elbow joint & form flexor
muscle compartment
•
Biceps brachii
– scapula to radial tuberosity
– flexes shoulder and elbow & supinates hand
•
Brachialis
– humerus to ulna
– flexion of elbow
•
Brachioradialis
– humerus to radius
– flexes elbow
AFAMS
‫قبض کننده ساعد(آرنج)‬
‫• سطح قدامی آرنج و جز عضله قابضه ساعد را‬
‫عبور مینماید‪.‬‬
‫• بایسپس عضدی ‪Biceps brachii‬‬
‫– کتف تا به قسمت برامده گی کعبره‬
‫– شانه و آرنج را قبض داده و دست را‬
‫بطرف باال وضعیت میدهد‪.‬‬
‫• ‪Brachialis‬عضدی‬
‫– عضد تا به زند‬
‫– قبض آرنج‬
‫• ‪Brachioradialis‬عضدی کعبری‬
‫– عضد تا به کعبره‬
‫– قبض آرنج‬
‫‪AFAMS‬‬
Arm
• The brachium which extends from the shoulder to
the elbow on the upper limb.
• On the anterior side of the arm, the cephalic vein
is evident in muscular individuals as it traverses
along the lateral border of the entire upper limb.
• This vein originates in a small surface depression,
bordered by the deltoid and pectoralis major
muscles, called the clavipectoral triangle.
13-52
AFAMS
Arm
• The basilic vein is sometimes evident along the medial side
of the upper limb.
• Brachial artery becomes subcutaneous along the medial
side of the brachium, and its pulse may be detected here.
• Clinically important in measuring blood pressure.
13-53
AFAMS
54
AFAMS
The Arm and Elbow
• The biceps brachii muscle becomes prominent when the
elbow is flexed.
• Located on the anterior surface of the elbow region, the
cubital fossa is a depression within which the median
cubital vein connects the basilic and cephalic veins.
• The cubital fossa is a common site for venipuncture
(removal of blood from a vein).
13-55
AFAMS
The Arm and Elbow
• The bulk of the posterior surface of the brachium is formed
by the triceps brachii muscle.
• Three bony prominences are readily identified in the distal
region of the brachium near the elbow.
• The lateral epicondyle of the humerus is a rounded lateral
projection at the distal end of the humerus.
• The olecranon of the ulna is palpated easily along the
posterior aspect of the elbow.
• The medial epicondyle of the humerus is more prominent
and may be easily palpated.
13-56
AFAMS
57
AFAMS
Extensors of the Forearm (elbow)
•
Cross posterior surface of elbow joint & forms extensor muscle compartment
•
Triceps brachii
– long head arises scapula
– medial & lateral heads from humerus
– inserts on ulna
– extends elbow & shoulder joints
•
Anconeus
– assists triceps brachii in extending the elbow
AFAMS
‫بسط کننده ساعد(آرنج)‬
‫• سطح خلفی مفصل آرنج و جز عضله باسطه‬
‫ساعد را عبور مینماید‪.‬‬
‫• عضدی ترایسپس‪Triceps brachii‬‬
‫– شعبه طویل آن از کتف منشاءگرفته‬
‫– شعبه وحشی و انسی از آن از عضد‬
‫منشاءمیگرد‪.‬‬
‫– داخل زند میگردد‪.‬‬
‫– مفاصل شانه و آرنج را وسعت میدهد‪.‬‬
‫• ‪Anconeus‬‬
‫– در وسعت دادن آرنج عضله ‪Triceps‬‬
‫‪ brachii‬را کمک مینماید‪.‬‬
‫‪AFAMS‬‬
Cross-Section Through Forearm
‫شق عرضانی از طریق ساعد‬
• If I am looking down onto this section is it from right or left arm?
.‫• اگر بطرف پائین نگاه کنیم آیا این بخش از بازو راست است یا چپ‬
AFAMS
‫شق عرضانی از طریق ساعد‬
‫‪AFAMS‬‬
Forearm
• The radius, the ulna, and the muscles that control hand
movements form the forearm, or antebrachium.
• Proximal part of the forearm is bulkier, due to the fleshy
bellies of the forearm muscles.
• Distally, the forearm becomes thinner as you are palpating
the tendons of these muscles.
• The styloid processes of the radius and ulna are readily
palpable as the lateral and medial bumps along the wrist,
respectively.
13-62
AFAMS
The Forearm
• Tendons of the extensor pollicis brevis, abductor
pollicis longus, and extensor pollicis longus
muscles mark the boundary of the triangular
anatomic snuffbox.
• Palpate the pulse of the radial artery here.
• Palpate the scaphoid bone in this region.
13-63
AFAMS
64
AFAMS
Retinaculum
‫ریتناکولم‬
• Tough connective tissue band that helps hold tendons in place
• Extensor & Flexor retinaculum cross wrist region attaching from bone to bone
(carpal tunnel syndrome = painful compression of median nerve due to narrowing
passageway under flexor retinaculum
AFAMS
‫‪Retinaculum‬‬
‫ریتناکولم‬
‫• نوار انساج ارتباطی کمک مینماید تا اربطه ها را در محل شان نگهدارد‪.‬‬
‫• ریتیناکولم قابضه و باسطه ناحیه بند دست را عبور نموده و از یک عظم به عظم دیگر‬
‫اتصال دارد (کارپال تونل سندروم= تحت فشار قرار گرفتن دردناک عصب متوسط‬
‫ناشی از تنگ شدن مسیر در تحت ریتیناکولم قابضه)‬
‫‪AFAMS‬‬
Intrinsic Muscles of the Hand
‫عضالت حقیقی داخلی دست‬
•
•
•
•
•
Origins & insertions are within the hand
Help move the digits
Thenar muscles move the thumb
Hypothenar muscles move the little finger
Opposition, flexion, extension, abduction & adduction
AFAMS
‫‪Intrinsic Muscles of the Hand‬‬
‫عضالت حقیقی داخلی دست‬
‫•‬
‫•‬
‫•‬
‫•‬
‫•‬
‫منشاءو دخول آن در بین دست واقع شده است‪.‬‬
‫کمک نموده تا انگشتان حرکت نماید‪.‬‬
‫عضالت تینار کف دست سبب حرکت انگشت شصت میگردد‪.‬‬
‫عضالت ‪Hypothenar‬انگشت کوچک را حرکت میدهد‪.‬‬
‫متقابل‪ ،‬تقبض‪ ،‬بسط‪ ،‬تبعد و تقرب‪abduction ،extension ،flexion ،opposition(.‬و ‪) adduction‬‬
‫‪AFAMS‬‬
69
AFAMS
Muscles Crossing the Hip Joint
•
•
•
•
Iliopsoas flexes hip joint
– arises lumbar vertebrae & ilium
– inserts on lesser trochanter
Quadriceps femoris has 4 heads
– Rectus femoris crosses hip
– 3 heads arise from femur
– all act to extend the knee
Adductor muscles
– bring legs together
– cross hip joint medially
– see next picture
Pulled groin muscle
– result of quick sprint activity
– stretching or tearing of iliopsoas
or adductor muscle
AFAMS
‫عضالت که از مفصل حرقفی فخذی عبور مینماید‬
‫•‬
‫•‬
‫•‬
‫•‬
‫‪ Iliopsoas‬سبب قبض مفصل حرقفی فخذی میگردد‪.‬‬
‫– از فقرات قطنی و حرقفه منشاءمیگرد‪.‬‬
‫– داخل تروخانتیر ضغیر میگردد‪.‬‬
‫عضله ‪ Quadriceps femoris‬دارای چهار رأس‬
‫میباشد‪.‬‬
‫– عضله ‪ Rectus femoris‬از مفصل حرقفی فخذی‬
‫عبور مینماد‬
‫– سه رأس آن از فخذ منشاءمیگرد‪.‬‬
‫– تمام آنها برای وسعت زانو فعالیت مینماید‪.‬‬
‫عضله تقرب دهنده‬
‫– پاها را باهمدیگر یکجا میسازد‪.‬‬
‫– وسطأ مفصل حرقفی فخذی را عبور مینماید‪.‬‬
‫– تصویر بعدی را تماشا کنید‪.‬‬
‫کشش عضله مغبنی‬
‫– فعایت دویدن سریع را باعث میشود‪.‬‬
‫– سبب کشش یا پاره گی عضله ‪ iliopsoas‬یا تقرب‬
‫دهنده میگردد‪.‬‬
‫‪AFAMS‬‬
Gluteal Region
• The inferior border of the gluteus maximus muscle forms
the gluteal fold.
• The gluteal (natal) cleft extends vertically to separate the
buttocks into two prominences.
• In the inferior portion of each buttock, an ischial tuberosity
can be palpated; these tuberosities support body weight
while seated.
• The gluteus maximus muscle forms most of the
inferolateral “fleshy” part of the buttock.
• The gluteus medius muscle may be palpated only in the
superolateral portion of each buttock.
13-72
AFAMS
Adductor Muscles of the Thigh
• Adductor group of
muscle extends from
pelvis to linea aspera on
posterior surface of
femur
– pectineus
– adductor longus
– adductor brevis
– gracilis
– adductor magnus
(hip extensor)
AFAMS
‫عضله تقرب دهنده ران‬
‫• گروپ عضالت تقرب دهند در‬
‫سطخ خلفی فخذ از حوصله تا‬
‫‪ linea aspera‬وسعت مینماید‪.‬‬
‫– ‪pectineus‬‬
‫– تقرب دهنده ‪longus‬‬
‫– تقرب دهنده ‪brevis‬‬
‫– ‪gracilis‬‬
‫– تقرب دهنده ‪magnus‬‬
‫(بسط دهنده ران )‬
‫‪AFAMS‬‬
The Thigh
• Many muscular and bony features are readily identified in
the thigh, which extends between the hip and the knee on
each lower limb.
• An extremely important element of thigh surface anatomy
is a region called the femoral triangle.
• The femoral triangle is a depression inferior to the groove
that overlies the inguinal ligament on the anteromedial
surface in the superior portion of the thigh.
• The femoral artery, vein, and nerve travel through this
region, making it an important arterial pressure point for
controlling lower limb hemorrhage.
13-75
AFAMS
Thigh and Knee
• On the distal part of the anterior thigh, are the three parts
of the quadriceps femoris as they approach the knee.
• Still on the anterior side of the thigh, three obvious skeletal
features can be observed and palpated:
– (1) The greater trochanter is palpated on the superior lateral surface
of the thigh;
– (2) the patella is located easily within the patellar tendon; and
– (3) the lateral and medial condyles of both the femur and tibia are
identified and palpated at each knee.
13-76
AFAMS
77
AFAMS
Muscles of the Calf (posterior leg)
• 3 muscles insert onto calcaneus
– gastrocnemius arises femur
• flexes knee and ankle
– plantaris & soleus arise from leg
• flexes ankle
• Deeper muscles arise from tibia or
fibula
– cross ankle joint to insert into
foot
• tibialis posterior
• flexor digitorum longus
• flexor hallucis longus
– flexing ankle joint & toes
AFAMS
‫عضالت ساق پا (پای خلفی)‬
‫•‬
‫•‬
‫سه عضله به کالکانوس داخل میگردد‪.‬‬
‫– ‪ gastrocnemius‬از فخذ منشاء گرفته‬
‫است‬
‫• زانو و عنق القدم را قبض میدهد‪.‬‬
‫– ‪ plantaris‬و ‪ soleus‬از پا‬
‫منشاءمیگیرد‪.‬‬
‫• قبض عنق القدم‬
‫عضالت عمیقتر از قصبه و شزیه‬
‫منشاءمیگرد‪.‬‬
‫– مفصل عنق القدم را عبور نموده و داخل‬
‫پا میگردد‪.‬‬
‫• قصبه خلفی‬
‫• قابضله‬
‫• ‪flexor hallucis longus‬‬
‫– مفصل عنق القدم و انگشتان را قبض‬
‫مینماید‪.‬‬
‫‪AFAMS‬‬
Muscles of the Leg and Foot
•
•
•
Anterior compartment of leg
– extensors of ankle & toes
• tibialis anterior
• extensor digitorum longus
• extensor hallucis longus
– tendons pass under retinaculum
Shin splits syndrome
– pain or soreness on anterior tibia
– running on hard surfaces
Lateral compartment of leg
– peroneus muscles plantarflex the
foot
– tendons pass posteriorly to axis of
ankle joint and into plantar foot
AFAMS
‫عضالت پا و قدم‬
‫• بخش قدامی پا‬
‫– بسط دهنده عنق القدم و انگشتان‬
‫• قدامی قصبه‬
‫• بسط دهنده ‪digitorum longus‬‬
‫• بسط دهنده ‪hallucis longus‬‬
‫– اربطه که از تحت ریتیناکولم عبور‬
‫مینماید‪.‬‬
‫• سندروم ‪Shinsplits‬‬
‫– درد یا ناراحتی در قسمت قدامی قصبه‬
‫– دویدن باالی سطح بسیار سخت‬
‫• بخش وحشی پا‬
‫– عضله ‪ peroneus‬قبض کننده کف پا‬
‫– اربطه های که خلفأ محور مفصل عنق‬
‫القدم را عبور نموده و به کف پا میرسد‪.‬‬
‫‪AFAMS‬‬
82
AFAMS
83
AFAMS
84
AFAMS
Muscles of the Plantar Foot
• Intrinsic muscles
– arise & insert in foot
• 4 layers of muscles
– get shorter as go into
deeper layers
• Flex, adduct & abduct toes
• Digiti minimi muscles
move little toe
• Hallucis muscles move big
toe
• Plantar fasciitis (painful
heel syndrome) chronic
irritation of plantar
aponeurosis at calcaneus
– improper shoes &
weight gain
AFAMS
‫عضالت کف پا یا پالنتر‬
‫•‬
‫•‬
‫•‬
‫•‬
‫•‬
‫•‬
‫عضالت حقیقی‬
‫– منشاءو دخول آن قدم است‪.‬‬
‫عضالت چهار طبقه دارد‪.‬‬
‫– به هر اندازه که به طبقه عمیق فرومیرود‬
‫عضله کوتاه تر میگردد‪.‬‬
‫انگشتان را قبض‪ ،‬تقرب و تبعد میدهد‪.‬‬
‫عضالت ‪Digiti minimi‬انگشت کوچک را‬
‫حرکت میدهد‪.‬‬
‫عضالت ‪ Hallucis‬انگشت بزرگ پا را‬
‫حرکت میدهد‪.‬‬
‫التهاب سفاق کف پا (سندروم دردناک کری پا)‬
‫تخریش مزمن پوشش وتری ناحیه کالکانوس‪.‬‬
‫– بوت های نامناسب و گرفتن وزن‬
‫‪AFAMS‬‬
Foot and Toes
• The phalanges, metatarsophalangeal joints, PIP and DIP
joints, and toenails are obvious surface landmarks readily
observed when viewing either the lateral side or the
dorsum of the foot.
• The medial surface of the foot clearly illustrates the high,
arched medial longitudinal arch.
• At the distal end of the medial longitudinal arch, the head
of metatarsal I appears as a prominent bump.
13-87
AFAMS
88
AFAMS
89
AFAMS
Homeostatic Imbalances Related
to Muscle System
• Muscular Dystrophy
• Rhabdomyolysis
• Compartment
Syndrome
AFAMS
Muscular Dystrophy
• Group of muscle diseases (Duchenne, Becker, limb-girdle,
oculopharyngeal are among the major types)
• Genetically inherited
• progressive skeletal muscle weakness, defects in muscle proteins, and the
death of muscle cells and tissue
• Most often effects males, but females can be carriers
• No cure, but physiotherapy, low intensity exercise, steroids, prednisone
can help manage disease
• Morbidity and mortality vary greatly with type and severity of disease
AFAMS
Rhabdomyolysis
•
•
•
•
•
associated with rapid skeletal muscle destruction
muscle breaks down into myoglobin released in the urine
may lead to kidney failure as high concentrations of myoglobin is harmful to the
kidneys
symptoms include muscle weakness, stiffness, and pain
treatment includes early use of intravenous fluid, dialysis as well as
hemofiltration in severe cases
AFAMS
Compartment Syndrome
• Is a limb-threatening condition which occurs after an injury, when there is
insufficient blood to supply the muscles and nerves because of the raised
pressure (due to swelling) within the compartment such as the arm, leg or any
enclosed space (muscle covered in fascia does not allow for much swelling)
• 6 P’s :
– Pain (seemingly out of proportion for nature of injury)
– Parasthesia
– Pallor
– Paralysis
– Pulselessness (very late, not often found)
– Pressure
• Treatment, if pressure sufficiently high, is fasciotomy
AFAMS
Questions?
(Insert Dari)
AFAMS
In-class assignment
(insert dari)
AFAMS
1. Identify the following muscles:
(Insert Dari)
8.
1.
2.
9.
10.
11.
3.
4.
12.
5.
6.
7.
AFAMS
1. Answer
8. Insert Dari
9. Insert Dari
1. Insert Dari
2. Insert Dari
10. Insert Dari
3. Insert Dari
11.Insert Dari
4. Insert Dari
12. Insert Dari
5. Insert Dari
6. Insert Dari
7. Insert Dari
AFAMS
2.Identify the following muscles:
(Insert Dari)
98
AFAMS
2.Identify the following muscles:
(Insert Dari)
99
AFAMS
3.Identify the following muscles:
(Insert Dari)
1
2
3
6
7
4
5
100
AFAMS
3.Identify the following muscles:
(Insert Dari)
101
AFAMS
4. Which of the following means rapid muscle
destruction?
(Insert Dari)
A) Atrophy
B) Hypertrophy
C) Rhabdomylosis
(Insert Dari)
AFAMS
4. Which of the following means rapid muscle
destruction?
(Insert Dari)
A) Atrophy
B) Hypertrophy
C) Rhabdomylosis
(Insert Dari)
AFAMS
5.Identify the types of levers in the diagrams
below:
Dari
AFAMS
5.Identify the types of levers in the diagrams
below:
Dari
AFAMS