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FDN Level 2 Muscle Chart Listed below are the muscles you will be expected to treat in FDN Level 2. Use this chart as a guide to focus on attachments, segments of innervation, and the functional role of each muscle. Begin to envision the three dimensionality of the anatomy. Understand that variations may be found across different resources. The information herein is adapted from: Davies, D. V., & Davies, F. (Eds.). (1962). Gray's anatomy: Descriptive and Applied. Longmans. Drake, R.L., Vogl, A.W., Mitchell, A.W.M. (2010). Gray’s Anatomy for Students. Churchill Livingstone. Lower Leg Muscle Popliteus Origin Lateral femoral condyle Insertion Posterior surface of proximal tibia Innervation L4-L5-S1 Tibial nerve Tibialis Posterior Flexor Digitorum Longus Flexor Hallucis Longus Extensor Hallucis Longus Posterior surfaces of interosseous membrane and adjacent regions of tibia and fibula Mainly to tuberosity and adjacent region of medial cuneiform (also navicular bone, sustentaculum tali of calcaneus, cuboid, and bases of metatarsals 2-4) L4-L5 Medial side of posterior surface of the tibia Plantar surfaces of bases of distal phalanges of toes 2-5 S2-S3 Posterior surface of fibula and adjacent interosseous membrane Plantar surface of distal phalanx of great toe S2-S3 Middle ½ of medial surface of fibula and adjacent surface of interosseous membrane Dorsal surface of base of distal phalanx of great toe L5-S1 Tibial nerve Action Stabilizes knee joint (resists lateral rotation of tibia on femur); unlocks knee joint (laterally rotates femur on fixed tibia) Inversion and plantar flexion of foot; support of medial arch of foot during gait Flexes toes 2-4 Tibial nerve Flexion of great toe Tibial nerve Deep Fibular nerve Extension of great toe and dorsiflexion of foot Lower Thoracic, Advanced Lumbar, Abdominal *See Muscles of the Back at end of the muscle chart for descriptions of erector spinae group (longissimus, iliocostalis and spinalis) and transversospinales group (Semispinalis, multifidus, rotatores) muscles. Muscle Origin Insertion Innervation Action Multifidus Sacrum, origin of erector spinae, posterior superior iliac spine, mammillary processes of lumbar vertebrae, transverse processes of thoracic vertebrae and articular processes of C4C7 Base of spinous processes of all vertebrae from L5 -C2 Medial branch of the dorsal rami of segmental spinal nerves Quadratus Lumborum Transverse Process of L5 vertebra, iliolumbar ligament, and iliac crest Pubic crest, pubic tubercle, and pubic symphysis Transverse processes of L1L4 vertebrae and inferior border of rib 12 T12-L4 Anterior rami Stabilizes vertebrae in local movements of the vertebral column. Global movements – Contract bilaterally to extend the vertebral column Contract unilaterally to produce rotation in opposite direction Depress and stabilize rib 12 and some lateral bending of trunk Costal cartilages of ribs 5-7; xiphoid process T7-T12 Anterior rami External Oblique Muscular slips from the outer surfaces of the lower eight ribs Lateral lip of iliac crest; aponeurosis ending in midline raphe (linea alba) T7-T12 Anterior rami Internal Oblique Thoracolumbar fascia; iliac crest between origins of external and transversus; lateral 2/3 of inguinal ligament Inferior border of the lower three or four ribs; aponeurosis ending in linea alba; pubic crest and pectineal line T7-T12 Anterior Rami Rectus Abdominus Compress abdominal contents; flex vertebral column; tense abdominal wall Compress abdominal contents both muscles flex trunk; each muscle bends trunk to same side, turning anterior part of abdomen to opposite side Compress abdominal contents; both muscles flex trunk; each muscle bends trunk and turns anterior part of abdomen to same side Advanced Hip Muscle Origin Insertion Innervation Action Piriformis Anterior surface of sacrum between anterior sacral foramina Medial side of superior border of greater trochanter of femur L5-S1-S2 Nerve to piriformis Superior Gemellus External surface of ischial spine L5-S1 Nerve to Obturator Internus Obturator Internus Anterolateral wall of true pelvis; deep surface of obturator membrane and surrounding bone Upper aspect of ischial tuberosity Along length of superior surface of the obturator internus tendon and into the medial side of greater trochanter with obturator internus tendon Medial side of greater trochanter of femur L5-S1 Nerve to Obturator Internus Laterally rotates the extended femur at hip joint; abducts flexed femur at hip joint Along length of inferior surface of the obturator internus tendon and into the medial side of greater trochanter with obturator internus tendon Quadrate tubercle on the intertrochanteric crest of the proximal femur Lesser trochanter of femur Lesser trochanter of femur L5-S1 Nerve to Quadratus Femoris Laterally rotates the extended femur at hip joint; abducts flexed femur at hip joint L5-S1 Nerve to Quadratus Femoris Laterally rotates femur at hip joint L2-L3 Femoral nerve Flexes the thigh at the hip joint L1-L2-L3 Flexes the thigh at the hip joint Inferior Gemellus Quadratus Femoris Lateral aspect of the ischium just anterior to the ischial tuberosity Iliacus Posterior abdominal wall (iliac fossa) Posterior abdominal wall (lumbar transverse processes, intervertebral Psoas Major Laterally rotates the extended femur at hip joint; abducts flexed femur at hip joint Laterally rotates the extended femur at hip joint; abducts flexed femur at hip joint Pectineus Adductor Brevis discs, and adjacent bodies from T12-L5 and tendinous arches between these points) Pectineal Line (pectin pubis) and adjacent bone of pelvis External surface of body of pubis and inferior pubic ramus Oblique line extending from base of lesser trochanter to linea aspera on posterior surface of proximal femur Posterior surface of proximal femur and upper 1/3 of linea aspera L2-L3 Obturator nerve Adducts and flexes thigh at the hip joint L2-L3 Obturator nerve Adducts the thigh at the hip joint Upper-Mid Thoracic and Parascapular *See Muscles of the Back at end of the muscle chart for descriptions of erector spinae group (longissimus, iliocostalis and spinalis) and transversospinales group (Semispinalis, multifidus, rotatores) muscles. Muscle Multifidus Levator Scapula Middle and Origin Insertion Innervation Action Sacrum, origin of erector spinae, posterior superior iliac spine, mammillary processes of lumbar vertebrae, transverse processes of thoracic vertebrae and articular processes of lower four cervical vertebrae Transverse processes C1-4 Base of spinous processes of all vertebrae from L5 -C2 Medial branch of the dorsal rami of segmental spinal nerves Stabilizes vertebrae in local movements of the vertebral column. Spinous process Superior edge of Global movements – Contract bilaterally to extend the vertebral column Contract unilaterally to produce rotation in opposite direction Upper portion medial border of scapula C3-C4 (anterior rami) and C4-C5 (dorsal scapular nerve) Motor - spinal Elevates scapula Middle fibres Lower Trapezius of C7-T12 and the related supraspinous ligaments the crest of the spine of the scapula and acromion part of the accessory nerve Sensory anterior rami of C3 and C4 retract scapula. Lower fibres depress scapula and assist in upward rotation of the scapula during abduction of the humerus above horizontal Rhomboid Minor Lower portion of ligamentum nuchae, spinous processes of C7T1 Spinous processes of T25 Medial border of scapula at the spine of scapula C4-C5 Dorsal Scapular nerve Retracts (adducts) and elevates scapula Medial border of scapula between spine and inferior angle C4-C5 Dorsal Scapular nerve Retracts (adducts) and elevates scapula Rhomboid Major Advanced Cervical Spine Muscle Origin Sternocleidomastoid (SCM) Sternal Head Upper part of anterior surface of manubrium of sternum Clavicular Head Superior surface of medial 1/3 of clavicle Rectus Capitis Posterior Major Spinous process C2 Obliquus Capitis Superior Transverse process of C1 Insertion Lateral ½ of superior nuchal line Lateral surface of mastoid process Lateral portion of occipital bone below inferior nuchal line Occipital bone between superior and inferior nuchal lines Innervation C2-C3 Anterior rami and Spinal Accessory nerve (XI) C1 Posterior ramus C1 Posterior ramus Action Acting unilaterallyipsilateral sidebending, contralateral rotation of head; Acting Bilaterallydraws head forward Extension of the head Extension of head and ipsilateral sidebending Obliquus Capitis Inferior Multifidus Spinous process C2 Sacrum, origin of erector spinae, posterior superior iliac spine, mammillary processes of lumbar vertebrae, transverse processes of thoracic vertebrae and articular processes of lower four cervical vertebrae Transverse process C1 Base of spinous processes of all vertebrae from L5 -C2 C1 Posterior ramus Medial branch of the dorsal rami of segmental spinal nerves Ipsilateral rotation Stabilizes vertebrae in local movements of the vertebral column. Global movements – Contract bilaterally to extend the vertebral column Contract unilaterally to produce rotation in opposite direction Shoulder Girdle and Upper Extremity Origin Insertion Subclavius Muscle 1 rib at junction between rib and costal cartilage Groove on inferior surface of middle 1/3 of clavicle C5-C6 Nerve to subclavius Pectoralis Minor Anterior surfaces of ribs 3-5 and deep fascia overlying the related intercostal spaces Medial 2/3 of subscapular fossa Coracoid process of scapula C6-C7-C8 Medial pectoral nerve Lesser tubercle of humerus C5-C6-C7 Upper and Lower Subscapular nerves Coracobrachialis Apex of coracoid process C5-C6-C7 Musculocutaneous nerve Biceps Brachii- Apex of Linear roughening on mid-shaft of humerus on medial side Radial Subscapularis st Innervation C5-C6 Action Pulls clavicle medially to stabilize sternoclavicular joint Depresses tip of shoulder; protracts scapula Rotator cuff muscle; medially rotates the humerus at the glenohumeral joint Flexor of the arm at the glenohumeral joint Powerful flexor Short head coracoid process tuberosity Musculocunateous nerve Supraspinatus Medial 2/3 of the supraspinous fossa of the scapula and the deep fascia that covers the muscle Lateral surfaces of ribs 1-8/9 and deep fascial overlying the related intercostal spaces Most superior facet on the greater tubercle of the humerus C5-C6 Suprascapular nerve Costal surface of medial border of scapula C5-C6-C7 Long thoracic nerve Serratus Anterior of the forearm at the elbow joint and supinator of the forearm Rotator cuff muscle; initiation of abduction of arm to 15º at glenohumeral joint Protraction and rotation of the scapula; keeps medial border of scapula opposed to the thoracic wall The Hand Muscle First Dorsal Interosseous Origin Insertion Lateral Head st 1 metacarpal, proximal half (ulnar border) Innervation C8 - T1 Extensor hood and proximal phalanx of index finger Action Abduction of index finger Ulnar nerve (deep palmar branch) Medial Head nd nd th 2 -4 Dorsal Interossei Palmar Interossei 2 metacarpal, entire length (radial border) Extensor hood and proximal phalanx nd of index finger (2 digit) Adjacent sides metacarpal bones Extensor hood and base of proximal rd phalanges of 3 , th and 4 digits C8 - T1 Extensor hoods of nd th thumb and 2 , 4 , th and 5 digits, and proximal phalanx of thumb C8 - T1 Sides of metacarpals Ulnar nerve (deep palmar branch) Ulnar nerve (deep palmar branch) Abduction of rd th 3 and 4 digits (draws fingers away from midline of hand) Adduction of nd rd 2 , 3 , and th 5 (draws fingers toward midline of hand) Adductor Pollicis Oblique Head C8 - T1 Ulnar nerve Capitate bone, bases of second and third metacarpals, intercarpal ligaments, sheath of flexor carpi radialis st Base of 1 phalanx and extensor hood Transverse Head C8 - T1 Ulnar nerve Abductor Pollicis Brevis Flexor Pollicis Brevis st Third metacarpal (volar surface, lower 2/3) Base of 1 phalanx of (ulnar side) and extensor hood Tubercles of scaphoid and trapezium, transverse carpal ligament, Base of 1 phalanx (radial side) and extensor hood st Lateral portion (more superficial) Trapezium and transverse carpal ligament and st Base of 1 phalanx of thumb (radial side) Medial portion (deeper and more medial) Opponens Pollicis st C8 - T1 Median nerve, recurrent branch C8 - T1 Median nerve, recurrent branch C8 - T1 First metacarpal bone between adductor pollicis st and 1 dorsal interosseous Base of 1 phalanx of thumb (ulnar side) Ulnar nerve Tubercle of trapezium, transverse carpal ligament Lateral (radial) margin and adjacent palmar st surface of 1 metacarpal C8- T1 Median nerve, recurrent branch Adducts thumb (approximates thumb to palm) Adducts thumb (approximates thumb to palm) Abducts thumb at MCP (draws thumb into plane at right angle to palm) Flexes and adducts the proximal phalanx Flexes thumb at MCP Medially rotates the thumb Abductor Digiti Minimi Flexor Digiti Minimi Opponens digiti minimi Pisiform, pisohamate ligament, and tendon of flexor carpi ulnaris Proximal phalanx th of 5 digit (ulnar side) C8 - T1 Hook of hamate, transverse carpal ligament (volar surface) Proximal phalanx th of 5 digit C8-T1 Hamate, transverse carpal ligament Medial (ulnar) th aspect of 5 metacarpal Ulnar nerve th Abducts 5 digit at MCP and assists flexing proximal phalanx th Flexes 5 digit at MCP Ulnar nerve C8 - T1 Ulnar nerve Laterally th rotates 5 metacarpal (to deepen hollow of palm) The Foot Muscle Origin Insertion Innervation Extensor Digitorum Brevis Superolateral surface of the calcaneus Lateral sides of the tendons of EDL of digits 2-4 S1-S2 Extensor Hallucis Brevis (same origin as extensor digitorum brevis) Base of proximal phalanx of great toe S1-S2 Dorsal Interossei Sides of adjacent metatarsals Extensor hoods and bases of proximal phalanges of digits 2-4 S2–S3 Extensor hoods and bases of proximal phalanges of toes 3-5 S2–S3 Plantar Interossei Medial sides of metatarsals of toes 3-4 Action Extension of toes 2-4 Deep Fibular nerve Deep Fibular nerve Lateral Plantar nerve (from st tibial, though 1 nd and 2 are also innervated by deep fibular) Lateral Plantar nerve (from tibial) Extension of MTP joint of great toe Abduction of toes 2-4 at MTP joints (away from the axis of the nd 2 toe); resist extension of MTP joints; and flexion of IP joints Adduction of toes 2-5 at MTP joints nd (toward the 2 toe); resist extension of MTP joints; and flexion of the IP joints Abductor Hallucis Medial process of calcaneal tuberosity Flexor Hallucis Brevis Plantar survace of cuboid and lateral cuneiform; tendon of tibialis posterior Adductor Hallucis Transverse Head Ligaments associated with rd MTP joints of 3 , th th 4 , and 5 toes Medial side of base of proximal phalanx of great toe S1–S2–S3 Lateral and medial sides of base of proximal phalanx of the great toe S1-S2 Medial Plantar nerve Medial Plantar nerve S2-S3 Lateral side of base of proximal phalanx of great toe Lateral Plantar nerve nd rd Lateral side of base of proximal phalanx of great toe Flexor Digitorum Brevis Medial process of calcaneal tuberosity and plantar aponeurosis Sides of plantar surface of middle phalanges of lateral four toes Quadratus Plantae Medial Head Medial surface of calcaneus Lateral Head Lateral process of calcaneal tuberosity S1-S2-S3 Medial Plantar nerve S1-S2-S3 Lateral side of tendon of flexor digitorum longus tendon in proximal sole of the foot Lateral side of tendon of flexor digitorum longus tendon in proximal sole of the foot Flexes MTP joint of the great toe Adducts the great toe at MTP joint Transverse head also approximates all the toes which increases curve of transverse arch of metatarsus Oblique Head Bases of 2 , 3 , th and 4 metatarsals, sheath covering fibularis longus tendon Abducts and flexes the great toe at MTP joint Lateral Plantar nerve Flexes lateral four toes at PIP joint Assists FDL tendon in flexing toes 25 (by converting the oblique pull of FDL into a direct backward pull on the toes) Abductor Digiti Minimi Flexor Digiti Minimi Brevis Lateral and medial processes of calcaneal tuberosity, and band of connective tissue connecting calcaneus with base th of 5 metatarsal Lateral side of base of proximal th phalanx of 5 digit S1-S2-S3 th Lateral side of base of proximal th phalanx of 5 digit S2-S3 Base of 5 metatarsal and related sheath of fibularis longus tendon Lateral Plantar nerve Lateral Plantar nerve Abducts the th 5 toe at MTP joint Flexes the little toe at MTP joint TMJ Muscle Temporalis Masseter Origin Temporal fossa Zygomatic arch Insertion Innervation Action Coronoid process and anterior ramus of mandible Mandibular branch of trigeminal nerve Vertical fibers elevate mandible Lateral surface ramus and angle of mandible Mandibular branch of trigeminal nerve Horizontal fibers retract the mandible Superficial fibers elevate and protrude the mandible. Deep fibers elevate and retrude ipsilateral deviation. Erector Spinae and Transversospinales Groups Muscle Origin Insertion Innervation Action Erector Spinae Iliocostalis, Longissimus, Spinalis Iliocostalis Lumborum Sacrum, spinous processes of T10-L5 and their supraspinous ligaments, and the iliac crest Segmental Angles of the lower six or seven ribs Thoracis Angles of ribs 612 (upper borders of the angles) Angles of ribs 16 (upper borders, transverse process C7 Cervicis Angles of ribs 36 Transverse processes C4C6 Primary extensors of the vertebral column and head. Acting bilaterally they straighten the back returning it upright from a flexed position. They also participate in controlling vertebral column flexion by contracting and relaxing in a coordinated fashion Acting unilaterally they produce ipsilateral lateral flexion and muscles attaching to the head turn the head to ipsilaterally. Longissimus Thoracis Blends with iliocostalis in lumbar region and is attached to transverse processes of lumbar vertebrae Segmental Transverse processes T1T12 and just lateral to the tubercles of ribs 2-12 Cervicis Transverse processes T1-T5 Transverse processes C2-6 Capitis Transverse processes T1-T5 and articular processes of C4/5-C7 Spinalis Posterior margin of the mastoid process Thoracis Angles of ribs 612 (upper borders of the angles) Angles of ribs 16 and transverse process C7 Cervicis Angles of ribs 36 Transverse processes C4C6 Capitis Usually blends with semispinalis capitis With semispinalis capitis Primary extensors of the vertebral column and head. Acting bilaterally they straighten the back returning it upright from a flexed position. They also participate in controlling vertebral column flexion by contracting and relaxing in a coordinated fashion Acting unilaterally they produce ipsilateral lateral flexion and muscles attaching to the head turn the head to ipsilaterally. Muscle Origin Insertion Innervation Action Transversospinales (Semispinalis, Multifidus, and Rotatores) Semispinalis Multifidus Rotatores Thoracis Transverse processes of T6T10 Cervicis Transverse processes T1T5/6 Capitis Transverse processes T1T6/7 and articular processes of C4C7 Sacrum, origin of erector spinae, posterior superior iliac spine, mammillary processes of lumbar vertebrae, transverse processes of thoracic vertebrae and articular processes of lower four cervical vertebrae Spinous processes of C6-T4 Spinous processes C2C5 Medial area between the superior and inferior nuchal lines of occipital bone Base of spinous processes of all vertebrae from L5 -C2 Lumborum Mammillary processes of lumbar vertebrae Thoracis Spinous processes of lumbar vertebrae Segmental Acting bilaterally these muscles extend the vertebral column in a fashion similar to the erector spinae. Acting unilaterally they pull the spinous process toward the transverse process on that side causing the trunk to turn or to turn or rotate in the opposite direction. Transverse processes of thoracic vertebrae Cervicis Spinous processes of thoracic vertebrae Articular processes of cervical vertebrae