Anatomy (Locomotor) (Subject) / Hand and foot (Lesson)

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• Arches of the feet + stability 1. Medial longitudinal arch - formed by the calcaneus, navicular, talus, cuneiforms and medial 3 metatarsals  2. Lateral longitudinal arch - formed by the calcaneus, cuboid and lateral 2 metatarsals  3. Transverse arch - region of the bases of the metatarsals  4. Stability - short interosseous ligaments between tarsal bones - spring ligament (calcaneonavicular ligament) - long and short plantar ligaments  - muscle tone  - plantar apaneurosis 
• Muscles of the hand 1. Lumbricals - attached to the flexor digitorum profundus tendon - Innervation: Lateral 2 - median nerve, medial 2 - deep branch of ulnar nerve  - Action: Flex metacarpo-phalangeal joints, extend interphalangeal joints (except thumb) 2. Interossei a) Palmar - attached to metacarpals 1,2,4,5 - Innervation: Deep branch of ulnar nerve  - Action: Adduction of fingers towards centre of third finger  b) Dorsal - attached to metacarpals 2-5 - Innervation: Deep branch of  ulnar nerve  - Action: Abduction of fingers from centre of third finger  3. Thenar muscles (thumb) a) Abductor pollicis brevis - median nerve - abduction thumb b) Flexor pollicis brevis -  median nerve - flexion metacarpo-phalangeal joint thumb  c) Opponens pollicis - median nerve - pulls thumb medially and forward across palm d) Adductor pollicis - deep branch of ulnar nerve - adduction thumb 4. Hypothenar muscles (little finger) a) Abductor digiti minimi -deep branch of ulnar nerve - abduction little finger b) Flexor digiti minimi - deep branch of ulnar nerve - flexion little finger c) Opponens digiti minimi - deep branch of ulnar nerve - pulls 5th metacarpal forward 
• Muscles of the foot 1. Intrinsic muscles of the dorsum of the foot a) Extensor digitorum brevis  2. Intrinsic muscles of the plantar aspect of the foot  a) Layer 1 - Abductor hallucis - medial plantar nerve - abduction+flexion big toe - Abductor digiti minimi -  lateral plantar nerve - abduction+flexion little toe - Flexor digitorum brevis - medial plantar nerve - flexion toe 2-5 b) Layer 2 - Lumbricals - medial plantar nerve (1st), lateral plantar nerve (2-4) - extension of toes at interphalangeal joints  - Tendon of flexor hallucis longus - tibial nerve - flexion distal phalanx of hallux  - Tendon of flexor digitorum longus - tibial nerve - flexion distal phalanges of toes 2-5 - Quadratus plantae - lateral plantar nerve - flexion toes 2-5 c) Layer 3 - Flexor hallucis brevis - medial plantar nerve - flexion prox phalanx hallux - Flexor digiti minimi - lateral plantar nerve - flexion prox phalanx little toe  - Adductor hallucis - lateral plantar nerve - adduction hallux  d) Layer 4 - Dorsal interossei - lateral plantar nerve - abduction digits 2-4  - Plantar interossei -  lateral plantar nerve - adduction digits 3-5  - Tendon of peroneus longus - superficial peroneal nerve - eversion foot - Tendon of peroneus brevis - supeficial peroneal nerve - eversion foot 
• Anatomical spaces: Tarsal tunnel - anatomical space located between the medial malleolus and the calcaneus  1. Contents: - posterior tibial artery - tibial nerve  - tendon of flexor hallucis longus - tendon of flexor digitorum longus  - tendon of tibialis posterior 
• Vessels of the upper limb 1. Arteries - subclavian artery --> axillary artery --> brachial artery --> radial and ulnar artery --> deep palmar branch (from radial artery) and superficial ulnar branch (from superficial artery) - Anastomoses: posterior and anterior humeral circumflex arteries, superficial and deep palmar branches 2. Veins  - Dorsal venous arch --> basilic vein (medial) and cephalic vein (lateral) --> median cubital vein (connection between basilic and cephalic vein) --> Axillary vein (formed by basilic vein and joined by cephalic vein) --> subclavian vein
• Vessels of the lower limb 1. Arteries - External iliac artery --> Femoral artery and profunda femoris artery --> popliteal artery --> anterior and posterior tibial artery + peroneal artery --> Dorsalis pedis artery (from anterior tibial artery) and medial and lateral plantar arteries (from posterior tibial artery) --> Plantar arterial arch --> digital arteries to toes  - Anastomoses: profunda femoris artery, internal and external iliac arteries linked by the inferior gluteal artery and circumflex arteries  2. Venes - Dorsal venous arch --> great saphenous vein (medially) and small saphenous vein (laterally) --> popliteal artery (formed by small saphenous vein) --> femoral vein --> 

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