ANATOMY OF

DMS (MUSCLES)
Muscle and compartment
of arm
ANTERIOR (FLEXOR) COMPARTMENT OF THE ARM

1. Biceps brachii
• Proximal attachment : scapula
• Distal attachment : radius
• Innervation : n.musculocutaneous
 2. Coracobrachialis
• Proximal attachment : scapula
• Distal attachment : humerus
• Innervation : n.musculocutaneous
 3. Brachialis
• Proximal attachment : humerus
• Distal attachment : ulna
• Innervation : n.musculocutaneous
 POSTERIOR (EXTENSOR) COMPARTMENT OF THE
ARM
1. Trichep brachii
• Proximal attachment :
long head --> scapula
lateral head humerus
medial head humerus
• Distal attachment : ulna
• Innervation : n. Radialis
 2. Anconeus
• Proximal attachment : Humerus
• Distal attachment : ulna
• Innervation : n. Radialis
Muscle and compartment
of forearm
ANTERIOR (FLEXOR-PRONATOR) COMPARTMENT
OF FOREARM
 Superficial Layer

1. Pronator teres
• Proximal attachment : Coronoid
• Distal attachment : radius
• Innervation : Median nerve

2. Flexor carpi radialis

• Proximal attachment : Humerus
• Distal attachment : 2nd metacarpal
• Innervation : Median nerve

3. Palmaris longus
• Proximal attachment : Humerus
• Distal attachment : 2nd,3rd,4th metacarpal
• Innervation : Median nerve

4. Flexor carpi ulnaris

• Proximal attachment : Ulna
• Distal attachment : Hamate & 5th metacarpal
• Innervation : Ulnar nerve
 Intermediate Layer

Flexor digitorum superficialis

• Proximal attachment : Humerus
• Distal attachment : Shafts of middle
phalanges of four digits
• Innervation : Median nerve
 Deep Layer

1. Flexor pollicis longus

• Proximal attachment : Radius
• Distal attachment : Base of distal
phalanx of thumb
• Innervation : Median nerve

2. Flexor digitorum profundus

• Proximal attachment : Ulna
• Distal attachment : 2nd, 3rd, 4th, 5th
phalanges
• Innervation : Median nerve

3. Pronator quadratus
• Proximal attachment : Distal quarter of
anterior surface ofUlna
• Distal attachment : Distal quarter of
anterior surface ofRadius
• Innervation : Median nerve
POSTERIOR (EXTENSOR) COMPARTMENT
OF FOREARM
 Superficial Layer

1. Bachioradialis
• Proximal attachment : Humerus
• Distal attachment : Radius
• Innervation : Radial nerve
 2. Extensor carpi radialis longus
• Proximal attachment : Humerus
• Distal attachment : base of 2nd
metacarpal
• Innervation : Median nerve

3. Extensor carpi radialis brevis

• Proximal attachment : Humerus
• Distal attachment : Dorsal aspect of
base of 3rd metacarpal
• Innervation : Radial nerve
 Superficial Layer

4 Extensor digitorum
• Proximal attachment : Humerus
• Distal attachment : medial four digits
• Innervation : Radial nerve

5. Extensor carpi ulnaris

• Proximal attachment : Humerus
• Distal attachment : base of 5th
metacarpal
• Innervation : Radial nerve
 Superficial Layer
5. Extensor digiti minimi
• Proximal attachment : Humerus
• Distal attachment : 5th digit
• Innervation : Radial nerve
 Deep Layer

1. Supinator
• Proximal attachment : Humerus
• Distal attachment : Radius Extensor indicis Supinator
• Innervation : Radial nerve

2. Extensor indicis
• Proximal attachment : Ulna
• Distal attachment : 2nd digit
• Innervation : Radial nerve
 Outcropping muscles of deep layer

1. Abductor pollicis longus 3. Extensor pollicis brevis

• Proximal attachment : Ulna, radius • Proximal attachment : Radius
• Distal attachment : Base of 1st metacarpal • Distal attachment : Thumb
• Innervation : Radial nerve • Innervation : Radial nerve

2. Extensor pollicis longus

• Proximal attachment : Ulna
• Distal attachment : thumb
• Innervation : Radial nerve
• Functionally and clinically
important peri-articular arterial
anastomoses surround
• the elbow. The resulting collateral
circulation allows blood to reach
the
• forearm when fl exion of the elbow
compromises fl ow through the
terminal
• part of the brachial artery.

ARTERIAL
SUPPLY OF ARM
AND FOREARM
VEINS OF UPPER LIMB
Muscle and compartment
of hand
The intrinsic muscles of the hand are located in five compartments:
 Muscle Proximal attachment Distal attachment Innervation Main action

Opponens Lateral side of 1st To oppose thumb

pollicis metacarpal
Abductor Lateral side of base Abduct thumnb
Flexor retinaculum and
pollicis brevis proximal phalanx of Reccurent branch of
tubercles of scaphoid and
thumb median nerve
trapezium
Flexor pollicis Medial side of base of Flexes thumb
brevis proximal phalanx of
thumb

Thenar
muscles
 Adductor pollicis muscles
Muscle Proximal attachment Distal attachment Innervation Main action

Adductor pollicis Bases of 2nd & 3rd

(oblique head) metacarpals Medial side of base of
Deep branch of ulnar Adduct thumb toward
Adductor pollicis Anterior surface of proximal phalanx of
nerve lateral border of palm
(transverse head) shaft of 3rd thumb
metacarpal
 Hypothenar muscles

Muscle Proximal attachment Distal attachment Innervation Main action

Abductor digiti Pisiform Abduct 5th finger

minimi Medial sideof base of
proxial phalanx of
Flexor digiti 5th finger Flexes proximal
Deep branch of ulnar
minimi brevis phalanx of 5th finger
Hook of hamats and flexor nerve
Opponens digiti retinaculum Medial border of 5th Bringing 5th finger
minimi metacarpal into opposition with
thumb
 Short muscles

Muscles Proximal Distal attachment Innervation Main action

attachment

Lumbricalis 1st and Lateral two tendons Median nerve -Flexi

2nd of flexor digitorum metacarphophalangea
profundus Lateral sides of l joints
extensor expansions
Lumbricalis 3rd and Medial three tendons Deep branch of ulnar
of 2nd-5th fingers - Extend
4th of flexor digitorum nerve
interphalangeal joints
profundus
of 2nd-5th fingers
 Interossei muscles

Muscles Proximal attachment Distal attachment Innervation Main action

Dorsal interossei Adjacent side of two Bases on proximal Deep branch of ulnar Abduct 2nd-4th
1st-4th metacarpals phalanges; extensor nerve fingers from axial
expansion of 2nd-4th line
fingers

Palmar interossei Palmar surface of 2nd, Bases on proximal Adduct 2nd,4th, and
1st-3rd 4th and 5th metacarpals phalanges; extensor 5th fingers toward
expansion of 2nd, axial line
4th and 5 th
fingers
The synovial sheaths of the flexor tendons of
the hand—the radial and ulnar bursae track
proximally deep to the flexor retinaculum and
provide a potential pathway of infection into
the forearm. In many cases these bursae
The midpalmar and thenar spaces: (a)
communicate.
projected on to the surface of the hand and
(b) in transverse section
Arteries of Hand
• Lymphatic drainage of
upper limb. Superficial
lymphatic
• vessels originate from
the digital lymphatic
vessels of the digits and
lymphatic plexus of the
palm. Most drainage
from the palm passes to
the dorsum of the hand
(small arrows)
Anterior axioappendicular
Muscles of the Upper Limb
Muscles Proximal Distal attachment Innervation Main action
attachment

Pectoralis -Clavicular head : Intertubercular groove Lateral and medial Adduct and
major anterior surface of of humerus pectoral nerve medially rotates
medial half of humerus; scapula
clavicle anteriorly and
- Sternocostal head : inferiorly
anterior surface of
sternum, superior six
costal cartilage

Pectoralis 3rd-5th ribs near Medial border and Medial pectoral Stabilizes scapula
minor their costal cartilage superior surface of nerve by drawing it
coracoid process of anteriorly and
scapula inferiorly against
thoracic wall

Subclavius Junction of 1st rib Inferior surface of Nerve to subclavius Anchors and
and its costal middle third of depresses clavicle
cartilage clavicle

Serratus Exsternal surface of Anterior surface of Long thoracic nerve Protracts scapula
anterior lateral parts of 1st- medial border of and holds it against
8th ribs scapula thoracic wall;
 Posterior axioappendicular
and Scapulohumeral Muscles
 Superficial posterior appendicular (extrinsic shoulder) muscles

Muscles Proximal attachment Distal attachment Innervation Main action

Trapezius Medial third of superior Lateral third of clavicle; CN XI (Acessory Descending part elevates;
nuchal line; eksternal acromion and spine of nerve) and C3,C4 ascending part depresses;
occipital protuberance; scapula spinal nerve and middle part retract
nuchal ligament; spinous scapula; descending and
process of C7-T12 ascending parts act
vertebrae together to rotate glenoid
cavity superiorly

Latissimus dorsi Spinous processes of Floor of intertubecular Thoracodorsal Extends, adduct, and
inferior 6 thoracic groove of humerus nerve (C6,C7,C8) medially rotates humerus;
vertebrae; thoracolumbar raises body toward arms
fascia; illiac crest; and during climbing
inferior 3 or 4 ribs
 Deep posterior appendicular (extrinsic shoulder) muscles

Muscles Proximal attachment Distal attachment Innervation Main action

Levator scapula Posterior tubercles of Medial border of Dorsal scapular (C5) Elevate scapula and
transverse processes scapula superior to and cevical (C3,C4) tilts its glenoid cavity
oc C1-C4 vertebrae root of spine nerves inferiorly by rotating
scapula
Rhomboid minor and Minor: nuchal Miinor: smooth Dorsal scapular nerve Retract scapula and
major ligament; spinous triangular area at (C4,C5) rotate it to depress
processus of C7 and medial end of scapular glenoid cavity; fix
T1 vertebrae space scapula to thoracic
Major: spinous Major: medial border wall
processus of T2-T5 of scapula from level
vertebrae of spine to inferior
angle
 Scapulohumeral (intrinsic shoulder) muscles

Muscles Proximal attachment Distal attachment Innervation Main action

Deltoid Lateral third of Deltoid tuberosity of Axillary nerve Anterior part: flexes and
clavicle;acromion and humerus (C5,C6) medially rotates arm; Middle
spine of scapula part: abduct ar,; Posterior part:
extends&laterally rotate arm

Supraspinatus Supraspinous fossa of Superior facet of Suprascapular Initiates and assists deltoid in
scapula geater tubercleof nerve(C4,C5,C6) abduction of arm and acts with
humerus rotator cuff muscle

Infraspinatus Infrasiponus fossa of Middle facet of Suprascapular

scapula greater tubercle of nerve(C5,C6)
humerus Laterally rotate arm; help hold
humeral head in glenoid cavity
Teres minor Middle part of lateral Inferior facet of Axillary nerve( of scapula
border of scapula greater tubercle of C5,C6)
humerus

Teres major Posterior surface of Intertubercular Lower subscapular Adduct and medially rotates
inferior angle of scapula groove of humerus nerve(C5,C6) arm

Subscapularis Subscapular fossa Lesser tubercle of Upper and lower Medially rotates and adduct
humerus subscapular arms; help hold humeral head in
nerve(C5,C6,C7) glenoid cavity
CUBITAL FOSSA
MUSCLE AND COMPARTMENT
OF THIGH
Compartement of Thigh
MUSCLES OF ANTERIOR THIGH:
FLEXORS OF HIP JOINT
 MUSCLES OF ANTERIOR THIGH:
FLEXORS OF HIP JOINT

1. Pectineus
• Proximal attachment : pubis
• Distal attachment : femur
• Innervation : femoral nerve
 MUSCLES OF ANTERIOR THIGH:
FLEXORS OF HIP JOINT
2. Illiopsoas
a. Psoas major
• Proximal attachment : T12-L5 vertebrae
• Distal attachment : femur
• Innervation : lumbar nerve

b. Psoas minor
• Proximal attachment : T12-L1 vertebrae
• Distal attachment : femur
• Innervation : femoral nerve

c. Illiacus
• Proximal attachment : illium, sacrum
• Distal attachment : femur
• Innervation : femoral nerve
MUSCLES OF ANTERIOR THIGH:
FLEXORS OF HIP JOINT
3. Sartorius
• Proximal attachment : Illiac
• Distal attachment : Tibia
• Innervation : Femoral nerve
MUSCLES OF ANTERIOR THIGH:
EXTENSORS OF KNEE
 MUSCLES OF ANTERIOR THIGH: EXTENSORS OF KNEE

QUADRICEPS FEMORIS
a. Rectus Femoris
• Proximal attachment : Illiac
• Distal attachment : Patella
• Innervation :

b. Vastus lateralis
• Proximal attachment : Greater trochanter
• Distal attachment : Patella
• Innervation : femoral nerve

c. Vastus medialis
• Proximal attachment : Intertrochanteric line
• Distal attachment : Patella
• Innervation : femoral nerve

d. Vastus intermedius
• Proximal attachment : shaft of femur
• Distal attachment : Patella
• Innervation : femoral nerve
MUSCLES OF MEDIAL THIGH: ADDUCTOR THIGH
 MUSCLES OF MEDIAL THIGH: ADDUCTOR THIGH

1. Adductor longus

• Proximal attachment : Body of

pubis inferior to pubic crest

• Distal attachment : Middle third

of linea aspera of femur

• Innervation : Obturator nerve

MUSCLES OF MEDIAL THIGH: ADDUCTOR THIGH

2. Adductor brevis

• Proximal attachment : Body and

inferior ramus of pubis

• Distal attachment : proximal part

of linea aspera of femur

• Innervation : Obturator nerve

 MUSCLES OF MEDIAL THIGH: ADDUCTOR THIGH

3. Adductor magnus

• Proximal attachment : ~Adductor part:

inferior ramus of pubis, ramus of ischium
~Hamstrings part: ischial tuberosity

• Distal attachment :
~Adductor part: gluteal tuberosity, linea
aspera, medial supracondylar line
~Hamstring part: adductor tubercle of femur

• Innervation :
~Adductor part: obturator nerve
~Hamstring part: sciatic nerve
MUSCLES OF MEDIAL THIGH: ADDUCTOR THIGH

4. Gracilis

• Proximal attachment : Body

and inferior ramus of pubis
• Distal attachment : Superior
part of medial surface of
tibia.

• Innervation : Obturator nerve

MUSCLES OF MEDIAL THIGH: ADDUCTOR THIGH

5. Obturator eksternus

• Proximal attachment :
Margins of obturator foramen

• Distal attachment :
Trochanteric fossa of femur

• Innervation : Obturator nerve

 MUSCLES OF POSTERIOR THIGH:
EXTENSORS OF HIP AND FLEXORS OF KNEE

• Proximal attachment to the ischial

tuberosity
•Distal attachment to the bones of the leg
Hamstring • Thus they act on two joints, producing
extension at the hip joint and flexion
muscle
at the knee joint.
•Innervation by sciatic nerve.

semitendinosus semimembranosus biceps femoris

 MUSCLES OF POSTERIOR THIGH:
EXTENSORS OF HIP AND FLEXORS OF KNEE
1. Semi tendinosus
• Proximal attachment : Ischial tuberosity
• Distal attachment : Medial surface of superior
part of tibia
• Innervation : sciatic nerve

2. Semimembranosus
• Proximal attachment : Ischial tuberosity
• Distal attachment : Posterior part of medial
condyle of tibia
• Innervation : sciatic nerve

3. Biceps femoris
• Proximal attachment : Long head: ischial
tuberosity Short head: linea aspera and lateral
supracondylar line of femur
• Distal attachment : Lateral side of head of
fibula
• Innervation : sciatic nerve
Arteri
Artery of anterior and medial
thigh
Muscle and compartment
of leg
MUSCLES & COMPARTMENT OF LEG
ANTERIOR COMPARTMENT OF LEG
 1. Tibialis anterior
• Proximal attachment : Lateral condyle
• Distal attachment : medial cuneiform and
base of 1st metatarsal
• Innervation : Deep fibular nerve

2. Extensor hallucis longus

• Proximal attachment : Middle part of anterior
surface of fibula
• Distal attachment : distal phalanx of great toe
• Innervation : Deep fibular nerve

3. Fibularis tertius
• Proximal attachment Inferior third of anterior
surface of fibula
• Distal attachment : Dorsum of base of 5th
metatarsal
• Innervation : Deep fibular nerve
 4 . Extensor digitorum longus

• Proximal attachment : Lateral condyle of tibia

and superior three quarters of medial surface
of fibula

• Distal attachment : Middle and distal

phalanges of lateral four digits

• Innervation : Deep fibular nerve

LATERAL COMPARTMENT OF LEG
 LATERAL COMPARTMENT OF LEG
1. Fibularis longus
• Proximal attachment : Head and superior two
thirds of lateral surface of fibula
• Distal attachment : Base of 1st metatarsal
and medial cuneiform
• Innervation : Superficial fibular nerve

2. Fibularis brevis
• Proximal attachment : Inferior two thirds of
lateral surface of fibula
• Distal attachment : Dorsal surface of
tuberosity on lateral side of base of 5th
metatarsal
• Innervation : Superficial fibular nerve
POSTERIOR COMPARTMENT OF LEG
 POSTERIOR COMPARTMENT OF LEG
(SUPERFICIAL)
1. Gastrocnemius
• Proximal attachment :
~ Lateral head: lateral aspect of lateral
condyle of femur
~Medial head: popliteal surface of femur;
superior to medial condyle
• Distal attachment : Posterior surface of
calcaneus via calcaneal tendon
• Innervation : Tibial nerve

2. Soleus
• Proximal attachment : Posterior aspect of
head and superior quarter of posterior
surface of fibula; soleal line and middle third
of medial border of tibia; and tendinous arch
extending between the bony attachments
• Distal attachment : Posterior surface of
calcaneus via calcaneal tendon
• Innervation : Tibial nerve
 3. Plantaris
• Proximal attachment Inferior end of
lateral supracondylar line of femur;
oblique popliteal ligament

• Distal attachment Posterior surface of

calcaneus via calcaneal tendon

• Innervation : Tibial nerve

 POSTERIOR COMPARTMENT OF LEG
(DEEP)

MUSCLE PROXIMAL ATTACHMENT DISTAL ATTACHMENT

Popliteus Lateral surface of lateral Posterior surface of tibia,
condyle of femur and lateral superior to soleal line
meniscus
Flexor hallucis longus Inferior two thirds of Base of distal phalanx of
posterior surface of fibula; great toe (hallux)
inferior part of interosseous
membrane
Flexor digitorum longus Medial part of posterior Bases of distal phalanges
surface of tibia inferior to of lateral four digits
soleal line; by a broad
tendon to fibula
Tibialis posterior Interosseous membrane; Tuberosity of navicular,
posterior surface of tibia cuneiform, cuboid, and
inferior to soleal line; sustentaculum tali of
posterior surface of fibula calcaneus; bases of 2nd,
3rd, and 4th metatarsals
POSTERIOR COMPARTMENT OF LEG
(DEEP)
Muscle and compartment
of foot
MUSCLES OF FOOT: 1ST and 2ND LAYERS OF SOLE
MUSCLES OF FOOT: 3rd and 4th LAYERS OF SOLE
MUSCLES OF FOOT: DORSUM OF FOOT
Muscle of gluteal region
 Muscles Proximal Distal attachment Innervation Main action
attachment
Gluteus maximus Ilium posterior to Most fibers end in Inferior gluteal Extends thigh
posterior gluteal line; iliotibial tract, nerve (L5, S1, (especially from flexed
dorsal surface of which inserts into S2) position) and assists in
sacrum and coccyx; lateral condyle of its lateral rotation;
sacrotuberous tibia; some fibers steadies thigh and
ligament insert on gluteal assists in rising from
tuberosity sitting position

Gluteus medius External surface of Lateral surface of

ilium between greater trochanter
anterior and posterior of femur
gluteal lines
Abduct and medially
rotate thigh; keep
Gluteus minimus External surface of Anterior surface of pelvis level when
ilium between greater trochanter Superior gluteal ipsilateral limb is
anterior and inferior of femur nerve (L5, S1) weight-bearing and
gluteal lines advance opposite
(unsupported) side
during its swing phase
Tensor of fascia Anterior superior Iliotibial tract,
lata iliac spine; anterior which attaches to
part of iliac crest lateral condyle of
tibia
 Muscles Proximal Distal attachment Innervation Main action
attachment
Piriformis Anterior surface of Superior border of Branches of
sacrum; greater trochanter of anterior rami of
sacrotuberous femur S1, S2
ligament

Obturator Pelvic surface of Medial surface of Nerve to obturator

internus obturator membrane greater trochanter internus (L5, S1) Laterally rotate
and surrounding (trochanteric fossa) extended thigh and
bones of femurb abduct flexed thigh;
steady femoral head in
acetabulum
Superior and Superior: ischial Medial surface of Superior gemellus:
inferior spine Inferior: ischial greater trochanter same nerve supply
gemelli tuberosity (trochanteric fossa) as obturator
of femurb internus Inferior
gemellus: same
nerve supply as
quadratus femoris

Quadratus Lateral border of Quadrate tubercle on Nerve to quadratus Laterally rotates

femoris ischial tuberosity intertrochanteric femoris (L5, S1) thighc; steadies
crest of femur and femoral head in
area inferior to it acetabulum
• Drainase Vena Superfisial

83
• Drainase Vena Profunda

84
• Drainase Limfatik
85
Popliteal Fossa

86
 Dermatome
• Distribusi sensori setiap nerve root
• Area kulit disuplai oleh satu nerve root
• Terdapat 31 segmen spinal cord, masing2
memiliki ventral dan dorsal root untuk fungsi
sensorik dan motoric. Kecuali C1.

87
88
 Aplikasi klinis Dermatom
• Dapat menentukan kelainan neurologis,
(radikulopati, HNP)
• Infeksi seperti Herpes zoster bermanifestasi
dermatomal

89
 Myotome
Kelompok otot
yang dipersarafi
satu nerve root

90
 Korelasi Klinis
• Infromasi level nervus spinalis yang
mengalami lesi
• Kelemahan otot
• IV disc herniation

91
Terimakasi
h

92