290
ANATOMIC AND PROCEDURAL ATLAS
HAND
Lumbricals
Origin:
Four muscles; Tendons of the fl exor digitorum profundus
Insertion:
Extensor hoods of digits II–V
Innervation: Medial two—Deep branch of ulnar nerve; Lateral two—Digital branches of
median nerve
Action:
Finger fl exion at metacarpophalangeal joints with extension at
interphalangeal joints
291
HAND
292
ANATOMIC AND PROCEDURAL ATLAS
HAND
Thenar Muscles 1
(Opponens pollicis, Abductor pollicis brevis, Flexor pollicis brevis)
Origin:
Opponens—Trapezium and fl exor retinaculum
Abductor—Scaphoid, trapezium, and fl exor retinaculum
Flexor—Trapezium and fl exor retinaculum
Insertion:
Opponens—Metacarpal I
Abductor—Extensor hood and proximal phalanx of thumb
Flexor—Proximal phalanx of thumb
Innervation: Recurrent branch of median nerve
Action:
Opponens—Medial rotation of thumb
Abductor—Thumb abduction at metacarpophalangeal joint
Flexor—Thumb fl exion at metacarpophalangeal joint
293
HAND
294
ANATOMIC AND PROCEDURAL ATLAS
HAND
Thenar Muscles 2
(Opponens pollicis, Abductor pollicis brevis, Flexor pollicis brevis)
Origin:
Opponens—Trapezium and fl exor retinaculum
Abductor—Scaphoid, trapezium, and fl exor retinaculum
Flexor—Trapezium and fl exor retinaculum
Insertion:
Opponens—Metacarpal I
Abductor—Extensor hood and proximal phalanx of thumb
Flexor—Proximal phalanx of thumb
Innervation: Recurrent branch of median nerve
Action:
Opponens—Medial rotation of thumb
Abductor—Thumb abduction at metacarpophalangeal joint
Flexor—Thumb fl exion at metacarpophalangeal joint
295
HAND
296
ANATOMIC AND PROCEDURAL ATLAS
HAND
Hypothenar Muscles
Origin:
Opponens—Hook of hamate and fl exor retinaculum
Abductor—Pisiform, pisohamate ligament, and tendon of the fl exor carpi ulnaris
Flexor—Hook of hamate and fl exor retinaculum
Insertion:
Opponens—Metacarpal V
Abductor—Proximal phalanx of fi fth fi nger
Flexor—Proximal phalanx of fi fth fi nger
Innervation: Deep branch of ulnar nerve
Action:
Opponens—Lateral rotation of fi fth fi nger
Abductor—Fifth fi nger abduction at metacarpophalangeal joint
Flexor—Fifth fi nger fl exion at metacarpophalangeal joint
297
HAND
298
ANATOMIC AND PROCEDURAL ATLAS
LOWER LIMB
Piriformis
Origin:
Anterior surface of the sacrum
Insertion:
Medial side of greater trochanter
Innervation: Branches of L5, 81, and 82
Action:
When hip is fl exed: Femoral abduction
When hip is extended: Lateral femoral rotation
299
LOWER LIMB
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
300
ANATOMIC AND PROCEDURAL ATLAS
LOWER LIMB
Psoas
(Proximal, Posterior Approach)
Origin:
Bodies, transverse processes, and intervertebral discs of T12 to L5
Insertion:
Major: Lesser trochanter of the femur
Minor: Pectineal line of pelvic brim and iliopubic eminence
Innervation: Major: Anterior rami of L1 to L3
Minor: Anterior rami of L1
Action:
Major: Hip fl exion
Minor: Lumbar vertebral fl exion
301
LOWER LIMB
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
302
ANATOMIC AND PROCEDURAL ATLAS
LOWER LIMB
Iliacus
Origin:
Posterior abdominal wall and upper two-thirds of iliac fossa
Insertion:
Lesser trochanter of femur
Innervation: Femoral nerve
Action:
Hip fl exion
NOTE:
Place probe on AS IS
Push probe medially to displace bowel and allow direct access to illiacus
303
LOWER LIMB
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
304
ANATOMIC AND PROCEDURAL ATLAS
LOWER LIMB
Iliopsoas
Origin:
Psoas: Bodies, transverse processes, and intervertebral discs of T12 to L5
Iliacus: Posterior abdominal wall and upper two-thirds of iliac fossa
Insertion:
Common tendon on lesser trochanter of femur
Innervation: Psoas: Anterior rami of L1 to L3
Iliacus: Femoral nerve
Action:
Hip fl exion, can contribute to lateral thigh rotation
305
LOWER LIMB
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
306
ANATOMIC AND PROCEDURAL ATLAS
LOWER LIMB
Adductors
Origin:
Magnus: Adductor part—ischiopubic ramus;
Hamstring part—ischial tuberosity
Longus: Body of the pubis
Insertion:
Magnus: Adductor part—posterior, proximal femur, linea aspera, and
medial supracondylar line;
Hamstring part—adductor tubercle and supracondylar line
Longus: Linea aspera
Innervation: Magnus: Adductor part—obturator nerve;
Hamstring part—sciatic nerve
Longus: Obturator nerve
Action:
Adduct and medially rotate thigh
307
LOWER LIMB
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
308
ANATOMIC AND PROCEDURAL ATLAS
LOWER LIMB
Semitendinosus
Origin:
Ischial tuberosity
Insertion:
Medial surface of proximal tibia
Innervation: Sciatic nerve
Action:
Knee fl exion, hip extension, and medial rotation of leg
309
LOWER LIMB
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
310
ANATOMIC AND PROCEDURAL ATLAS
LOWER LIMB
Semimembranosus
Origin:
Ischial tuberosity
Insertion:
Medial tibial condyle
Innervation: Sciatic nerve
Action:
Knee fl exion, hip extension, and medial rotation of leg
311
LOWER LIMB
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
312
ANATOMIC AND PROCEDURAL ATLAS
LOWER LIMB
Rectus Femoris
(Proximal)
Origin:
Straight Head: Anterior inferior iliac spine; Refl ected Head: Ilium
Insertion:
Quadriceps femoris tendon
Innervation: Femoral nerve
Action:
Hip fl exion, knee extension
313
LOWER LIMB
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
314
ANATOMIC AND PROCEDURAL ATLAS
LOWER LIMB
Rectus Femoris
(Distal)
Origin:
Straight Head: Anterior inferior iliac spine; Refl ected Head: Ilium
Insertion:
Quadriceps femoris tendon
Innervation: Femoral nerve
Action:
Hip fl exion, knee extension
315
LOWER LIMB
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
316
ANATOMIC AND PROCEDURAL ATLAS
LOWER LIMB
Gastrocnemius
(Lateral Head)
Origin:
Lateral femoral condyle
Insertion:
Posterior surface of calcaneus, via Achilles tendon
Innervation: Tibial nerve
Action:
Knee fl exion, foot plantarfl exion
317
LOWER LIMB
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
318
ANATOMIC AND PROCEDURAL ATLAS
LOWER LIMB
Gastrocnemius
(Medial Head, Transverse View)
Origin:
Just superior to medial femoral condyle
Insertion:
Posterior surface of calcaneus, via Achilles tendon
Innervation: Tibial nerve
Action:
Knee fl exion, foot plantarfl exion
319
LOWER LIMB
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
320
ANATOMIC AND PROCEDURAL ATLAS
LOWER LIMB
Gastrocnemius
(Medial Head, Longitudinal View)
Origin:
Just superior to medial femoral condyle
Insertion:
Posterior surface of calcaneus, via Achilles tendon
Innervation: Tibial nerve
Action:
Knee fl exion, foot plantarfl exion
321
LOWER LIMB
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
322
ANATOMIC AND PROCEDURAL ATLAS
LOWER LIMB
Soleus
Origin:
Soleal line, medial border of tibia, posterior fi bular head, adjacent neck
and proximal shaft
Insertion:
Calcaneal tendon to posterior calcaneus
Innervation: Tibial nerve
Action:
Foot plantarfl exion
323
LOWER LIMB
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
324
ANATOMIC AND PROCEDURAL ATLAS
LOWER LIMB
Tibialis Posterior
Origin:
Posterior interosseous membrane and adjacent tibia and fi bula
Insertion:
Tuberosity of navicular and adjacent medial cuneiform
Innervation: Tibial nerve
Action:
Foot inversion and plantarfl exion, medial arch support during gait
325
LOWER LIMB
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
326
ANATOMIC AND PROCEDURAL ATLAS
LOWER LIMB
Flexor Digitorum Longus
Origin:
Medial and posterior tibia
Insertion:
Base of distal phalanges of toes 2-5, plantar surface
Innervation: Tibial nerve
Action:
Flexion of toes 2-5
327
LOWER LIMB
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
328
ANATOMIC AND PROCEDURAL ATLAS
LOWER LIMB
Fibularis Longus
Origin:
Head of fi bula, lateral fi bular shaft, lateral tibial condyle
Insertion:
Base of metatarsal I and medial cuneiform, plantar surface
Innervation: Superfi cial fi bular nerve
Action:
Foot eversion and plantarfl exion, arch support
329
LOWER LIMB
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
330
ANATOMIC AND PROCEDURAL ATLAS
LOWER LIMB
Fibularis Brevis
Origin:
Lateral fi bular shaft
Insertion:
Base of metatarsal V
Innervation: Superfi cial fi bular nerve
Action:
Foot eversion
331
LOWER LIMB
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
332
ANATOMIC AND PROCEDURAL ATLAS
LOWER LIMB
Extensor Hallucis Longus
(Transverse View)
Origin:
Medial surface of fi bula and interosseous membrane
Insertion:
Base of distal phalanx of great toe, dorsal surface
Innervation: Deep fi bular nerve
Action:
Foot dorsifl exion and extension of great toe
333
LOWER LIMB
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
334
ANATOMIC AND PROCEDURAL ATLAS
LOWER LIMB
Extensor Hallucis Longus
(Longitudinal View)
Origin:
Medial surface of fi bula and interosseous membrane
Insertion:
Base of distal phalanx of great toe, dorsal surface
Innervation: Deep fi bular nerve
Action:
Foot dorsifl exion and extension of great toe
335
LOWER LIMB
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
336
ANATOMIC AND PROCEDURAL ATLAS
LOWER LIMB
Flexor Hallucis Brevis
Origin:
Planter surface of cuboid and lateral cuneiform. Tendon of tibialis
posterior.
Insertion:
Base of proximal phalanx of great toe
Innervation: Medial plantar nerve (from tibial nerve)
Action:
Flexion of metatarsophalangeal joint of great toe
337
LOWER LIMB
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
338
ANATOMIC AND PROCEDURAL ATLAS
LOWER LIMB
Flexor Digitorum Brevis
Origin:
Medial process of calcaneal tuberosity and plantar aponeurosis
Insertion:
Plantar surfaces of middle phalanges of toes 2-5
Innervation: Medial plantar nerve (from tibial nerve)
Action:
Flexion of proximal interphalangeal (PIP) joints of toes 2-5
339
LOWER LIMB
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis
Soleus
Tibialis Posterior
Flexor Digitorum Longus
Fibularis Longus
Fibularis Brevis
Extensor Hallucis Longus
(Transverse View)
Extensor Hallucis Longus
(Longitudinal View)
Flexor Hallucis Brevis
Flexor Digitorum Brevis