肌肉

  • Muscular Tissue
    • types
      • Skeletal muscle tissue
        • move the bones
        • voluntary (under the conscious control)
        • 随意肌
      • Cardiac muscle tissue
        • only found in the heart
        • involuntary
      • Smooth muscle tissue
        • in the walls of hollow internal structures, such as blood vessels, airways, and most organs in the digestive system
        • involuntary.
    • 结构
      • Belly 肌腹
        • fleshy portion of the muscle
      • Fascicle 肌束
        • A bundle of muscle fibers
        • 由好多muscle fiber组成
    • 起点与止点
      • Origin
        • the attachment to the more stationary bone
      • Insertion
        • the attachment to the more movable bone
      • 比喻上,连着门的弹簧是肌肉,连着门框的是起点,连着门的是止点
      • A rule of thumb
        • the origin is proximal and the insertion is distal
        • the insertion is usually pulled toward the origin
      • Certain muscles are also capable of reverse muscle action(RMA)
  • 肌肉的形状
    • Parallel 平行
      • Fascicles are parallel to the long axis of the muscle
      • 比如 Sartorius
        • origin
          • Anterior superior iliac spine 髂前上棘
        • insertion
          • Medial surface of body of tibia 胫骨上端内侧面
    • Fusiform 梭形
      • narrow toward the ends and wide in the middle 1 belly, 2 tendon
      • Fascicles taper down to a tendon at two ends
      • 比如biceps brachii 肱二头肌
    • Circular 环状
      • Fascicles are in concentric rings
      • 比如Orbicularis oculi 轮匝肌
    • Triangular 三角
      • The muscle has a triangular appearance
      • 比如
        • pectoralis major 胸大肌
        • subscapularis 肩胛下肌
        • infraspinatus 冈下肌
    • Pennate 羽状
      • Unipennate
        • fascicles on only one side of tendon
        • 比如Extensor digitorum longus趾长伸肌
      • Bipennate
        • fascicles on both sides of centrally positioned tendons
        • 比如Rectus femoris 骨直肌
      • Multipennate
        • several tendons extend entire length of muscle
        • 比如Deltoid 三角肌
  • How skeletal muscles produce movements
    • Bones serve as levers杠杆, and joints serve as fulcrums支点
    • Two different forces act on the lever
      • load (resistance)
      • effort
    • Mechanical disadvantage
      • the effort is closer to the fulcrum than the load
    • 肱二头肌
      • Long head originates from tubercle above glenoid cavity of scapula 肩胛骨盂上结节
      • Short head originates from coracoid process of scapula 肩胛骨喙突
      • Insertion on Radial tuberosity 桡骨粗隆
      • 通过这个图可以看出肱二头肌的起点止点连接
    • Opposing pair (flexor–extensor, abductor–adductor)
      • 分为原动肌和拮抗肌
        • the prime mover contracts to cause an action
        • the antagonist stretches
      • 例
        • Flexing the forearm at the elbow
          • biceps brachii: prime mover
          • triceps brachii: antagonist
        • Extending the forearm at the elbow:
          • triceps brachii: prime mover
          • biceps brachii: antagonist
        • No movement
          • a prime mover and its antagonist contract at the same time with equal force
    • Coordination among Muscles
      • Prime mover 原动肌
      • Antagonist 拮抗肌
      • Synergist 协同肌
      • Fixator 固定肌
  • Principal Skeletal Muscles
    • Muscles of the abdomen that protect abdominal viscera
      • rectus abdominis 腹直肌
        • rectus = fascicles parallel to midline
        • Extends the entire length of the anterior abdominal wall
        • Tendinous intersections 腱划,结缔组织
        • 图
      • external oblique 腹外斜肌
        • superficial flat muscle
        • Rectus sheaths (腹直肌鞘) 盖在腹直肌上面
        • Linea alba白线 from the xiphoid胸骨剑突 process to the pubic symphysis耻骨联合
      • internal oblique 腹内斜肌
      • transversus abdominis 腹横肌
      • The fascicles extend in a different direction in each layer
      • 整体结构来说,腹直肌在身体中央,被腹外斜肌,腹内斜肌,腹横肌包裹在腹直肌鞘中,然后腹外斜肌最浅,腹横肌最深
    • Muscles of the thorax that assist in breathing
      • diaphragm
        • The dome-shaped diaphragm is a muscular wall to separate the thoracic and abdominal cavities
        • It moves up and down and aids in breathing
        • consists of a peripheral muscular part and a central tendon
        • Openings in the diagram
          • esophageal hiatus 食管裂孔
          • aortic hiatus 主动脉裂孔
          • vena cava foramen 腔静脉孔
        • 图
    • Muscles of the thorax that move the pectoral girdle肩带
      • Anterior thoracic muscles
        • Pectoralis minor 胸小肌
          • Origin
            • Ribs 3–5
          • Insertion
            • coracoid process of scapula 喙突
          • 图
          • Contract to rotate scapula downward
          • Tension of pectoralis minor causes hunchback驼背
          • RMA is to elevates升高 ribs 3–5 during forced inhalation when scapula is fixed
          • 胸大肌与胸小肌的作用完全没关联
        • Serratus anterior 前锯肌
          • Origin
            • Ribs 1–8 or 1–9
          • Insertion
            • medial border and inferior angle of scapula 肩胛骨内侧缘和下角
          • 图
          • Keep the scapula closely attaches to the thoracic cage
          • RMA is to elevate ribs when scapula is stabilized
          • “boxer’s muscle” – involve in horizontal arm movements such as punching and pushing
        • 胸小肌与前锯肌不够有力会发生winged scapula 翼状肩
      • Posterior thoracic muscles
        • Trapezius 斜方肌
          • Extends from the occipital bone and vertebral column medially to the pectoral girdle laterally
          • 从中部的枕骨和脊柱延伸至外侧的肩带
          • Superior, middle, and inferior fibers
          • Weakness of middle fibers causes hunchback
          • It helps to extend head, elevate the scapula and retract the scapula
        • Rhomboid 菱形肌*2
          • retract scapula
          • Minor is above the major
          • Rhomboid minor 小菱形肌
            • Origin
              • Spines of T2–T5
            • Insertion
              • scapula
          • Rhomboid major 大菱形肌
            • Origin
              • Spines of C7–T1
            • Insertion
              • scapula
    • Muscles of the thorax and shoulder that move the humerus肱骨
      • Axial muscles that move the humerus
        • Pectoralis major 胸大肌
          • a large, thick muscle that covers the superior part of the thorax
          • Origin
            • Clavicle, sternum, and costal cartilages of ribs 2–6 肋软骨
          • Insertion
            • humerus
          • 图
        • Latissimus dorsi 背阔肌
          • latissimus = widest, dorsum = back, dorsi = dorsal
          • a broad muscle located on the inferior part of the back
          • form the width of your back
          • Origin
            • spines of T7–L5, sacrum骶骨 and ilium髂qia骨
          • Insertion
            • humerus
          • 图
          • Synergists协同肌 - teres major大圆肌, latissimus dorsi
          • Enable to do a pullup
          • AKA swimmer’s muscle because its many actions are used while swimming
      • Scapular muscles that move the humerus
        • Deltoid 三角肌
          • The deltoid is a thick shoulder muscle that covers the shoulder joint.
          • pulls on the humerus to abduct外展 the arm
          • a site of intramuscular injections 肌内注射
          • 图
          • In abduction of the arm
            • Prime mover - deltoid
            • Fixators - pectoralis minor, trapezius, serratus anterior…
            • Fixators hold the scapula firmly against the back of the chest
            • Fixator固定肌 is to stabilize origin of the prime mover
        • Rotator cuff muscles 肩袖肌群
          • Supraspinatus 冈上肌
            • in the supraspinous fossa of the scapula
          • Infraspinatus 冈下肌
            • in the infraspinous fossa of the scapula
          • Teres minor 小圆肌
            • often inseparable from the infraspinatus
          • Subscapularis 肩胛下肌
            • in the subscapular fossa肩胛下窝 of the scapula 在前面
          • 肩胛骨后视图
          • Their tendons fuse together to form the rotator cuff , a nearly complete circle of tendons around the shoulder joint
          • 冈下肌和小圆肌是协同肌//都贴一块了,肯定是
        • Teres major 大圆肌
          • 在小圆肌底下
          • 大圆肌与背阔肌是协同肌
          • 图
    • Muscles of the arm that move the radius and ulna
      • Forearm flexors 屈肌
        • Biceps brachii 肱二头肌
          • 2 origins
          • cross two joints, have more complex actions
          • 肱2/3头肌
        • Brachioradialis 肱桡肌
          • Origin
            • Lateral border of distal end of humerus
          • Insertion
            • Superior to styloid process of radius
          • Action is flexes forearm at elbow joint
          • 图
          • 肱二头肌与肱桡肌是协同肌
      • Forearm extensors 伸肌
        • Triceps brachii 肱三头肌
          • 3 oringins
          • cross two joints, have more complex actions
    • Muscles of the forearm that move the wrist, hand, thumb, and digits
      • Superficial anterior compartment
        • flexor carpi radialis 桡侧腕曲肌
          • 止于第二掌骨底
        • palmaris longus 掌长肌
        • flexor carpi ulnaris 尺侧腕曲肌
          • 止于豌豆骨
      • Common origin
        • medial epicondyle of humerus 内上髁
      • palmer aponeurosis 掌腱膜
      • 图
      • 图
    • Muscles of the gluteal region that move the femur
      • Gluteus maximus 臀大肌
        • 最外面这块
      • Gluteus medius 臀中肌
        • 在臀大肌上方
        • The common sites for intramuscular injections 肌肉注射
          • the gluteus medius 臀中肌
          • the vastus lateralis (vastus股肌)
          • the deltoid 三角肌
      • Gluteus minimus 臀小肌
        • 在最深层
        • 久坐可能导致梨状肌压迫坐骨神经导致 Pseudo-sciatica 假性坐骨神经痛
    • Muscles of the thigh that move the femur, tibia, and fibula
      • The anterior muscles of the thigh
        • Sartorius 缝匠肌
          • AKA tailor’s muscle
          • long, narrow muscle
          • across the thigh from the ilium of the hip bone to the medial side of the tibia
          • cross two joints - have more complex actions
          • help with cross-legged sitting position 翘二郎腿
          • 图
        • Quadriceps femoris 股四头肌
          • rectus femoris 股直肌
            • on the anterior aspect of the thigh
          • vastus lateralis 股外侧肌
            • on the lateral aspect of the thigh
          • vastus intermedius 股中间肌
            • located deep to the rectus femoris between the vastus lateralis and vastus medialis
          • vastus medialis 股内侧肌
            • on the medial aspect of the thigh
          • 股直肌在最外侧,盖在股中间肌上面
        • Femoral triangle 股三角
          • 记法 SAIL
            • Sartorius + Adductor longus 内收长肌 + Inguinal Ligament 腹股沟韧带
          • 里面有股神经,股动脉,股静脉
          • 做手术Cardiac catheterization 心导管时候就是从这的静脉插根管子进去,一直通到心脏搭桥
      • The posterior muscles of the thigh
        • hamstrings 腘绳肌
          • biceps femoris 股二头肌
            • Origin
              • Long head arises from ischial tuberosity 坐骨结节
              • short head arises from linea aspera of femur 股骨粗线
            • Insertion
              • Head of fibula腓骨头
            • 图
          • Semitendinosus 半腱肌
          • Semimembranosus 半膜肌
          • 图
    • Muscles of the leg that move the foot and toes
      • Anterior compartment
        • Tibialis anterior 胫骨前肌
          • against the lateral surface of the tibia
        • Extensor hallucis longus 拇长伸肌
          • partly deep to the tibialis anterior
        • Extensor digitorum longus
      • Posterior compartment
        • gastrocnemius 腓肠肌
          • 图
        • soleus 比目鱼肌
          • 图
        • They share a common tendon of insertion, the calcaneal (Achilles跟腱) tendon, the strongest tendon of the body
  • 总结
    • Principal superficial skeletal muscles
    • 前
    • 后