Manual of Structural Kinesiology

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Manual Struktural
Kinesiologi
RT Floyd EdD, ATC, CSCS
Direktur Pelatihan Atletik dan Kedokteran Olahraga Profesor
Pendidikan Jasmani dan Ketua Pelatihan Atletik, Departemen
Pendidikan Jasmani dan
Pelatihan Atletik
University of West Alabama (sebelumnya
Livingston University)
Livingston, Alabama
EDISI kesembilan belas

PEDOMAN KINESIOLOGI STRUKTUR, EDISI kesembilan belas
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ISBN 978-0-07-336929-7
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Library of Congress Katalogisasi-dalam-Data Publikasi

Floyd, RT, penulis.
Manual kinesiologi struktural. — Edisi kesembilan belas / RT Floyd, EdD, ATC, CSCS, Direktur Pelatihan Atletik dan Kedokteran
Olahraga, Profesor Pendidikan Jasmani dan Pelatihan Atletik, Ketua, Departemen Pendidikan Jasmani dan Pelatihan Atletik,
Universitas West Alabama ( sebelumnya Livingston University), Livingston, Alabama.
halaman cm
ISBN 978-0-07-336929-7 (sampul tipis: kertas bebas asam) 1. Kinesiologi. 2. Penggerak manusia.
3. Otot. I. Judul.
QP303.T58 2015
612.7'6 — dc23
2014000497
Alamat Internet yang tercantum dalam teks akurat pada saat publikasi. Dimasukkannya situs web tidak menunjukkan
dukungan dari penulis atau McGraw-Hill Education, dan McGraw-Hill Education tidak menjamin keakuratan informasi yang
disajikan di situs ini.
www.mhhe.com
C tenda
Kata pengantar, v
1 Fondasi Kinesiologi Struktural, 1

2 Dasar-dasar Neuromuskuler, 35
3 Faktor Biomekanis Dasar dan
Konsep, 69
4 The Shoulder Girdle, 89
5 Sendi Bahu, 111

6 Sendi Siku dan Radioulnar, 143
7 Sendi Pergelangan Tangan dan Tangan, 169
8 Analisis Otot Ekstremitas Atas

Latihan, 207
9 Sendi Pinggul dan Korset Panggul, 229
10 Sendi Lutut, 273

11 Sendi Pergelangan Kaki dan Kaki, 293
12 Kolom Batang dan Tulang Belakang, 329
13 Analisis Otot Batang dan

Latihan Ekstremitas Bawah, 363
Lampiran, 377
Glosarium, 387
Kredit, 397
Indeks, 399
www.mhhe.com/f loyd19e aku aku aku

halaman ini sengaja dibiarkan kosong
P. reface
Dalam revisi ini, saya telah berusaha untuk memperbarui informasi Hadirin
dan meningkatkan kejelasan konsep dan ilustrasi sambil
mempertahankan pendekatan presentasi yang sukses yang didirikan Teks ini dirancang untuk mahasiswa dalam program sarjana
oleh Dr. Clem Thompson dari tahun 1961 hingga 1989. Saya pertama kinesiologi struktural setelah menyelesaikan mata kuliah
kali menggunakan buku ini sebagai sarjana dan kemudian dalam anatomi dan fisiologi manusia. Sementara terutama digunakan
ajaran saya selama bertahun-tahun. Setelah mengembangkan rasa dalam pendidikan jasmani, ilmu olahraga, pelatihan atletik,
hormat yang besar terhadap teks ini dan gaya Dr. Thompson, saya terapi fisik, dan kurikulum terapi pijat, sering digunakan sebagai
bermaksud untuk terus mempertahankan keefektifan teks yang referensi berkelanjutan oleh dokter dan pendidik lain dalam
dihormati waktu ini, sambil menambahkan materi yang berkaitan menangani masalah muskuloskeletal dari orang yang aktif
dengan profesi yang bekerja dengan populasi aktif secara fisik yang secara fisik. Ahli kinesiologi terapan, pelatih atletik, pelatih
terus berkembang saat ini. Mudah-mudahan, saya mempertahankan atletik, pendidik fisik, ahli terapi fisik, terapis okupasi, instruktur
metode presentasi yang jelas, ringkas, dan sederhana ditambah klub kesehatan, spesialis kekuatan dan pengkondisian, pelatih
dengan informasi aplikatif yang diperoleh melalui penelitian dan pribadi, terapis pijat, dokter, dan orang lain yang bertanggung
pengalaman karir saya. jawab untuk mengevaluasi, meningkatkan, dan memelihara
kekuatan otot , daya tahan, fleksibilitas, dan kesehatan individu
secara keseluruhan akan mendapat manfaat dari teks ini.
Naskah ini, yang sekarang memasuki tahun ke-67, telah
mengalami banyak revisi selama bertahun-tahun. Tujuan saya
terus membuat materi dapat diterapkan semaksimal mungkin
untuk aktivitas fisik dan membuatnya lebih dapat dipahami dan Dengan pertumbuhan yang terus menerus dalam jumlah
lebih mudah digunakan oleh siswa dan profesional. Saat membaca peserta dari segala usia dalam spektrum aktivitas fisik, sangat
teks ini, saya menantang mahasiswa dan profesional kinesiologi penting bahwa profesional medis, kesehatan, kebugaran, dan
untuk segera menerapkan konten ke aktivitas fisik yang mereka pendidikan yang terlibat dalam memberikan instruksi dan
kenal secara individu. Saya berharap pembaca secara bersamaan informasi kepada aktif secara fisik harus benar dan bertanggung
akan meraba sendi yang bergerak dan otot yang berkontraksi jawab untuk ajaran yang mereka berikan. Variasi mesin latihan,
untuk mendapatkan penerapan. Bersamaan dengan itu, saya teknik, program penguatan dan fleksibilitas, dan program
mendorong siswa untuk meraba sendi dan otot sesama siswa pelatihan terus berkembang dan berubah, tetapi sistem
untuk mendapatkan pemahaman yang lebih baik tentang berbagai muskuloskeletal tetap dalam desain dan arsitekturnya. Terlepas
anatomi normal dan, bila memungkinkan, menghargai variasi dari dari tujuan yang dicari atau pendekatan yang digunakan dalam
normal yang ditemukan pada cedera dan anatomi muskuloskeletal aktivitas olahraga, tubuh manusia adalah bahan dasar dan harus
patologis. Selain itu, Dengan pertumbuhan luar biasa dari dipahami serta dipertimbangkan secara menyeluruh untuk
informasi dan media yang tersedia melalui Internet dan sarana memaksimalkan kemampuan kinerja dan meminimalkan hasil
teknologi lainnya, saya mendorong eksplorasi sumber daya ini yang tidak diinginkan. Sebagian besar kemajuan dalam
secara cermat dan terus menerus. Sumber daya ini harus kinesiologi dan ilmu olahraga terus dihasilkan dari pemahaman
membantu, tetapi harus ditinjau dengan mata kritis, sebagaimana yang lebih baik tentang tubuh dan bagaimana fungsinya. Saya
seharusnya semua informasi. percaya bahwa seseorang di bidang ini tidak akan pernah cukup
belajar tentang struktur dan fungsi
www.mhhe.com/f loyd19e v
dari tubuh manusia dan ini biasanya paling baik dipelajari Ucapan Terima Kasih
melalui aplikasi praktis.
Mereka yang diberi tanggung jawab untuk memberikan Saya sangat menghargai banyak komentar, ide, dan saran yang
pemeriksaan, instruksi dan konsultasi kepada yang aktif secara fisik diberikan oleh delapan reviewer. Tinjauan ini telah menjadi
akan menemukan teks ini sebagai sumber yang berguna dan panduan yang paling membantu dalam revisi ini dan saran telah
berharga dalam pencarian mereka yang tiada henti untuk dimasukkan sejauh mungkin jika sesuai. Pengulas ini adalah:
pengetahuan dan pemahaman tentang gerakan manusia.
Andrew J. Accacian, Universitas Dubuque

Baru di edisi ini
Jessica Adams, Universitas Kean
Beberapa konten tambahan telah ditambahkan dengan sedikit Pam Brown, Universitas Carolina Utara di
revisi di banyak area. Tabel dan ilustrasi telah diperhalus dan Greensboro
diperbarui, dan sejumlah foto dan gambar telah ditambahkan
atau diganti untuk meningkatkan kualitas dan kejelasan visual. Adam Bruenger, Universitas Central Arkansas
Beberapa lembar kerja bab juga telah direvisi. Alamat situs web
telah dipindahkan ke Pusat Pembelajaran Online di www Phillip Morgan, Universitas Negeri Washington
Dean Smith, Universitas Miami
. mhhe.com/ fl oyd19e agar lebih mudah diakses dan diperbarui Scott Strohmeyer, Universitas Missouri Tengah
sesuai kebutuhan. Pertanyaan dan latihan tambahan akan
terus ditambahkan ke Pusat Pembelajaran Online. Akhirnya,
beberapa istilah baru telah ditambahkan ke Daftar Istilah. Traci Worby, Universitas Illinois Timur
Saya ingin mengucapkan terima kasih secara khusus

kepada para mahasiswa dan fakultas kinesiologi / pelatihan
Pusat Pembelajaran Online atletik dari University of West Alabama atas saran, nasihat, dan
masukan mereka selama revisi ini. Bantuan dan saran mereka
www.mhhe.com/ fl oyd19e sangat membantu. Saya sangat berterima kasih kepada Britt
Pusat Pembelajaran Online yang menyertai teks ini menawarkan Jones dari Livingston, Alabama, atas fotografinya yang luar
sejumlah sumber daya tambahan untuk siswa dan instruktur. biasa. Saya juga mengucapkan terima kasih kepada John Hood
Kunjungi situs web ini untuk menemukan materi bermanfaat seperti dan Lisa Floyd dari Birmingham dan Livingston, Alabama,
ini: masing-masing, untuk foto-fotonya yang bagus. Terima kasih
khusus kepada Linda Kimbrough dari Birmingham, Alabama,
Untuk instruktur:
atas ilustrasi dan wawasannya yang luar biasa. Saya
• Presentasi PowerPoint yang dapat diunduh
menghargai model untuk foto-fotonya, Audrey Crawford, Fred
• Bank citra
Knighten, Darrell Locket, Amy Menzies, Matthew Phillips, Jay
• Uji pertanyaan bank
Sears, Marcus Shapiro, dan David Whitaker. Terima kasih juga
• Latihan akhir bab dan jawaban lembar kerja
untuk Emily Nesheim dan Erin Guendelsberger, Sara Jaeger,
Untuk siswa:
• Self-scoring pilihan ganda, pencocokan, dan kuis video
• Kartu anatomi dan teka-teki silang untuk mempelajari

istilah-istilah kunci dan definisinya
• Strategi Sukses Siswa RT Floyd

• Glosarium
vi www.mhhe.com/f loyd19e
SEBUAH tentang Penulis

RT Floyd berada di tahun keempat puluh dalam memberikan layanan menulis edisi keempat sampai kesebelas. Pada tahun 2010, sebagian
pelatihan atletik untuk University of West Alabama. Saat ini, ia menjabat besar konten teks ini dimasukkan ke dalam
sebagai Direktur Pelatihan Atletik dan Kedokteran Olahraga untuk Pusat Kinesiologi untuk Terapi Manual, yang dia tulis bersama
Pelatihan Atletik dan Kedokteran Olahraga UWA, Direktur Program untuk dengan Nancy Dail dan Tim Agnew.
kurikulum terakreditasi CAATE UWA, dan sebagai profesor di Departemen
Pendidikan Jasmani dan Pelatihan Atletik, yang ia pimpin. Dia telah Floyd adalah anggota bersertifikat dari Asosiasi Pelatih Atletik Nasional,
mengajar berbagai kursus dalam pendidikan jasmani dan pelatihan atletik, Spesialis Pengkondisian & Kekuatan Bersertifikat, dan Pelatih Pribadi
termasuk kinesiologi, baik di tingkat sarjana maupun pascasarjana sejak Bersertifikat di Asosiasi Pengkondisian dan Kekuatan Nasional. Dia juga
1980. seorang Manajer Peralatan Atletik Bersertifikat di Asosiasi Manajer
Peralatan Atletik, anggota dari American College of Sports Medicine,
American Orthopedic Society for Sports Medicine, American Osteopathic
Floyd telah mempertahankan kehidupan profesional yang aktif sepanjang Academy of Sports Medicine, American Sports Medicine Fellowship
kariernya. Dia saat ini menjabat sebagai Presiden dari National Athletic Society, dan Aliansi Amerika untuk Kesehatan, Pendidikan Jasmani,
Trainers 'Association (NATA) Research & Education Foundation setelah Rekreasi dan Tari. Selain itu, ia memiliki lisensi di Alabama sebagai Pelatih
menjabat dalam berbagai peran di Dewan Direksi sejak 2002. Dia baru-baru Atletik dan Teknisi Medis Darurat.
ini menyelesaikan delapan tahun pengabdiannya di Dewan Direksi NATA
yang mewakili Distrik IX, Asosiasi Pelatih Atletik Tenggara (SEATA).
Sebelumnya, ia menjabat sebagai perwakilan Distrik IX untuk Komite
Multimedia Pendidikan NATA dari 1988 hingga 2002. Ia telah menjabat
sebagai Ketua Pemilihan Lokasi Konvensi untuk Distrik IX dari 1986 hingga Floyd dianugerahi Penghargaan Layanan Pelatih Atletik NATA pada tahun
2004 dan telah mengarahkan Kompetensi SEATA tahunan dalam Lokakarya 1996, Penghargaan Pelatih Atletik Paling Terhormat oleh NATA pada tahun
Pelatih Atletik sejak 1997 . Dia juga menjabat sebagai penguji Dewan 2003, dan menerima Penghargaan Pembicara NATA “Bud” Miller
Komisaris NATA selama lebih dari satu dekade dan telah beberapa kali Distinguished Educator pada tahun 2007. Pada tahun 2013 ia dilantik ke
menjabat sebagai Komite Peninjau Bersama untuk Program Pendidikan di dalam Hall of Fame NATA . Dia menerima Penghargaan Distrik IX untuk
situs Pelatihan Atletik. Dia telah memberikan lebih dari seratus presentasi Kontribusi Luar Biasa ke bidang Pelatihan Atletik oleh SEATA pada tahun
profesional di tingkat lokal, negara bagian, regional, dan nasional dan juga 1990 dan Penghargaan Merit pada tahun 2001 sebelum dilantik ke dalam Hall
telah menerbitkan beberapa artikel dan video yang berkaitan dengan aspek of Fame organisasi pada tahun 2008. Dia dinobatkan sebagai Who's Who
praktis dari pelatihan atletik. Dia mulai menulis Among America's Teachers pada tahun 1996, 2000, 2004, dan 2005. Pada
tahun 2001, ia dilantik ke dalam Honor Society of Phi Kappa Phi dan Hall of
Fame Atletik Universitas West Alabama. Dia dilantik ke Hall of Fame Asosiasi
Pelatih Atletik Alabama pada Mei 2004.
Manual Kinesiologi Struktural pada tahun 1992 dengan tanggal dua belas
edisi setelah meninggalnya Dr. Clem W. Thompson, yang
www.mhhe.com/f loyd19e vii

Untuk
keluarga saya,
Lisa, Robert Thomas, Jeanna, Rebecca, dan Kate
yang mengerti, mendukung, dan mengizinkan saya untuk
mengejar profesiku
dan untuk orang tua saya,

Ruby dan George Franklin,
yang mengajari saya pentingnya etos kerja yang kuat
dengan hasil yang berkualitas
RTF
1
1
C HAPTER Bab
F PONDASI
S TRUKTURAL K INESIOLOGI
Tujuan
K prinsip anatomi
inesiologi (aktif dan pasif
dapat didefinisikan sebagai studi tentang
j Untuk meninjau anatomi sistem kerangka struktur), fisiologi, dan mekanika dalam hubungannya dengan
gerakan manusia. Penekanan dari teks ini adalah kinesiologi
j Untuk meninjau dan memahami terminologi yang digunakan struktural —Pelajaran tentang otot, tulang, dan persendian
untuk menggambarkan lokasi bagian tubuh, posisi referensi, dan karena mereka terlibat dalam ilmu gerak. Untuk tingkat yang
arah anatomi lebih rendah, prinsip fisiologis dan mekanis tertentu ditujukan
untuk meningkatkan pemahaman tentang struktur yang
j Untuk meninjau bidang gerak dan sumbu rotasinya
dibahas.
masing-masing dalam kaitannya dengan gerakan manusia
Tulang bervariasi dalam ukuran dan bentuk, yang menjadi

j Mendeskripsikan dan memahami berbagai jenis tulang dan faktor dalam jumlah dan jenis gerakan yang terjadi di antara
sendi dalam tubuh manusia beserta fungsi, ciri, dan tulang sendi. Jenis sambungan bervariasi dalam struktur dan
karakteristiknya fungsinya. Otot juga sangat bervariasi dalam ukuran, bentuk, dan
struktur dari satu bagian tubuh ke bagian lain.
j Untuk mendeskripsikan dan mendemonstrasikan gerakan
sendi
Ahli anatomi, pelatih atletik, ahli terapi fisik, ahli terapi okupasi,
dokter, perawat, terapis pijat, pelatih, spesialis kekuatan dan
pengkondisian, spesialis peningkatan kinerja, pelatih pribadi,
pendidik fisik, dan orang lain di bidang yang berhubungan dengan
kesehatan harus memiliki pengetahuan dan pemahaman yang
memadai tentang semua kelompok otot besar sehingga mereka
dapat mengajari orang lain cara memperkuat, meningkatkan, dan
Sumber Daya Pusat Pembelajaran Online
memelihara bagian-bagian tubuh manusia ini. Pengetahuan ini
menjadi dasar dari program latihan yang harus diikuti untuk
Mengunjungi Manual Kinesiologi Struktural 's Pusat Pembelajaran Online di www.mhhe.com/
fl oyd19e untuk informasi tambahan dan bahan pelajaran untuk bab ini, memperkuat dan memelihara semua otot. Dalam kebanyakan
termasuk: kasus, latihan yang melibatkan penggerak utama yang lebih besar
juga melibatkan otot yang lebih kecil.
j Kuis penilaian mandiri
j Kartu anatomi
j Animasi
j Situs web terkait Lebih dari 600 otot ditemukan di tubuh manusia. Dalam
buku ini, penekanan ditempatkan pada otot-otot besar yang
terutama terlibat dalam pergerakan sendi. Detail yang berkaitan
dengan banyak otot kecil yang terletak di tangan, kaki, dan
tulang belakang diberikan pada tingkat yang lebih rendah.
www.mhhe.com/f loyd19e 1
1 Kurang dari 100 otot terbesar dan terpenting, penggerak Posisi referensi
utama, dibahas dalam teks ini. Beberapa otot kecil dalam tubuh
manusia, seperti multi fi dus, plantaris, skalenus, dan serratus Sangat penting bagi mahasiswa kinesiologi untuk memulai dengan
posterior, dihilangkan karena mereka berlatih dengan titik referensi untuk lebih memahami sistem muskuloskeletal,
penggerak utama lain yang lebih besar. Selain itu, sebagian bidang gerakannya, klasifikasi sendi, dan terminologi gerakan
besar otot kecil pada tangan dan kaki tidak diberikan perhatian sendi. Dua posisi referensi dapat digunakan sebagai dasar untuk
penuh pada otot yang lebih besar. Banyak otot kecil tulang menggambarkan gerakan sendi. Itu posisi anatomi adalah yang
belakang tidak dipertimbangkan secara lengkap. paling banyak digunakan dan akurat untuk semua aspek tubuh.
Gambar 1.1 menunjukkan posisi referensi ini, dengan subjek
berdiri dalam postur tegak, menghadap lurus ke depan, dengan
kaki sejajar dan dekat, serta telapak tangan menghadap ke depan.
Siswa kinesiologi sering menjadi begitu asyik mempelajari Itu
otot individu sehingga mereka kehilangan pandangan dari sistem
otot total. Mereka kehilangan "gambaran besar" —bahwa posisi fundamental pada dasarnya sama dengan posisi anatomi,
kelompok otot menggerakkan sendi dalam gerakan tertentu yang hanya saja lengan berada di samping dengan telapak tangan
diperlukan untuk gerakan tubuh dan kinerja terampil. Meskipun menghadap ke badan.
sangat penting untuk mempelajari detail kecil dari keterikatan
otot, lebih penting lagi untuk dapat menerapkan informasi Garis referensi
tersebut ke situasi kehidupan nyata. Setelah informasi dapat
diterapkan dengan cara yang berguna, detail spesifik biasanya Untuk lebih membantu dalam memahami lokasi satu bagian tubuh
lebih mudah dipahami dan dihargai. dalam kaitannya dengan yang lain, garis referensi imajiner tertentu
dapat digunakan. Beberapa contoh mengikuti Gambar 1.2.
Unggul
Baik Kiri
(cephalic)
Unggul
(cephalic)
Garis tengah
Proksimal
Depan Belakang
Inferior
Saya panggil (ekor)
(perut) (punggung)
Distal
Lat eral
Inferior
(ekor)
Proksimal
Distal
Distal
Proksimal
ARA. 1.1 • Posisi anatomi dan arah anatomi. Arah anatomi mengacu pada posisi satu bagian tubuh dalam hubungannya dengan yang
lain.
2 www.mhhe.com/f loyd19e
Bab
Garis aksila posterior: Garis yang sejajar 1

garis ketiak tengah dan melewati lipatan kulit ketiak posterior
Bagian tengah klavikula kanan Garis tengah-buritan
baris
Garis mid-klavikula: Sebuah garis yang membentang secara
vertikal di permukaan tubuh melewati titik tengah klavikula
Anterior kanan
garis ketiak
Titik tengah inguinal: Titik di tengah antara spina iliaka anterior
superior dan simfisis pubis
Garis skapula: Sebuah garis yang membentang secara vertikal ke

Garis aksila posterior
bawah permukaan posterior tubuh melewati sudut inferior
Garis skapula
Garis vertebral skapula
Garis vertebral: Sebuah garis yang mengalir secara vertikal ke bawah melalui
proses spinosus tulang belakang
Arah anatomi
ARA. 1.2 • Garis referensi.
terminologi GAMBAR. 1.1, 1.3, 1.4
Penting bagi kita semua untuk dapat menemukan jalan di sekitar tubuh
Garis tengah ketiak: Garis vertikal di permukaan tubuh melewati manusia. Sampai batas tertentu, kita dapat menganggap ini serupa
puncak ketiak (ketiak)
dengan memberi atau menerima arahan tentang cara pergi dari satu
lokasi geografis ke lokasi lain. Sama seperti kita menggunakan
Garis mid-sternal: Sebuah garis yang membentang secara vertikal di istilahnya kiri, kanan, selatan, barat, timur laut, dll. untuk
permukaan tubuh melewati bagian tengah tulang dada mendeskripsikan arah geografis, kami memiliki istilah seperti lateral,
medial, inferior, anterior, inferomedial, dll. yang digunakan untuk
Garis ketiak anterior: Garis yang sejajar dengan garis petunjuk anatomi. Dengan arah geografis yang dapat kami gunakan Barat
pertengahan ketiak dan melewati lipatan kulit ketiak anterior untuk menunjukkan ujung barat jalan
Depan
Tuberositas tibial
Anteromedial Anterolateral
Ligamentum cruciatum anterior
Meniskus medial
Meniskus lateral
Medial Lateral
Medial
tibial
dataran Dataran tinggi tibialis lateral
Posteromedial Posterolateral
Ligamentum cruciatum posterior

Belakang
Lutut kanan, pandangan superior dengan tulang paha diangkat
ARA. 1.3 • Terminologi arah anatomi.
1 Unggul
Superolateral Superomedial
Epikondilus lateral Epikondilus medial
Lateral Medial
Tempurung lutut
Kondilus femoralis lateral
Kondilus femoralis medial
Kondilus tibialis lateral

Kondilus tibialis medial
Kepala fibular
Tuberositas tibial
Tulang betis
Tulang kering
Inferolateral Inferomedial
Inferior
Lutut kanan, tampak anterior
ARA. 1.4 • Terminologi arah anatomi.
atau Amerika Serikat bagian barat. Hal yang sama berlaku jika kita Dexter: Berkaitan dengan, atau terletak di sebelah kanan atau di sisi
menggunakan petunjuk anatomi. Kami dapat menggunakan kanan, sesuatu
unggul untuk menunjukkan ujung tulang di kaki bagian bawah kita yang Distal: Terletak jauh dari pusat atau garis tengah tubuh, atau jauh
paling dekat dengan lutut, atau kita mungkin berbicara tentang bagian atas dari titik asal
tengkorak. Itu semua tergantung konteks saat itu. Sama seperti kita
Dorsal (dorsum): Berhubungan dengan punggung, sedang atau terletak di
menggabungkan Selatan dan
dekat, di, atau ke arah belakang, bagian posterior, atau permukaan atas;
timur mendapatkan tenggara untuk tujuan menunjukkan di suatu tempat
juga berhubungan dengan bagian atas kaki
di antara arah ini, kami dapat menggabungkan depan dan lateral mendapatkan
anterolateral
untuk mendeskripsikan arah atau lokasi umum "di depan dan ke Berserat: Berkaitan dengan sisi fibula (lateral) dari ekstremitas
luar". Gambar. 1.3 dan 1.4 memberikan contoh lebih lanjut. bawah
Inferior (infra): Di bawah ini terkait dengan struktur lain; kaudal
Depan: Di depan atau di depan

Inferolateral: Bawah dan ke luar
Anteroinferior: Di depan dan di bawah
Inferomedial: Di bawah dan menuju garis tengah atau dalam
Anterolateral: Di depan dan ke luar
Ipsilateral: Di sisi yang sama
Anteromedial: Di depan dan ke arah sisi dalam atau garis tengah
Lateral: Di atau ke samping; di luar, lebih jauh dari bidang median
atau midsagital
Anteroposterior: Berhubungan dengan depan dan belakang
Medial: Berkaitan dengan tengah atau tengah; lebih dekat ke bidang
Anterosuperior: Di depan dan di atas
median atau midsagital
Bilateral: Berkaitan dengan sisi kanan dan kiri tubuh atau struktur
Median: Berhubungan dengan, terletak di, atau meluas ke tengah;
tubuh seperti ekstremitas kanan dan kiri
terletak di tengah, medial
Palmar: Berkaitan dengan aspek telapak tangan atau volar tangan
Caudal: Di bawah ini terkait dengan struktur lain; inferior
Plantar: Berkaitan dengan telapak kaki atau permukaan bawah kaki
Belakang: Di belakang, di belakang, atau di belakang

Cephalic: Di atas dalam kaitannya dengan struktur lain; lebih tinggi, lebih
unggul Posteroinferior: Di belakang atau di belakang dan di bawah
Kontralateral: Menyinggung atau berhubungan dengan sisi yang berlawanan Posterolateral: Di belakang dan ke satu sisi, khususnya ke luar
Dalam: Di bawah atau di bawah permukaan; digunakan untuk menggambarkan Posteromedial: Di belakang dan ke dalam
kedalaman relatif atau lokasi otot atau jaringan Posterosuperior: Di belakang atau di belakang dan di atas
Bab
Rentan: Posisi tubuh menghadap ke bawah; berbaring tengkurap gerak (Gbr. 1.5). Sebuah bidang gerak mungkin saja 1
didefinisikan sebagai permukaan dua dimensi imajiner yang digunakan
Proksimal: Batang terdekat atau titik asal untuk memindahkan segmen tubuh atau tubuh.
Ada tiga yang spesifik, atau kardinal , bidang gerak di mana
Radial: Berkaitan dengan sisi radial (lateral) lengan bawah atau
berbagai gerakan sendi dapat diklasifikasikan. Bidang spesifik
tangan
yang membagi tubuh menjadi dua bagian sering disebut
Bidang skapula: Sejalan dengan posisi istirahat normal skapula
sebagai bidang kardinal. Bidang kardinal adalah bidang sagital,
karena terletak di tulang rusuk posterior; gerakan pada bidang
frontal, dan transversal. Ada sejumlah tak terhingga bidang
skapuler sejajar dengan skapula, yang berada pada sudut 30
dalam setiap setengah yang sejajar dengan bidang kardinal. Ini
hingga 45 derajat dari bidang frontal
paling baik dipahami dalam contoh gerakan berikut di bidang
sagital. Sit-up melibatkan tulang belakang dan, akibatnya,
Jahat: Berkaitan dengan, atau terletak di kiri atau di sisi kiri, dilakukan di bidang sagital kardinal, yang juga dikenal sebagai
sesuatu
Superfisial: Dekat permukaan; digunakan untuk menggambarkan kedalaman
relatif atau lokasi otot atau jaringan
Superior (supra): Di atas dalam kaitannya dengan struktur lain; lebih midsagittal atau median pesawat. Biceps curl dan ekstensi lutut
tinggi, cephalic dilakukan parasagital
pesawat, yang sejajar dengan bidang midsagital. Meskipun
Superolateral: Di atas dan ke luar
contoh-contoh terakhir ini tidak berada di bidang kardinal,
Superomedial: Di atas dan menuju garis tengah atau dalam
mereka dianggap sebagai gerakan di bidang sagital.
Terlentang: Posisi tubuh menghadap ke atas; berbaring telentang
Meskipun setiap gerakan sendi tertentu dapat diklasifikasikan
Tibial: Berkaitan dengan sisi tibialis (medial) dari ekstremitas sebagai salah satu dari tiga bidang gerakan, gerakan kita
bawah biasanya tidak sepenuhnya dalam satu bidang tertentu tetapi
Ulnar: Berkaitan dengan sisi ulnaris (medial) lengan bawah atau terjadi sebagai kombinasi gerakan di lebih dari satu bidang.
tangan Gerakan-gerakan dalam bidang gabungan ini dapat digambarkan
sebagai terjadi di bidang gerak diagonal, atau miring.
Ventral: Berhubungan dengan perut atau perut, di atas atau di
depan, bagian anterior
Volar: Berkaitan dengan telapak tangan atau telapak kaki Bidang sagital, anteroposterior, atau AP
Bidang sagital, anteroposterior, atau AP membagi dua tubuh
Terminologi variasi perataan
dari depan ke belakang, membaginya menjadi dua bagian
Anteversi: Rotasi yang tidak normal atau berlebihan ke depan suatu simetris kanan dan kiri. Umumnya gerakan fleksi dan ekstensi
struktur, seperti anteversi femoralis seperti biceps curl, knee extension, dan sit-up terjadi pada
pesawat ini.
Kifosis: Peningkatan lengkungan tulang belakang ke luar atau ke
belakang pada bidang sagital
Bidang depan, koronal, atau lateral
Lordosis: Peningkatan lengkungan tulang belakang ke dalam atau ke depan
Bidang frontal, juga dikenal sebagai bidang koronal atau lateral,
pada bidang sagital
membagi dua tubuh secara lateral dari sisi ke sisi, membaginya
Recurvatum: Membungkuk ke belakang, seperti pada hiperekstensi lutut
menjadi bagian depan (ventral) dan belakang (punggung).
Gerakan abduksi dan adduksi seperti jumping jack (bahu dan
Belokan ke belakang: Rotasi yang tidak normal atau berlebihan ke belakang pinggul) dan fleksif lateral tulang belakang terjadi pada bidang ini.
suatu struktur, seperti retroversi femoralis
Skoliosis: Lekukan lateral tulang belakang

Bidang melintang, aksial, atau horizontal
Valgus: Angulasi luar dari segmen distal tulang atau sendi, seperti
lutut ketukan Bidang transversal, juga dikenal sebagai bidang aksial atau
horizontal, membagi tubuh menjadi bagian superior (cephalic) dan
Varus: Angulasi ke dalam segmen distal tulang atau sendi, seperti
inferior (caudal). Umumnya, gerakan rotasi seperti pronasi lengan
pada kaki busur
bawah dan supinasi serta rotasi tulang belakang terjadi pada
bidang ini.
Bidang gerak
Saat kita mempelajari berbagai sendi tubuh dan menganalisis Bidang diagonal atau miring ARA. 1.6
gerakannya, akan sangat membantu jika kita Bidang diagonal atau miring adalah kombinasi dari lebih dari
mengkarakterisasikannya menurut bidang tertentu. satu bidang gerak. Pada kenyataannya,
1 Unggul Sumbu vertikal

(membujur,
panjang)
Sumbu sagital Frontal

(anteroposterior, bidang (lateral,
AP) mahkota)
Pesawat sagital
(anteroposterior,
AP)
Melintang
pesawat (aksial,
horisontal)
Frontal
sumbu (koronal,
lateral,
mediolateral)
Aspek medial
Aspek lateral
Inferior
SEBUAH B C
ARA. 1.5 • Bidang gerak dan sumbu rotasi. SEBUAH, Bidang sagital dengan sumbu frontal; B, Bidang depan dengan sumbu sagital; C, Bidang melintang
dengan sumbu vertikal.
sebagian besar gerakan kita dalam kegiatan olahraga berada di Sumbu frontal, koronal, lateral, atau mediolateral
antara paralel dan tegak lurus dengan bidang yang dijelaskan Jika bidang sagital membentang dari anterior ke posterior,
sebelumnya dan terjadi dalam bidang diagonal. Untuk maka porosnya harus berjalan dari sisi ke sisi. Karena sumbu
menggambarkan lebih lanjut, semua gerakan pada bidang ini memiliki orientasi arah yang sama dengan bidang gerak
diagonal terjadi pada bidang diagonal tinggi atau salah satu dari frontal, maka dinamai serupa. Saat siku bergerak keluar dan
dua bidang diagonal rendah. Bidang diagonal tinggi digunakan meluas di bidang sagital selama biceps curl, lengan bawah
untuk gerakan overhand pada ekstremitas atas, sedangkan dua sebenarnya berputar pada sumbu frontal yang berjalan secara
bidang diagonal rendah digunakan untuk membedakan gerakan lateral melalui sendi siku. Sumbu frontal juga dapat disebut
underhand ekstremitas atas dari gerakan diagonal ekstremitas sebagai sumbu bilateral.
bawah.
Sumbu sagital atau anteroposterior
Sumbu rotasi Gerakan yang terjadi pada bidang frontal berputar di sekitar sumbu
sagital. Sumbu sagital ini memiliki orientasi arah yang sama dengan
Saat gerakan terjadi pada bidang tertentu, sambungan bergerak atau bidang gerak sagital dan membentang dari depan ke belakang pada
berbelok di sekitar sumbu yang memiliki hubungan 90 derajat ke sudut siku-siku ke bidang gerak frontal. Saat pinggul menculik dan
bidang tersebut. Sumbu diberi nama sehubungan dengan orientasinya adduct selama jumping jack, tulang paha berputar sekitar sumbu
(Gbr. 1.5). Tabel 1.1 mencantumkan bidang-bidang gerak dengan yang membentang dari depan ke belakang melalui sendi pinggul.
sumbu rotasinya.
Bab
Diagonal
bidang gerak
Diagonal
bidang gerak
Sumbu Sumbu
Sumbu
SEBUAH B C
ARA. 1.6 • Bidang diagonal dan sumbu rotasi. SEBUAH, Pergerakan dan sumbu bidang diagonal tinggi pada ekstremitas atas; B, Gerakan dan sumbu
bidang diagonal rendah ekstremitas atas; C, Bidang diagonal rendah ekstremitas bawah
gerakan dan sumbu.
TABEL 1.1 • Bidang gerak dan sumbu rotasinya
Pesawat Deskripsi pesawat Sumbu rotasi Deskripsi sumbu Gerakan umum
Sagittal Membagi tubuh menjadi dua Frontal (koronal, lateral,

Berjalan medial / lateral Fleksi, ekstensi
(anteroposterior atau AP) bagian kanan dan kiri atau mediolateral)
Membagi tubuh
Frontal Sagittal Berjalan anterior /
ke anterior dan Penculikan, adduksi
(koronal atau lateral) (anteroposterior atau AP) belakang
bagian posterior
Membagi tubuh
Melintang Vertikal Menjalankan superior / Rotasi internal,
menjadi superior dan
(aksial, horizontal) (longitudinal atau long) inferior rotasi eksternal
bagian inferior
Sumbu vertikal atau longitudinal porosnya tegak lurus dengan bidang melalui kepala humerus.
Sumbu vertikal, juga dikenal sebagai sumbu longitudinal atau
longitudinal, membentang lurus ke bawah melalui bagian atas kepala
dan berada pada sudut siku-siku terhadap bidang gerak transversal.
Wilayah tubuh
Saat kepala berputar atau berputar dari kiri ke kanan saat menunjukkan
ketidaksetujuan, tengkorak dan vertebra serviks berputar di sekitar Seperti disebutkan kemudian di bawah sistem kerangka, tubuh
sumbu yang mengalir ke bawah melalui tulang belakang. dapat dibagi menjadi daerah aksial dan apendikuler.
Masing-masing daerah ini dapat dibagi lagi menjadi subregional
yang berbeda, seperti cephalic, cervical, trunk, tungkai atas, dan
Sumbu diagonal atau miring ARA. 1.6 tungkai bawah. Di dalam masing-masing wilayah ini terdapat
Sumbu diagonal, juga dikenal sebagai sumbu miring, berjalan pada lebih banyak subkawasan dan wilayah tertentu. Tabel 1.2
sudut siku-siku terhadap bidang diagonal. Saat sendi glenohumeral merinci rincian daerah-daerah ini dan nama umumnya,
bergerak dari abduksi diagonal ke adduksi diagonal dalam diilustrasikan pada Gambar 1.7.
lemparan overhand,
1 TABEL 1.2 • Bagian tubuh dan wilayah

Nama wilayah Nama yang umum Subkawasan Nama wilayah tertentu Nama umum untuk wilayah tertentu
Frontal Dahi
Cranial (tengkorak)
Berhubung dgn tengkuk Dasar tengkorak
Orbital Mata
Berhubung dgn telinga Telinga

Cephalic Kepala
Sengau Hidung
Facial (wajah)
Bukal Pipi
Lisan Mulut
Mental Dagu
Yg berhubung dgn kuduk Leher posterior

Serviks Leher
Tenggorokan Leher anterior
Klavikula Tulang kerah
Pectoral Dada
Thoracic Thorax Abadi Tulang dada
Axial
Costal Tulang iga
Mammary Payudara
Tulang belikat Tulang belikat

Dorsal Kembali Vertebral Kolom tulang belakang
Pinggang Punggung bawah atau

Bagasi
Celiac pinggang
Perut Abdomen
Pusat Pusar
Inguinal Kunci paha
Kemaluan Genital
Coxal Panggul
Panggul Panggul
Sakral Di antara pinggul
Gluteal Pantat
Perineal Perineum
Akromial Titik bahu
Bahu Omus Berbentuk delta
Ketiak Ketiak
Brachial Lengan
Olecranon Titik siku

Kubital Siku
Tungkai atas
Antecubital Bagian depan siku
Antebrachial Lengan bawah
Carpal Pergelangan tangan
Palmar telapak tangan
Manual Dorsal Punggung tangan

Appendicular
Digital Jari
Femoralis Paha
Tempurung lutut Kneecap
Popliteal Belakang lutut
Sural Betis
Crural Kaki
Tungkai bawah Lereng Pergelangan kaki
Calcaneal Tumit
Dorsum Kaki bagian atas

Pedal Kaki
Tarsal Punggung kaki
Plantar Tunggal
Digital Kaki
Bab
Nasal (hidung) Cephalic (kepala) Cranial

(sekitarnya
1
Otic (telinga) Frontal (dahi) otak)
Lisan (mulut) Orbital (mata) Berhubung dgn tengkuk

(dasar tengkorak)
Serviks (leher) Buccal (pipi)
Yg berhubung dgn kuduk
Klavikula (tulang selangka) Mental (dagu) Belakang (leher posterior)

toraks
Tulang belikat
Akromial Tenggorokan
(titik bahu) (tulang belikat)
Abadi Bahu
Ketiak (ketiak)
Pectoral
Mammary (payudara) wilayah Vertebral
(dada) (tulang belakang)
Brachial
(lengan) Depan Brachial
kubital (lengan)
Antecubital (kubital
Perut
(depan siku) fossa)
Olecranon
Celiac atau abdominal Pusar
(titik siku)
(perut)
Inguinal Pinggang
Antebrachial (kunci paha) (punggung bawah
(lengan bawah) atau pinggang)
Dorsum dari
Carpal (pergelangan tangan)
tangan
Palmar (telapak tangan)
Gluteal (pantat)
Digital (jari) Coxal (pinggul)
Sakral
Genital
Femoral (paha) Perineal
Femoral (paha)
Patela (tempurung lutut)
Fossa poplitea
Kram anterior (kaki) (belakang lutut)
Sural (betis)
Peroneal
(fibular)
Talus (pergelangan kaki) Creek
Dorsum kaki
Digital (jari kaki) Plantar (tunggal)
Tarsal (punggung kaki)
SEBUAH B
ARA. 1.7 • Wilayah tubuh. SEBUAH, Tampilan anterior; B, Tampilan posterior.
Sistem rangka kerangka terdiri dari tengkorak, tulang belakang, tulang rusuk, dan
tulang dada. Sebagian besar siswa yang mengambil kursus ini
Gambar 1.8 menunjukkan pandangan anterior dan posterior telah memiliki mata kuliah anatomi manusia, tetapi tinjauan singkat
dari sistem rangka. Sekitar 206 tulang membentuk sistem diperlukan sebelum memulai studi kinesiologi. Bab-bab selanjutnya
rangka, yang memberikan dukungan dan perlindungan bagi memberikan informasi tambahan dan ilustrasi yang lebih rinci dari
sistem tubuh lainnya dan menyediakan keterikatan otot ke tulang-tulang tertentu.
tulang, yang digunakan untuk menghasilkan gerakan. Fungsi
kerangka tambahan adalah penyimpanan mineral dan
hemopoiesis, yang melibatkan pembentukan sel darah di
Ilmu tulang
sumsum tulang merah. Kerangka dapat dibagi menjadi
kerangka apendikuler dan aksial. Kerangka apendikular terdiri Kerangka dewasa, terdiri dari sekitar 206 tulang, dapat dibagi
dari pelengkap, atau ekstremitas atas dan bawah, serta sabuk menjadi kerangka aksial dan kerangka apendikuler. Kerangka
bahu dan panggul. Aksial aksial berisi 80 tulang, yang meliputi tengkorak, tulang
belakang, tulang dada, dan tulang rusuk. Kerangka apendikuler
berisi
1
Frontal
Tulang parietal
tulang
Tulang sementara Tulang oksipital
Tengkorak
Zygomatic Tonjolan oksipital
Rahang atas
tulang Rahang bawah
Vertebra serviks
Sudut superior
Tulang belakang skapula (7)
Manubrium
Tulang selangka
Proses korakoid Vertebra toraks
Proses akromion
Kepala humerus (12)
Tulang belikat
Perbatasan ketiak
Tulang dada Tuberkel lebih besar
Perbatasan vertebral
Tulang rusuk
Tuberkulum kecil
Sudut inferior
kandang
Tulang iga Kartilago kosta
(12 pasang)
Proses Xiphoid
Vertebra lumbal (5)
Epikondilus medial Humerus
Epikondilus lateral
Kepala radial Kolom vertebral
Tuberositas radial Proses olekranon
Tulang hasta dari ulna
Korset panggul
Os coxa Korset panggul
Puncak iliac
Tulang kelangkang
Tulang pangkal paha Tulang sulbi Lebih besar

Radius trochanter
Femoralis
Carpal Lebih kecil
kepala
tulang (8) trochanter
Sumbat
foramen Tulang metacarpal (5)
Iskium Trochanter yang lebih besar
Trochanter kecil Falang (5)

Pubis
Tuberositas iskia
Femoralis medial
Tulang paha
kondilus
Tempurung lutut
Femoralis lateral
Kepala fibula kondilus
Tuberositas tibial
Tulang kering
Tulang betis
Maleolus lateral
Lereng
Maleolus medial Calcaneus
Tulang tarsal (7)

Tulang metatarsal (5)
Falang (5)
SEBUAH B
ARA. 1.8 • Kerangka. SEBUAH, Tampilan anterior; B, Tampilan posterior.
126 tulang, yang mencakup semua tulang ekstremitas atas dan 2. Dukungan untuk menjaga postur tubuh
bawah. Pelvis terkadang diklasifikasikan sebagai bagian dari 3. Gerakan dengan berfungsi sebagai titik keterikatan otot dan
kerangka aksial karena pentingnya dalam menghubungkan bertindak sebagai pengungkit
kerangka aksial dengan ekstremitas bawah dari kerangka 4. Penyimpanan mineral seperti kalsium dan fosfor
apendikular. Jumlah pasti tulang serta ciri-ciri spesifiknya
kadang-kadang berbeda dari orang ke orang. 5. Hemopoiesis, yaitu proses pembentukan darah yang terjadi di
sumsum tulang merah yang terletak di badan tulang belakang,
tulang paha, humerus, tulang rusuk, dan tulang dada.
Fungsi kerangka
Kerangka memiliki lima fungsi utama:
1. Perlindungan jaringan lunak vital seperti jantung, paru-paru,

dan otak
Bab
1
Tulang hasta
Tulang sphenoid
Patella anterior
melihat
Tulang belikat
Tulang paha
Lereng
Patella posterior
melihat
Ruas
Sesamoid
Tulang dada tulang
Berbentuk kepala
tulang (karpal) Jari kaki yang bagus
sesamoid
Radius
Panjang Pendek Datar Tidak teratur Sesamoid
ARA. 1.9 • Klasifikasi tulang berdasarkan bentuk.
Jenis tulang tulang di dalam tendon fleksor jempol kaki dan ibu jari. Tulang
sesamoid kadang-kadang disebut sebagai tulang aksesori dan, di
Tulang sangat bervariasi dalam bentuk dan ukuran tetapi dapat luar yang telah disebutkan, dapat muncul dalam jumlah yang
diklasifikasikan dalam lima kategori utama (Gbr. 1.9). bervariasi dari satu individu ke individu lainnya. Mereka paling
sering ditemukan pada persendian yang lebih kecil di ekstremitas
Tulang panjang: Terdiri dari poros silinder panjang dengan ujung
distal kaki, pergelangan kaki, dan tangan.
yang relatif lebar dan menonjol; berfungsi sebagai pengungkit.
Poros berisi rongga meduler. Contohnya termasuk falang,
metatarsal, metacarpals, tibia, fibula, femur, radius, ulna, dan
humerus.
Tulang pendek: Tulang padat berbentuk kubus kecil yang biasanya memiliki
Fitur tulang yang khas
permukaan artikular besar yang proporsional untuk diartikulasikan dengan
lebih dari satu tulang. Tulang pendek memberikan beberapa penyerapan Tulang panjang memiliki ciri khas tulang pada umumnya,
kejutan dan termasuk karpal dan tarsal. seperti yang diilustrasikan pada Gambar 1.10. Tulang panjang
memiliki batang atau diafisis , yang merupakan bagian silinder
Tulang pipih: Biasanya memiliki permukaan yang melengkung dan bervariasi dari tebal panjang dari tulang. Dinding diafisis, terbentuk dari tulang yang
(di mana tendon menempel) hingga sangat tipis. Tulang pipih umumnya memberikan keras, padat, dan padat, adalah korteks . Permukaan luar diafisis
perlindungan dan termasuk ilium, tulang rusuk, tulang dada, klavikula, dan tulang ditutupi oleh membran serat padat yang dikenal sebagai periosteum
belikat. . Selaput serat serupa yang dikenal sebagai endosteum menutupi
Tulang tidak beraturan: Tulang berbentuk tidak beraturan melayani bagian dalam korteks. Di antara dinding diafisis terletak
berbagai tujuan dan termasuk tulang di seluruh tulang belakang dan
iskium, pubis, dan rahang atas.
berkenaan dgn sungsum atau rongga sumsum, yang berisi sumsum
Tulang wijen: Tulang kecil yang tertanam di dalam tendon unit kuning atau berlemak. Di setiap ujung tulang panjang adalah epiphysis , yang
muskulotendinous yang memberikan perlindungan serta biasanya membesar dan dibentuk secara khusus untuk bergabung
meningkatkan keunggulan mekanis unit muskulotendinous. dengan epifisis tulang yang berdekatan pada suatu sendi. Epiphysis
Selain patela, ada sesamoid kecil terbentuk dari spons atau kanselus atau trabekuler tulang.
1 Pelat epifisis
Tulang rawan artikular
Proksimal
Tulang spons
epiphysis
Ruang yang ditempati

sumsum merah Diafisis
Epiphyseal
piring
Endosteum Epiphysis
Cortex
Rongga meduler
Diafisis
Sumsum kuning Epiphyseal
piring
Periosteum
ARA. 1.11 • Kehadiran lempeng epifisis, seperti yang terlihat pada radiografi
tangan seorang anak, menunjukkan hal itu
tulangnya masih tumbuh panjang.
TABEL 1.3 • Jadwal penutupan epifisis
Perkiraan usia Tulang

Distal
Ramus inferior pubis dan iskium (hampir
epiphysis 7–8
lengkap)
Tulang paha Skapula, epikondilus lateral humerus,

15–17
proses olekranon ulna
ARA. 1.10 • Bagian utama dari tulang panjang. Epikondilus medial humerus, kepala dan
18–19
batang jari-jari
Kepala humerus, ujung distal radius dan

Selama pertumbuhan tulang, diafisis dan epifisis dipisahkan oleh pelat Sekitar 20 ulna, ujung distal femur dan fibula, ujung
tipis tulang rawan yang dikenal sebagai piring epifisis , biasa disebut proksimal tibia
sebagai pelat pertumbuhan (Gbr. 1.11). Saat kematangan tulang
20–25 Acetabulum di panggul
tercapai, pada jadwal yang bervariasi dari satu tulang ke tulang lainnya
seperti yang dijelaskan di Tabel 1.3, lempeng-lempeng diganti dengan Vertebrae dan sakrum, klavikula, ujung
25
tulang dan ditutup. Untuk memfasilitasi pergerakan yang mulus dan proksimal fibula, sternum, dan rusuk
mudah pada persendian, epiphysis ditutupi artikular atau seperti kaca tulang
Diadaptasi dari Goss CM: Anatomi tubuh manusia Gray,
rawan, yang memberikan efek bantalan dan mengurangi gesekan. ed 29, Philadelphia, 1973, Lea & Febiger.
Pertumbuhan ini berlanjut, dan tulang rawan secara bertahap mengalami perubahan
yang signifikan untuk berkembang menjadi tulang panjang, seperti yang dijelaskan
Perkembangan dan pertumbuhan tulang
pada Gambar 1.12.
Sebagian besar tulang kerangka yang menjadi perhatian kita dalam Tulang terus tumbuh secara longitudinal selama pelat epifisis
kinesiologi struktural adalah tulang endokondral , terbuka. Piring-piring ini mulai menutup sekitar masa remaja dan
yang berkembang dari tulang rawan hialin. Saat kita berkembang menghilang. Paling dekat pada usia 18, tetapi beberapa mungkin
dari embrio, massa tulang rawan hialin ini tumbuh dengan cepat terbuka sampai usia 25. Pertumbuhan diameter terus berlanjut
menjadi struktur yang bentuknya mirip dengan tulang yang sepanjang hidup. Ini dilakukan oleh lapisan internal periosteum
nantinya akan menjadi.
Bab
Sisa dari
Artikular 1
tulang rawan
epifisis
Sekunder
piring
osifikasi
Bertulang rawan Mengembangkan Tulang kompak pusat
model periosteum mengembangkan
Kenyal
tulang
Epiphyseal
piring
Darah
Berkenaan dgn sungsum Berkenaan dgn sungsum Berkenaan dgn sungsum
kapal
rongga rongga rongga
Kompak
tulang
Sisa dari
Epiphyseal epifisis
Kalsifikasi Utama piring piring
tulang rawan osifikasi Sekunder Kenyal

pusat osifikasi tulang
pusat
Artikular
tulang rawan
(Sebuah) (b) (c) (d) (e) (f)
ARA. 1.12 • Tahapan utama a – f dalam perkembangan tulang endokondral (ukuran tulang relatif tidak berskala).
Pertumbuhan epifisis
Pertumbuhan tulang rawan
Tulang rawan artikular
epiphysis sekitarnya
Tulang rawan diganti
dengan tulang
Tulang direnovasi
Garis epifisis
Pertumbuhan panjang
Pertumbuhan tulang rawan
piring epifisis
Tulang rawan diganti

dengan tulang
Tulang direnovasi
Resorpsi tulang
Pertumbuhan diameter
Penambahan tulang
Resorpsi tulang
Tumbuh tulang Tulang dewasa
ARA. 1.13 • Renovasi tulang panjang.
membangun lapisan konsentris baru pada lapisan lama. sel-sel yang menyerap tulang tua adalah osteoklas .
Bersamaan dengan itu, tulang di sekitar sisi rongga meduler Perombakan tulang ini, seperti yang digambarkan pada Gambar 1.13, diperlukan
diserap kembali sehingga diameternya terus meningkat. Tulang untuk pertumbuhan tulang yang berkelanjutan, perubahan bentuk tulang,
baru dibentuk oleh sel khusus yang dikenal sebagai osteoblas , sedangkan
penyesuaian tulang terhadap tekanan, dan perbaikan tulang.
1 TABEL 1.4 • Tanda tulang

Menandai Deskripsi Contoh Halaman
Proyeksi besar dan bulat yang biasanya

Kondilus Kondilus medial atau lateral femur 276
diartikulasikan dengan tulang lain
Proses
Segi Kecil, datar atau hampir rata di permukaan Sisi artikular vertebra 331
bentuk itu
sendi Proyeksi ujung proksimal tulang yang menonjol
230, 232,
Kepala dan membulat, biasanya mengartikulasikan Kepala tulang paha, kepala humerus
233, 113
Proyeksi sudut bengkok atau

Sudut Sudut skapula superior dan inferior 90, 91
menonjol
Perbatasan atau
Garis tepi atau batas suatu tulang Perbatasan lateral dan medial skapula 90, 91
batas
Menonjol, sempit, seperti punggung bukit 230, 231,

Puncak Panggul Iliac
proyeksi 232
Epikondilus medial atau lateral

Epikondilus Proyeksi terletak di atas kondilus 144
humerus
Punggung tulang kurang menonjol dari puncak

Baris Linea aspera tulang paha 232
Proses 90, 91,

Proses akromion skapula, proses
yang Proses Proyeksi yang menonjol 113, 114,
olekranon humerus
otot, 144
tendon, atau Bagian tulang yang bentuknya tidak beraturan yang

ligamen Ramus lebih tebal dari suatu proses dan membentuk sudut Ramus pubis superior dan inferior 230
melampirkan
dengan tubuh utama
Tulang belakang
Proses spinous vertebra, tulang belakang 330, 331,
(spinous Proyeksi tajam dan ramping
skapula 91
proses)
Jahitan sagital antara tulang tengkorak

Jahitan Garis penyatuan antar tulang 16
parietal
Trochanter Proyeksi yang sangat besar Trochanter femur yang lebih besar atau lebih kecil 230, 232
Tuberkel humerus yang lebih besar dan lebih

Tuberkel Proyeksi kecil dan bulat 113
kecil
Proyeksi besar, bulat, atau kasar

Tuberositas Tuberositas radial, tuberositas tibia 144, 276
Permukaan artikulasi yang rata atau dangkal Faset intervertebralis di tulang belakang
Segi 331
leher, toraks, dan lumbal
Foramen Lubang bundar atau bukaan pada tulang Foramen obturator di panggul 230, 231
Berongga, tertekan, atau permukaan rata

Fossa Fossa supraspinatus, fossa iliaka 90, 230
Rongga Fovea Lubang atau depresi yang sangat kecil Fovea kapitis tulang paha 233
(depresi) Meatus pendengaran eksternal dari tulang

Meatus Bagian seperti tabung di dalam tulang 343
temporal
Takik Depresi di tepi tulang Rongga atau ruang Trochlear dan radial notch dari ulna Sinus 144
Sinus kosong di dalam tulang frontal
Sulcus Kerutan atau depresi seperti groovel pada tulang Alur intertuberkular (bicipital) humerus
113
(alur)
Bab
Sifat tulang Deskripsi rinci dan contoh dari banyak tulang 1

penandaan diberikan pada Tabel 1.4.
Kalsium karbonat, kalsium fosfat, kolagen, dan air adalah dasar
komposisi tulang. Sekitar 60% hingga 70% berat tulang terdiri
Jenis sendi
dari kalsium karbonat dan kalsium fosfat, dengan air
membentuk sekitar 25% hingga 30% berat tulang. Kolagen Artikulasi dua tulang atau lebih memungkinkan berbagai jenis
memberikan fleksibilitas dan kekuatan dalam menahan gerakan. Tingkat dan jenis gerakan menentukan nama yang
ketegangan. Penuaan menyebabkan hilangnya kolagen secara diterapkan pada sendi. Struktur tulang membatasi jenis dan
progresif dan meningkatkan kerapuhan tulang, sehingga jumlah gerakan di setiap sendi. Beberapa sendi atau arthroses
meningkatkan kemungkinan patah tulang.
tidak memiliki gerakan, yang lain hanya dapat bergerak sedikit,
dan lainnya dapat bergerak bebas dengan berbagai rentang
Kebanyakan tulang terluar bersifat kortikal; tulang kanselus di gerakan. Jenis dan rentang gerakan serupa pada semua
bawahnya. Tulang kortikal lebih keras dan lebih padat, dengan manusia; tetapi kebebasan, jangkauan, dan kekuatan gerakan
hanya sekitar 5% sampai 30% volumenya yang keropos, dengan dibatasi oleh konfigurasi tulang di mana mereka bersatu, dan
jaringan nonmineral. Sebaliknya, tulang kanselus adalah spons, oleh ligamen dan otot.
dengan sekitar 30% hingga 90% volumenya berpori. Tulang kortikal
lebih kaku; ia dapat menahan stres yang lebih besar, tetapi lebih Artikulasi dapat diklasifikasikan menurut struktur atau
sedikit ketegangan, daripada tulang kanselus. Karena kenyal, tulang fungsinya. Klasifikasi menurut struktur menempatkan sendi
kanselus dapat mengalami tekanan yang lebih besar sebelum patah. menjadi salah satu dari tiga kategori: fibrosa, tulang rawan, atau
sinovial. Klasifikasi fungsional juga menghasilkan tiga kategori:
synarthrosis (synarthrodial), amphiarthrosis (amphiarthrodial),
Ukuran dan bentuk tulang dipengaruhi oleh arah dan
besarnya gaya yang biasanya diterapkan padanya. Tulang dan diarthrosis (diarthrodial). Ada subkategori di setiap
membentuk kembali dirinya berdasarkan tekanan yang diberikan klasifikasi. Karena hubungan yang kuat antara struktur dan
padanya, dan massanya meningkat seiring waktu dengan fungsi, ada tumpang tindih yang signifikan antara sistem
peningkatan stres. klasifikasi. Artinya, ada lebih banyak kesamaan daripada
Konsep adaptasi tulang terhadap stres ini dikenal sebagai Hukum perbedaan antara dua anggota di masing-masing pasangan
Wolff , yang pada dasarnya menyatakan bahwa tulang pada individu berikut: sendi fibrosis dan sinartrodial, sendi tulang rawan dan
yang sehat akan beradaptasi dengan beban yang ditempatkan di amphiarthrodial, dan sendi sinovial dan diartrodial. Namun,
bawahnya. Ketika tulang tertentu mengalami peningkatan beban, tidak semua sambungan cocok dengan kedua sistem tersebut.
tulang akan merombak dirinya sendiri dari waktu ke waktu menjadi Tabel 1.5 memberikan daftar rinci semua jenis sambungan
lebih kuat untuk menahan jenis beban tertentu. Akibatnya, bagian menurut kedua sistem klasifikasi. Karena teks ini terutama
kortikal tulang luar menjadi lebih tebal. Kebalikannya juga benar: berkaitan dengan gerakan, sistem yang lebih fungsional
ketika beban pada tulang berkurang, tulang akan menjadi lebih (sambungan sinartrodial, amphiartrodial, dan diartrodial) akan
lemah. digunakan secara keseluruhan, mengikuti penjelasan singkat
tentang klasifikasi struktural.
Tanda tulang
Sendi fibrosa bergabung bersama oleh serat jaringan ikat dan
Tulang memiliki tanda khusus yang ada untuk meningkatkan
umumnya tidak dapat digerakkan. Subkategori adalah jahitan dan
hubungan fungsionalnya dengan sendi, otot, tendon, saraf, dan
gomphosis, yang tidak bisa digerakkan, dan syndesmosis, yang
pembuluh darah. Banyak dari tanda ini berfungsi sebagai
memungkinkan sedikit gerakan. Sendi tulang rawan bergabung
penanda tulang yang penting dalam menentukan lokasi dan
bersama oleh tulang rawan hialin atau fibrokartilago, yang
perlekatan otot serta fungsi sendi. Pada dasarnya, semua tanda
memungkinkan gerakan yang sangat sedikit. Subkategori meliputi
tulang dapat dibagi menjadi
sinkronisasi dan simfisis. Sendi sinovial dapat digerakkan dengan
bebas dan umumnya bersifat diartrodial. Struktur dan subkategori
1. Proses (termasuk elevasi dan proyeksi), yang membentuk mereka dibahas secara rinci di bawah sambungan diarthrodial.
sendi atau berfungsi sebagai titik perlekatan untuk otot,
tendon, atau ligamen, dan
Artikulasi dikelompokkan menjadi tiga kelas berdasarkan
2. Rongga (depresi), yang meliputi bukaan dan alur yang jumlah pergerakan yang mungkin, dengan pertimbangan
berisi tendon, pembuluh, saraf, dan ruang untuk struktur strukturnya.
lain.
1 TABEL 1.5 • Klasifikasi gabungan berdasarkan struktur dan fungsi

Klasifikasi struktural
Berserat Bertulang rawan Sinovial
Gomphosis
Synarthrodial --- ---
Jahitan
Simfisis
Amfiartrodial Sindesmosis ---
Sinkronisasi
Fungsional Arthrodial
klasifikasi Kondiloid
Enarthrodial
Diarthrodial --- ---
Ginglymus
Sellar
Trochoidal
Jaringan ikat fibrosa Sendi synarthrodial (tidak bisa digerakkan) ARA. 1.14
Secara struktural, artikulasi ini dibagi menjadi dua jenis:
Jahitan
Ditemukan di jahitan tulang tengkorak. Jahitan tengkorak benar-benar

tidak bisa digerakkan setelah masa bayi.
Gomphosis
Ditemukan di rongga gigi. Soket gigi sering disebut sebagai
gomphosis (jenis sendi di mana sambungan berbentuk kerucut
masuk ke dalam soket). Biasanya, pada dasarnya tidak ada
pergerakan gigi di mandibula atau rahang atas.
Sendi amfiartrodial (sedikit bergerak) ARA. 1.15

Jahitan Secara struktural, artikulasi ini dibagi menjadi tiga jenis:
Gomphosis Sindesmosis
ARA. 1.14 • Sendi sinartrodial. Jenis sambungan yang disatukan oleh struktur ligamen yang kuat
yang memungkinkan pergerakan minimal antar tulang. Contohnya
adalah sendi coracoclavicular dan sendi tibiofibular inferior.
Jaringan ikat fibrosa
Intervertebral
disk (fibrocartilage)
Tulang dada
Tulang selangka
Badan vertebra Tulang rusuk

Costal
tulang rawan
Disk interpubik
(fibrocartilage)
Sindesmosis Simfisis pubis
SEBUAH B C
ARA. 1.15 • Sendi amfiartrodial. SEBUAH, Sendi sindroma; B, Sendi simfisis; C, Sendi synchondrosis.
Bab
Simfisis tidak elastis ligamen yang memberikan tambahan 1

dukungan terhadap gerakan abnormal atau pembukaan sendi.
Jenis sendi yang dipisahkan oleh bantalan fibrokartilago yang
Ligamen ini bervariasi dalam lokasi, ukuran, dan kekuatan
memungkinkan pergerakan yang sangat sedikit di antara tulang.
tergantung pada sendi tertentu. Ligamen, dalam menghubungkan
Contohnya adalah simfisis pubis dan diskus intervertebralis.
tulang ke tulang, memberikan stabilitas statis pada persendian.
Sinkronisasi Dalam banyak kasus, ligamen tambahan, tidak berlanjut

Jenis sendi yang dipisahkan oleh tulang rawan hialin yang memungkinkan dengan kapsul sendi, memberikan dukungan lebih lanjut. Dalam
pergerakan yang sangat sedikit di antara tulang. Contohnya adalah sendi beberapa kasus, ligamen tambahan ini mungkin terkandung
costochondral dari tulang rusuk dengan tulang dada. seluruhnya di dalam kapsul sendi; atau intraartikular, seperti
ligamentum cruciatum anterior di lutut; atau lebih khusus lagi,
seperti ligamentum kolateral fibula lutut, yang berada di luar
Sendi diarthrodial (bergerak bebas) ARA. 1.16 kapsul sendi.
Sendi diartrodial, juga dikenal sebagai sendi sinovial, dapat
digerakkan dengan bebas. Selubung jaringan ligamen yang Permukaan artikular di ujung tulang di dalam rongga sendi
mirip lengan yang dikenal sebagai kapsul sendi mengelilingi ditutupi dengan lapisan artikular atau tulang rawan hialin yang
ujung tulang yang membentuk sendi. Kapsul ligamen ini dilapisi membantu melindungi ujung tulang dari keausan dan
dengan kapsul sinovial vaskular tipis yang mengeluarkan cairan kerusakan. Tulang rawan ini cukup tangguh karena sedikit
sinovial untuk melumasi area di dalam kapsul sendi, yang kompresibel dan elastis, yang memungkinkannya menyerap
dikenal sebagai rongga sendi . Di daerah tertentu kapsul gaya tekan dan geser. Permukaan artikular, sebagian berkat
menebal agar bentuknya keras, pelumasan
Tulang
Bursa
Pembuluh darah
Saraf
Rongga sendi (terisi

Membran sinovial
dengan cairan sinovial) Bersama
Kapsul berserat kapsul

Artikular
tulang rawan
Urat daging
sarung
Urat daging
Lapisan berserat
Tulang
Periosteum
Lapisan membran
ARA. 1.16 • Struktur sendi sinovial diartrodial.
1 dari cairan sinovial, memiliki jumlah gesekan yang sangat rendah mungkin dalam satu bidang dikatakan memiliki satu derajat
dan sangat tahan lama. Ketika permukaan sendi diturunkan atau kebebasan bergerak, sedangkan sambungan yang memiliki
terganggu, tulang rawan artikular ini perlahan-lahan menyerap gerakan dalam dua dan tiga bidang gerak digambarkan memiliki
sedikit cairan sinovial sendi, hanya untuk secara perlahan dua dan tiga derajat kebebasan gerak. Lihat Tabel 1.6 untuk
mengeluarkannya selama menahan beban dan kompresi perbandingan fitur sambungan diarthrodial menurut
berikutnya. Tulang rawan artikular memiliki suplai darah yang subkategori.
sangat terbatas dan akibatnya bergantung pada pergerakan sendi
untuk menyediakan nutrisi melalui aliran sinovial ini. Oleh karena
itu, memelihara dan memanfaatkan sendi melalui rentang gerakan Sendi artrodial (meluncur, bidang)
normalnya penting untuk menjaga kesehatan dan fungsi sendi. This joint type is characterized by two flat, or plane, bony
surfaces that butt against each other. This type of joint permits
limited gliding movement. Examples are the carpal bones of the
Selain itu, beberapa sendi diarthrodial memiliki disk wrist and the tarsometatarsal joints of the foot.
fibrokartilago di antara permukaan artikularnya untuk memberikan
penyerapan kejutan tambahan dan selanjutnya meningkatkan
stabilitas sendi. Contohnya adalah menisci medial dan lateral lutut
Condyloidal (ellipsoid, ovoid, biaxial
serta labrum asetabular dan glenoid pada sendi pinggul dan bahu.
ball-and-socket) joint
Secara struktural, jenis artikulasi ini dapat dibagi menjadi enam This is a type of joint in which the bones permit movement in
kelompok, seperti yang ditunjukkan pada Gambar 1.17. two planes without rotation. Examples are the wrist (radiocarpal
joint) between the radius and the proximal row of the carpal
bones or the second, third, fourth, and fifth
Sendi diartrodial memiliki kemungkinan gerak dalam satu metacarpophalangeal joints.
atau lebih bidang. Sendi itu bergerak
Radius
Ulna
Head of humerus
Enarthrodial Trochoidal
Ball-and-socket joint Pivot joint
(glenohumeral) (radioulnar)
Scapula
Humerus
Carpal
bones Arthrodial
Ginglymus Gliding joint

(intercarpal)
Hinge joint
(humeroulnar)
Ulna
Carpal bone Metacarpal bone

Metacarpal Phalanx
Sellar bone Condyloidal
Saddle joint
Ellipsoid joint
(carpometacarpal)
(metacarpophalangeal)
FIG. 1.17 • Types of diarthrodial or synovial joints.
Final PDF to printer
Chapter
TABLE 1.6 • Diarthrodial joint classification 1

Classification Number of Degrees of Typical Joint Plane for Axis for
name axes freedom movements examples examples examples
Elbow joint (humeroul-

Ginglymus Flexion,
nar) Sagittal Frontal
(hinge) extension
Ankle joint (talocrural)
Uniaxial One Internal

Proximal and distal
Trochoidal rotation,
radioulnar joint Transverse Vertical
(pivot, screw) external
Atlantoaxial joint
rotation
Condyloidal Flexion, Wrist (radiocarpal)

(ellipsoid, extension, 2nd–5th Sagittal Frontal
Biaxial Two
ball-and-socket, abduction, metacarpophalangeal Frontal Sagittal
ovoid) adduction joints
Transverse tarsal joint Variable Variable

Arthrodial (glid-
Vertebral facets in spine Frontal Sagittal
ing, plane) Flexion, Intercarpal joints in wrist Variable Variable
extension,
Enarthrodial Glenohumeral joint Sagittal Frontal
abduction,
(ball-and-socket, Multiaxial Three Hip joint Frontal Sagittal
adduction,
spheroidal) (acetabularfemoral) Transverse Vertical
internal rotation,
external rotation Sagittal Frontal
Sellar 1st carpometacarpal
Frontal Sagittal
(saddle) joint
Transverse Vertical
Enarthrodial (spheroidal, multiaxial comparing the same joints between individuals, but also when
ball-and-socket) joint comparing one joint versus another in the same individual. Both
This type of joint is most like a true ball-andsocket in that it heredity and developmental factors (Wolff’s law for bone and
permits movement in all planes. Examples are the shoulder Davis’s law for soft tissue) contribute to these variances. In a
(glenohumeral) and hip (acetabularfemoral) joints. manner similar to the adaption of bone to loading, as previously
discussed in Wolff’s law, soft tissue also adapts to stress or the
lack thereof. This corollary to Wolff’s law is known as
Ginglymus (hinge) joint
This is a type of joint that permits a wide range of movement in
Davis’s law , which essentially states that ligaments, muscle,
only one plane. Examples are the elbow (humeroulnar), ankle
and other soft tissue when placed under appropriate tension will
(talocrural), and knee (tibiofemoral) joints.
adapt over time by lengthening, and conversely, when
maintained in a loose or shortened state over a period of time
Sellar (saddle) joint will gradually shorten.
This type of reciprocal reception is found only in the thumb at

Five major factors affect the total stability, and consequently
the carpometacarpal joint and permits ball-and-socket
the mobility, of a joint (see Fig. 1.18).
movement, with the exception of slight rotation.
• Bones—Although bones are usually very similar in bilateral
comparisons within an individual, the actual anatomical
Trochoidal (pivot, screw) joint configuration at the joint surfaces in terms of depth and
shallowness may vary significantly between individuals.
This is a type of joint with a rotational movement around a long
axis. An example is the rotation of the radius on the ulna at the
proximal and distal radioulnar joints.
• Cartilage—The structures of both hyaline cartilage and
specialized cartilaginous structures, such as the knee
Stability and mobility of diarthrodial joints menisci, glenoid labrum, and acetabular labrum, further
Generally, the more mobile a joint is, the less stable it is, and assist in joint congruency and stability. As with bones,
vice versa. This is true when these
Structural
pter
1 Diarthrodial joint stability
Functional
Increased • Bony architecture
joint
• Cartilaginous structure
Static
stability
leads • Ligamentous and
to
connective tissue laxity
decreased Increased
joint joint
mobility mobility
• Muscle strength,
leads
endurance, and flexibility
Dynamic
to
decreased
• Proprioception and
joint
motor control stability
Diarthrodial joint mobility
FIG. 1.18 • Factors affecting diarthrodial joint stability.
structures normally are the same in bilateral comparisons in providing joint stability unless they can be activated
within an individual, but may vary between individuals in precisely when needed.
size and configuration. Ligaments and connective
The integrity of any of these structures may be affected by
• tissue—Ligaments and connective tissue provide static
acute or chronic injury. These structures adapt over time both
stability to joints. As with bones and cartilage, variances
positively and negatively to the specific biomechanical demands
exist between individuals in the degree of restrictiveness of
placed upon them. When any of the above factors are
ligamentous tissue. An individual’s amount of hypo- or
compromised, additional demands are placed on the remaining
hyperlaxity is primarily due to the proportional amount of
structures to provide stability, which in turn may compromise
elastin versus collagen within the joint structures. Simply
their integrity, resulting in abnormal mobility. This abnormal
put, individuals with proportionally higher elastin-to-collagen
mobility, whether hypermobility or hypomobility, may lead to
ratios are hyperlax, or “loose-jointed,” whereas individuals
further pathological conditions such as tendinitis, bursitis,
with proportionally lower ratios are tighter.
arthritis, internal derangement, and joint subluxations.
Muscles—Muscles provide dynamic stability to joints when
actively contracting. Without active tension via contraction,
muscles provide minimal static stability. Consequently,
• strength and endurance are significant factors in stabilizing
joints, whereas muscle flexibility may affect the total range
of joint motion possible.
Movements in joints
In many joints, several different movements are possible. Some
joints permit only flexion and extension; others permit a wide
range of movements, depending largely on the joint structure.
• Proprioception and motor control— We refer to the area through which a joint may normally be
Proprioception is the subconscious mechanism by which freely and painlessly moved as the range of motion (ROM) . The
the body is able to regulate posture and movements by specific amount of movement possible in a joint or range of
responding to stimuli originating in the proprioceptors motion may be measured by using an instrument known as a
embedded in joints, tendons, muscles, and the inner ear.
Motor control is the process by which bodily actions and
movements are organized and executed. To determine the goniometer to compare the change in joint angles. The
appropriate amount of muscular forces and joint activations goniometer has a moving arm, a stationary arm, and an axis or
needed, sensory information from the environment and the fulcrum. Measuring the available range of motion in a joint or
body must be integrated and then coordinated in a the angles created by the bones of a joint is known as goniometry
cooperative manner between the central nervous system .
and the musculoskeletal system. Muscle strength and The goniometer axis, or hinge point, is placed even with the
endurance are not very useful axis of rotation at the joint line. The stationary arm is held in
place either along or parallel to the long axis of the more
stationary bone (usually the more proximal bone), and
Chapter
person to person. Appendixes 1 and 2 provide 1

the average normal ranges of motion for all joints.
When using movement terminology, it is important to
understand that the terms are used to describe the actual
change in position of the bones relative to each other. That is,
the angles between the bones change, whereas the movement
occurs between the articular surfaces of the joint. We may say,
in describing knee movement, “flex the leg at the knee”; this
movement results in the leg moving closer to the thigh. Some
describe this as leg flexion occurring at the knee joint and may
say “flex the leg,” meaning flex the knee. Additionally,
FIG. 1.19 • Goniometric measurement of knee joint flexion. movement terms are utilized to describe movement occurring
throughout the full range of motion or through a very small
range. Using the knee flexion example again, we may flex the
the moving arm is placed either along or parallel to the long axis knee through the full range by beginning in full knee extension
of the bone that moves the most (usually the more distal bone). (zero degrees of knee flexion) and flexing it fully, so that the
The joint angle can then be read from the goniometer, as shown heel comes in contact with the buttocks; this would be
in Fig. 1.19. As an example, we could measure the angle approximately 140 degrees of flexion. We may also begin with
between the femur and the trunk in the anatomical position the knee in 90 degrees of flexion and then flex it 30 degrees
(which would usually be zero), and then ask the person to flex more; this movement results in a knee flexion angle of 120
the hip as far as possible. If we measured the angle again at full degrees, even though the knee flexed only 30 degrees. In both
hip flexion, we would find a goniometer reading of around 130 examples, the knee is in different degrees of flexion. We may
degrees. also begin with the knee in 90 degrees of flexion and extend it
40 degrees, which would result in a flexion angle of 50 degrees.
Even though we extended the knee, it is still flexed, only less so
Depending on the size of the joint and its movement than before.
potential, different goniometers may be more or less
appropriate. Fig. 1.20 depicts a variety of goniometers that may
be utilized to determine the range of motion for a particular joint.
Inclinometers may also be used to measure range of motion,
particularly in the spine.
Please note that the normal range of motion for a particular In this example, we more commonly move the distal
joint varies to some degree from extremity in relation to the proximal extremity, which is usually
more stationary. However, there are examples in every joint
where the distal segment may be more stationary and we move
the proximal segment in relation to it. An example is the knee in
doing a squat from the standing position. As the squat occurs,
the thigh moves toward the stabler leg, still resulting in knee
flexion that could be stated as flexing the thigh at the knee.
Some movement terms may be used to describe motion at

several joints throughout the body, whereas other terms are
relatively specific to a joint or group of joints (Fig. 1.21). Rather
than list the terms alphabetically, we have chosen to group
them according to the body area and pair them with opposite
terms where applicable. Additionally, the prefixes hyper - and hypo
- may be combined with these terms to emphasize motion
beyond and below normal, respectively. Of these combined
terms, hyperextension is the most commonly used.
FIG. 1.20 • Various goniometers used for measuring joint range of

motion.
pter
A B C
FIG. 1.21 • Joint movements. A, Examples of sagittal plane movements: extension of left toes, ankle (plantar flexion), knee, hip, shoulder,
elbow, wrist, fingers, lumbar and cervical spine; flexion of right toes, ankle
(dorsiflexion), knee, hip, shoulder, elbow, wrist, and fingers. B, Examples of frontal plane movements: abduction of left transverse
tarsal/subtalar joints (eversion), shoulder, wrist, fingers, and shoulder girdle (upward rotation), lumbar (lateral flexion to right) and cervical
spine (lateral flexion to left), and right hip; adduction of right transverse tarsal/subtalar joints (inversion), shoulder, wrist, fingers, and
shoulder girdle (downward rotation). C, Examples of transverse plane movements: internal rotation of right hip, left shoulder, radioulnar
joints (pronation); external rotation of left knee, hip, right shoulder, radioulnar joints (supination), and lumbar (right rotation) and cervical
spine (right rotation).
Terms describing general fashion around a fixed point, either clockwise or

counterclockwise.
movements
Diagonal abduction: Movement by a limb through a diagonal plane
Abduction: Lateral movement away from the midline of the trunk away from the midline of the body, such as in the hip or
in the frontal plane. An example is raising the arms or legs to the glenohumeral joint.
side horizontally. Diagonal adduction: Movement by a limb through a diagonal plane
Adduction: Movement medially toward the midline of the trunk in toward and across the midline of the body, such as in the hip or
the frontal plane. An example is lowering the arm to the side or glenohumeral joint.
the thigh back to the anatomical position. External rotation: Rotary movement around the longitudinal axis of
a bone away from the midline of the body. Occurs in the
Flexion: Bending movement that results in a decrease of the angle transverse plane and is also known as rotation laterally, outward
in a joint by bringing bones together, usually in the sagittal plane. rotation, and lateral rotation.
An example is the elbow joint when the hand is drawn to the
shoulder. Internal rotation: Rotary movement around the longitudinal axis
Extension: Straightening movement that results in an increase of the of a bone toward the midline of the body. Occurs in the
angle in a joint by moving bones apart, usually in the sagittal plane. transverse plane and is also known as rotation medially, inward
Using the elbow, an example is when the hand moves away from the rotation, and medial rotation.
shoulder.
Circumduction: Circular movement of a limb that delineates an
arc or describes a cone. It is a combination of flexion, Terms describing ankle
extension, abduction, and adduction. Sometimes referred to and foot movements
as circumflexion. An example is when the shoulder joint or the
hip joint moves in a circular Eversion: Turning the sole of the foot outward or laterally in
the frontal plane; abduction. An
Chapter
example is standing with the weight on the inner edge of the Terms describing shoulder joint 1
foot.
Inversion: Turning the sole of the foot inward or medially in the
(glenohumeral) movements
frontal plane; adduction. An example is standing with the weight Horizontal abduction: Movement of the humerus or femur in the
on the outer edge of the foot. horizontal plane away from the midline of the body. Also known
as horizontal extension or transverse abduction.
Dorsal flexion (dorsiflexion): Flexion movement of the ankle that
results in the top of the foot moving toward the anterior tibia in the Horizontal adduction: Movement of the humerus or femur in the
sagittal plane. horizontal plane toward the midline of the body. Also known as
Plantar flexion: Extension movement of the ankle that results in horizontal flexion or transverse adduction.
the foot and/or toes moving away from the body in the sagittal
plane. Scaption: Movement of the humerus away from the body in the
Pronation: A position of the foot and ankle resulting from a scapular plane. Glenohumeral abduction in a plane 30 to 45
combination of ankle dorsiflexion, subtalar eversion, and forefoot degrees between the sagittal and frontal planes.
abduction (toe-out).
Supination: A position of the foot and ankle resulting from a
combination of ankle plantar flexion, subtalar inversion, and
forefoot adduction (toe-in).
Terms describing spine movements
Lateral flexion (side bending): Movement of the head and/or trunk
Terms describing radioulnar in the frontal plane laterally away from the midline. Abduction of
the spine.
joint movements
Reduction: Return of the spinal column in the frontal plane to the
Pronation: Internally rotating the radius in the transverse plane so anatomic position from lateral flexion. Adduction of the spine.
that it lies diagonally across the ulna, resulting in the palm-down
position of the forearm.
Supination: Externally rotating the radius in the transverse plane Terms describing wrist
so that it lies parallel to the ulna, resulting in the palm-up
and hand movements
position of the forearm.
Dorsal flexion (dorsiflexion): Extension movement of the wrist in the
sagittal plane with the dorsal or posterior side of the hand moving
Terms describing shoulder girdle
toward the posterior side of the forearm.
(scapulothoracic) movements
Palmar flexion: Flexion movement of the wrist in the sagittal plane
Depression: Inferior movement of the shoulder girdle in the frontal
with the volar or anterior side of the hand moving toward the
plane. An example is returning to the normal position from a
anterior side of the forearm.
shoulder shrug.
Radial flexion (radial deviation): Abduction movement at the wrist in
Elevation: Superior movement of the shoulder girdle in the frontal
the frontal plane of the thumb side of the hand toward the lateral
plane. An example is shrugging the shoulders.
forearm.
Ulnar flexion (ulnar deviation): Adduction movement at the wrist in
Protraction (abduction): Forward movement of the shoulder
the frontal plane of the little finger side of the hand toward the
girdle in the horizontal plane away from the spine. Abduction
medial forearm.
of the scapula.
Opposition of the thumb: Diagonal movement of the thumb across
Retraction (adduction): Backward movement of the shoulder girdle
the palmar surface of the hand to make contact with the fingers.
in the horizontal plane toward the spine. Adduction of the
scapula.
Reposition of the thumb: Diagonal movement of the thumb as it
Rotation downward: Rotary movement of the scapula in the frontal
returns to the anatomical position from opposition with the hand
plane with the inferior angle of the scapula moving medially and
and/or fingers.
downward. Occurs primarily in the return from upward rotation.
The inferior angle may actually move upward slightly as the These movements are considered in detail in the chapters
scapula continues in extreme downward rotation. that follow as they apply to the individual joints.
Rotation upward: Rotary movement of the scapula in the frontal Combinations of movements can occur. Flexion or extension
plane with the inferior angle of the scapula moving laterally and can occur with abduction, adduction, or rotation.
upward.
pter
1 Movement icons (pedagogical feature) displayed on that page. As further explained in Chapter 2, the
actions displayed represent the movements that occur when the
Throughout this text a series of movement icons will be utilized muscle contracts concentrically. Table 1.7 provides a complete
to represent different joint movements. These icons will be list of the icons. Refer to them as needed when reading
displayed in the page margins to indicate the joint actions of the Chapters 4, 5, 6, 7, 9, 10, 11, and 12.
muscles
TABLE 1.7 • Movement icons representing joint actions
Shoulder girdle
Scapula
Scapula Scapula Scapula Scapula Scapula upward downward
elevation depression abduction adduction rotation rotation
Glenohumeral
Shoulder Shoulder Shoulder Shoulder

Shoulder Shoulder Shoulder Shoulder external internal horizontal horizontal
flexion extension abduction adduction rotation rotation abduction adduction
Elbow Radioulnar joints
Elbow flexion Elbow extension Radioulnar supination Radioulnar pronation
Wrist
Wrist extension Wrist flexion Wrist abduction Wrist adduction
Chapter
TABLE 1.7 (continued) • Movement icons representing joint actions 1

Thumb carpometacarpal joint Thumb metacarpophalangeal joint Thumb interphalangeal joint
Thumb CMC Thumb CMC Thumb CMC Thumb MCP Thumb MCP Thumb IP Thumb IP
flexion extension abduction flexion extension flexion extension
2nd, 3rd, 4th, 2nd, 3rd, 4th, 2nd, 3rd, 4th,

2nd, 3rd, 4th, and 5th MCP, 2nd, 3rd, 4th, and 5th
and 5th MCP and 5th PIP and 5th DIP
PIP, and DIP joints metacarpophalangeal joints
and PIP joints joints joints
2nd–5th
2nd–5th MCP, MCP, PIP, 2nd–5th
PIP, and DIP and DIP MCP and PIP 2nd–5th MCP 2nd–5th MCP 2nd–5th PIP 2nd–5th DIP
flexion extension flexion flexion extension flexion flexion
Hip
Hip external Hip internal

Hip flexion Hip extension Hip abduction Hip adduction rotation rotation
Knee
Knee flexion Knee extension Knee external rotation Knee internal rotation
Ankle Transverse tarsal and subtalar joints
Transverse tarsal and Transverse tarsal and

Ankle plantar flexion Ankle dorsal flexion subtalar inversion subtalar eversion
pter
1 TABLE 1.7 (continued) • Movement icons representing joint actions

Great toe metatarsophalangeal and 2nd–5th metatarsophalangeal, proximal interphalangeal,
interphalangeal joints and distal interphalangeal joints
Great toe MTP and IP Great toe MTP and IP 2nd–5th MTP, PIP, and DIP 2nd–5th MTP, PIP, and DIP
flexion extension flexion extension
Cervical spine
Cervical flexion Cervical extension Cervical lateral flexion Cervical rotation unilaterally
Lumbar spine
Lumbar rotation
Lumbar flexion Lumbar extension Lumbar lateral flexion unilaterally
Physiological movements versus osteokinematic motion . In order for these osteokinematic
accessory motions motions to occur, there must be movement between the actual
articular surfaces of the joint. This motion between the articular
Movements such as flexion, extension, abduction, adduction, surfaces is known as arthrokinematics , and it includes three
and rotation occur by the bones moving through planes of specific types of accessory motions . These accessory motions,
motion about an axis of rotation at the joint. These movements named specifically to describe the actual change in relationship
may be referred to as physiological movements. The motion of between the articular surface of one bone relative to another,
the bones relative to the three cardinal planes resulting from are spin ,
these physiological movements is referred to as
roll , and glide ( Fig. 1.22).
Roll
FIG. 1.22 • Joint arthrokinematics. A, Spin; B, Roll; C, Glide.
Chapter
FIG. 1.23 • Knee joint arthrokinematics. A, Standing from squatting; B, Flexing from non-weight-bearing position.
Roll is sometimes referred to as rock or rocking, whereas structure. To some degree, spin occurs at the knee as it flexes
glide is sometimes referred to as slide or translation. If and extends. In the squatting to standing example, the femur
accessory motion is prevented from occurring, then spins medially or internally rotates as the knee reaches full
physiological motion cannot occur to any substantial degree extension. Table 1.8 provides examples of accessory motion.
other than by joint compression or distraction. Because most
diarthrodial joints in the body are composed of a concave
surface articulating with a convex surface, roll and glide must
Roll (rock): A series of points on one articular surface contacts a
occur together to some degree. For example, as illustrated in
series of points on another articular surface.
Fig. 1.23, as a person stands from a squatting position, in order
for the knee to extend, the femur must roll forward and
simultaneously slide backward on the tibia. If not for the slide, Glide (slide, translation): A specific point on one articulating
the femur would roll off the front of the tibia, and if not for the surface comes in contact with a series of points on another
roll, the femur would slide off the back of the tibia. surface.
Spin: A single point on one articular surface rotates about a single
point on another articular surface. Motion occurs around some
stationary longitudinal mechanical axis in either a clockwise or a
Spin may occur in isolation or in combination with roll and counterclockwise direction.
glide, depending upon the joint
TABLE 1.8 • Accessory motion
Accessory motion Anatomical joint example Analogy
Knee extension occurring from femoral condyles Tire rolling across a road surface, Combination of roll and glide: Tire
Roll (rocking) rolling forward on tibia as a person stands from as in normal driving with good spinning on slick ice (i.e., poor
squatting position traction traction) but still resulting in
Knee extension occurring from femoral condyles Tire skidding across a slick movement across the road
Glide (slide or surface
sliding backward on tibia as a person stands from surface with the brakes locked
translation)
squatting position
Radioulnar pronation/supination occur-

Spin ring from spinning of radial head against Point of a toy top spinning around in one spot on the floor
humeral capitulum
pter
1 REVIEW EXERCISES with straps over your shoulders running from your _____
chest to your _____ shoulders, you must have been
wearing one with crossing straps as I see you have tan
1. Complete the blanks in the following paragraphs using
lines running in a(n) _____ direction to your _____ low back
each word from the list below only once except for the ones
from the _____ aspect of your _____ shoulders. You should
marked with two asterisks,**, which are used twice. The
have spent more time lying _____.” She replied, “Well, I did
number of dashes indicates the number of letters of the
lie partially on my back and my right side for a while. See
word for each blank.
where the _____ portion of my right thigh and the _____
portion of my left thigh are tanned just right, but
a. anterior** s. medial
unfortunately in that position the _____ right thigh and _____
b. anteroinferior t. palmar
thigh received relatively little exposure.” Jacob commented,
c. anterolateral u. plantar
“Yep, when you lie on one side most of the time, you get all
d. anteromedial v. posterior**
the sun on the _____ side and none on the _____ side. It
e. anteroposterior w. posteroinferior
looks like you must have had a towel covering your feet
f. anterosuperior x. posterolateral
and ankles since your _____ lower extremities are not
g. bilateral y. posteromedial
nearly as tan as your _____ lower extremities.” Stephanie
h. caudal z. posterosuperior
replied, “You are correct. I kept the bottom of my lower legs
i. cephalic aa. prone
covered almost all of the time while lying on both sides so
j. contralateral bb. proximal
that the sensitive skin on my _____ and _____ shins would
k. deep cc. superficial
not burn. But I did get a good _____ tan on my _____ trunk,
l. distal dd. superior
except for the _______ aspect of my right elbow I was
m. dorsal ee. superolateral**
resting on.” As Jacob slipped his sandals on to protect the
n. inferior ff. superomedial
_____ aspect of his feet from the hot sand, he said, “Well,
o. inferolateral gg. supine
nice to see you. I have to go by the doctor’s office and get
p. inferomedial hh. ventral
a(n) _____ chest X-ray to make sure my pneumonia has
q. ipsilateral ii. volar
cleared up.”
r. lateral
When Jacob greeted Stephanie at the beach, he reached

out with the _____ surface of his hand to grasp the _____
surface of her hand for a handshake. As the _____ aspects
of their bodies faced each other, Jacob noticed that the hair
located on the most _____ part of Stephanie’s head
appeared to be a different color than he remembered. He
then asked her to turn around so that he could see it from 2. Joint movement terminology chart
a(n) _____ view. As she did so, it became obvious to him
that she had blonde streaks running from her _____ region The specific body area joint movement terms arise from the
in a(n) _____ direction all the way down to her _____ region. basic motions in the three specific planes: flexion/extension in
the sagittal plane, abduction/ adduction in the frontal plane,
and rotation in the transverse plane. With this in mind,
complete the chart by writing the basic motion in the right
Stephanie then asked Jacob if the sunburn on the _____ column for each specific motion listed in the left column by
portions of his shoulders was due to the exposure that his using either flexion, extension, abduction, adduction, or rotation
tank-top shirt provided. He replied yes but that it was only (external or internal).
a(n) _____ burn and did not go too ____. He then said, “I
wish I had had my shirt off so that I would have gotten Specific motion Basic motion
some more sun on the _____ portion of my shoulders up to
Eversion
my neck.”
Inversion
Stephanie said that she recently got sunburned on her Dorsal flexion
back while lying _____ at the beach. She then flipped her Plantar flexion
hair around the _____ side of her neck toward the _____
Pronation (radioulnar)
portion of her trunk to expose her _____ region. Jacob
Supination (radioulnar)
remarked, “Wow, instead of the bikini you have on today
Lateral flexion
Chapter
Specific motion Basic motion

4. What are the five functions of the skeleton? List the 1
5. bones of the upper extremity. List the bones of the
Reduction 6. lower extremity. List the bones of the shoulder girdle.
Radial flexion 7. List the bones of the pelvic girdle.
Ulnar flexion 8.
9. Describe and explain the differences and similarities
between the radius and ulna.
3. Bone typing chart
10. Describe and explain the differences and similarities
between the humerus and femur.
Utilizing Fig. 1.8 and other resources, place an “X” in the
11. Using body landmarks, how would you suggest determining
appropriate column to indicate its classification.
the length of each lower extremity for comparison to
Bone Long Short Flat Irregular Sesamoid determine whether someone had a true total leg length
Frontal
discrepancy?
12. Explain why the fibula is more susceptible to fractures than
Zygomatic
the tibia.
Parietal 13. Why is the anatomical position so important in
Temporal understanding anatomy and joint movements? Label the
Occipital 14. parts of a long bone.
Maxilla
Mandible
Cervical
vertebrae
Clavicle
Scapula
Humerus
Ulna
Radius
Carpal bones
Metacarpals
Phalanges
Ribs
Sternum
Lumbar
vertebrae
Ilium
Ischium
Pubis
Femur
Patella
Fabella
Tibia
Fibula
Talus
Calcaneus
Navicular
Femur
Cuneiforms
Metatarsals
pter
1 15. Joint type, movement, and plane of motion chart
Complete the chart by filling in the type of diarthrodial joint and then listing the movements of the joint under the plane of motion in
which they occur.
Planes of motion
Joint Type Sagittal Lateral Transverse
Scapulothoracic joint
Sternoclavicular
Acromioclavicular
Glenohumeral joint
Elbow
Radioulnar joint
Wrist
1st carpometacarpal joint
1st metacarpophalangeal joint
Thumb interphalangeal joint
2nd, 3rd, 4th, and 5th metacarpophalangeal joints 2nd, 3rd, 4th,
and 5th proximal interphalangeal joints 2nd, 3rd, 4th, and 5th distal
interphalangeal joints Cervical spine C1–C2
Cervical spine C2–C7
Lumbar spine
Hip
Knee (tibiofemoral joint)
Knee (patellofemoral joint)
Ankle
Transverse tarsal and subtalar joints
Metatarsophalangeal joints
Great toe interphalangeal
2nd, 3rd, 4th, and 5th proximal interphalangeal joints 2nd, 3rd, 4th,
and 5th distal interphalangeal joints
Chapter
16. Joint position chart 1

Using proper terminology, complete the chart by listing the name of each joint involved and its position upon completion of the multiple
joint movement.
Multiple joint movement Joints and respective position of each
Reach straight over the superior aspect of your head to

touch the contralateral ear
Place the toe of one foot against the posterior aspect of

the contralateral calf
Reach behind the back and use your thumb to touch a

spinous process
Pull the knee as far as possible to the ipsilateral

shoulder
Place the plantar aspect of both feet against each other
17. Plane of motion and axis of rotation chart joint, and wrist. Which plane are these movements
occurring in primarily? What axis of rotation is involved
For each joint motion listed in the chart, list the plane of primarily?
motion in which the motion occurs and its axis of rotation. 20. List the similarities between the ankle/foot/toes and the
wrist/hand/fingers regarding the bones, joint structures, and
movements. What are the differences?
Motion Plane of motion Axis of rotation
Cervical rotation 21. Compare and contrast the glenohumeral and

Shoulder girdle acetabulofemoral joints. Which one is more susceptible to
elevation dislocations and why?
Glenohumeral 22. Compare and contrast the elbow and knee joints. Considering
horizontal adduction the bone and joint structures and their functions, what are the
similarities and differences?
Elbow flexion
Radioulnar pronation
LABORATORY EXERCISES
Wrist radial deviation
Metacarpophalan-
1. Choose several different locations on your body at random
geal abduction
and specifically describe the locations, using the correct
Lumbar lateral
anatomical directional terminology. Determine which joints
flexion
2. have movements possible in each of the following planes:
Hip internal rotation
Knee extension a. Sagittal
Ankle inversion b. Frontal
Great toe extension
c. Transverse
3. List all the diarthrodial joints of the body that are capable of
the following paired movements:
18. List two sport skills that involve movements more clearly a. Flexion/extension
seen from the side. List the primary movements that occur in b. Abduction/adduction
the ankle, knee, hip, spine, glenohumeral joint, elbow, and c. Rotation (left and right)
wrist. In which plane are these movements occurring d. Rotation (internal and external)
primarily? What axis of rotation is involved primarily? 4. Determine the planes in which the following activities occur.
Also, use a pencil to visualize the axis for each of the
19. List two sport skills that involve movements more clearly following activities.
seen from the front or rear. List the primary movements that a. Walking up stairs
occur in the transverse tarsal/subtalar joint, hip, spine, b. Turning a knob to open a door
glenohumeral c. Nodding the head to agree
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1 d. Shaking the head to disagree References

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b. Elbow e. Knee
c. Glenohumeral f. Wrist
10. Is there more inversion or more eversion possible in the
transverse tarsal and subtalar joints? Explain this
occurrence based on anatomy.
11. Is there more abduction or more adduction possible in the
For additional resources and a list of related websites,
wrist joint? Explain this occurrence based on anatomy.
visit www.mhhe.com/floyd19e.
Chapter
1
Worksheet Exercises
For in- or out-of-class assignments, or for testing, utilize this tear-out worksheet.
Anterior skeletal worksheet

On the anterior skeletal worksheet, label the bones and their prominent features by filling in the blanks.
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1 Worksheet Exercises
Posterior skeletal worksheet

On the posterior skeletal worksheet, label the bones and their prominent features by filling in the
blanks.
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C HAPTER 2 Chapter
N EUROMUSCULAR
F UNDAMENTALS
Objectives
S ofkeletal
the body and all
muscles itsresponsible
are joints. Muscle
for contraction
movement
j To review the basic anatomy and function of the muscular produces the force that causes joint movement in the human
and nervous systems body. In addition to the function of movement, muscles also
provide both dynamic stability of joints and protection, contribute
j To review and understand the basic terminology used to to posture and support, and produce a major portion of total
describe muscular locations, body heat. There are over 600 skeletal muscles, which
arrangements, characteristics, and roles, as well as constitute approximately 40% to 50% of body weight. Of these,
neuromuscular functions
there are 215 pairs of skeletal muscles. These pairs of muscles
j To learn and understand the different types of muscle usually work in cooperation with each other to perform opposite
contraction and the factors involved in each actions at the joints they cross. In most cases, muscles work in
groups rather than independently to achieve a given joint
motion. This is known as aggregate muscle action .
j To learn and understand basic neuromuscular concepts
in relation to how muscles function in joint movement and
work together in effecting motion.
j To develop a basic understanding of the neural control Muscle nomenclature

mechanisms for movement
In attempting to learn the skeletal muscles, it is helpful to have
an understanding of how they are named. Muscles are usually
named because of one or more distinctive characteristics, such
as their visual appearance, anatomical location, or function.
Examples of skeletal muscle naming are as follows:
Online Learning Center Resources

Shape —deltoid, rhomboid
Visit Manual of Structural Kinesiology ’s Online Learning Center at www.mhhe.com/floyd19e
Size —gluteus maximus, teres minor
for additional information and study material for this chapter, including:
Number of divisions —triceps brachii
Direction of its fibers —external abdominal oblique
Location —rectus femoris, palmaris longus
j Self-grading quizzes
j Anatomy flashcards
Points of attachment —coracobrachialis, extensor hallucis
j Animations longus, flexor digitorum longus
j Related websites Action —erector spinae, supinator, extensor digiti minimi
Action and shape —pronator quadratus In discussions regarding the muscles, they are often grouped
Action and size —adductor magnus together for brevity of conversation and clearer understanding.
The naming of muscle groups follows a similar pattern. Here are
pter Shape and location —serratus anterior
some
2 Location
Location and and number—brachioradialis
attachment of divisions —biceps femoris
Superficial Deep
Frontalis
Orbicularis oculi
Masseter
Zygomaticus major
Orbicularis oris
Sternocleidomastoid
Platysma Trapezius
Pectoralis minor
Deltoid Coracobrachialis
Pectoralis major Serratus anterior
Brachialis
Biceps brachii
Rectus abdominis
Supinator
Flexor digitorum
profundus
Brachioradialis
Flexor pollicis longus
Flexor carpi radialis
Transverse abdominal
External abdominal
Internal abdominal
oblique
oblique
Pronator quadratus
Tensor
fasciae latae
Adductor longus
Sartorius Adductors
Rectus femoris Vastus lateralis
Vastus lateralis Vastus intermedius
Vastus medialis Gracilis
Fibularis longus
Gastrocnemius
Tibialis anterior Soleus
Extensor digitorum
Extensor digitorum longus
longus
FIG. 2.1 • Superficial and deep muscles of the human body, anterior view.
muscle groups assembled according to different naming Figs. 2.1 and 2.2 depict the muscular system from both a
rationales: superficial and a deep point of view.
Muscles shown in these figures, and many Chapter
Shape —hamstrings
other muscles, will be studied in more detail
Number of divisions —quadriceps, triceps surae
Location —peroneals, abdominal, shoulder girdle
as each joint of the body is considered in later 2
chapters.
Action —hip flexors, rotator cuff
Deep Superficial
Occipitalis
Semispinalis capitis
Sternocleidomastoid
Splenius capitis
Trapezius
Levator scapulae
Supraspinatus
Rhomboideus minor
Rhomboideus major
Infraspinatus
Deltoid (cut)
Teres minor
Infraspinatus
Teres major
Serratus anterior
Triceps brachii
Triceps brachii (cut)
Serratus posterior inferior
Latissimus dorsi
External abdominal oblique
Internal abdominal oblique

External abdominal
Erector spinae oblique
Flexor carpi ulnaris Gluteus medius
Extensor digitorum (cut)
Gluteus maximus
Gluteus minimus
Lateral rotators
Adductor
magnus
Gracilis
Iliotibial band
Semitendinosus
Semimembranosus
Iliotibial band
Biceps femoris
Biceps femoris
Gastrocnemius (cut)
Soleus
Gastrocnemius
Tibialis posterior
Flexor digitorum longus
Soleus
Extensor hallucis longus
Fibularis longus
Calcaneal tendon
FIG. 2.2 • Superficial and deep muscles of the human body, posterior view.
Shape of muscles and fiber arrangement similar to that of a feather. This arrangement increases the
cross-sectional area of the muscle, thereby increasing its force
Various muscles have different shapes, and their fibers may be production capability. Pennate muscles are categorized on the
pter
arranged differently in relation to each other and to the tendons basis of the exact arrangement between the fibers and the
2 that connect them to bone. The shape and fiber arrangement
play a role in the muscle’s ability to exert force and in the range
tendon, as follows:
through which it can effectively exert force on the bones to

Unipennate muscle fibers run obliquely from a tendon on one side
which it is attached. A factor in the ability of a muscle to exert
only. Examples are seen in the biceps femoris, extensor
force is its cross-section diameter. Keeping all other factors
digitorum longus, and tibialis posterior.
constant, a muscle with a greater cross-section diameter will be
able to exert a greater force. A factor in the ability of a muscle to
Bipennate muscle fibers run obliquely from a central tendon on both
move a joint through a large range of motion is its ability to
sides, as in the rectus femoris and flexor hallucis longus.
shorten. Generally, longer muscles can shorten through a
greater range and therefore are more effective in moving joints
Multipennate muscles have several tendons with fibers running
through large ranges of motion.
diagonally between them, as in the deltoid.
Bipennate and unipennate muscles produce the strongest

contractions. Review Table 2.1 regarding muscle shapes and
Essentially, all skeletal muscles may be grouped into two fiber arrangements.
major types of fiber arrangements: parallel and pennate. Each
may be subdivided further according to shape.
Muscle tissue properties
Parallel muscles have their fibers arranged parallel to the Skeletal muscle tissue has four properties related to its ability to
length of the muscle. Generally, parallel muscles will produce a produce force effecting movement about joints. Irritability or excitability
greater range of movement than similar-size muscles with a is the muscle property of being sensitive or responsive to
pennate arrangement. Parallel muscles are categorized into the chemical, electrical, or mechanical stimuli. When an appropriate
following shapes: stimulus is provided, muscle responds by developing tension. Contractility
Flat muscles are usually thin and broad, originating from broad,
is the ability of muscle to contract and develop tension or
fibrous, sheetlike aponeuroses that allow them to spread their
internal force against resistance when stimulated. The ability of
forces over a broad area. Examples include the rectus
muscle tissue to develop tension or contract is unique in that
abdominis and external oblique.
other body tissues do not have this property. Extensibility
Fusiform muscles are spindle-shaped with a central belly that tapers

is the ability of muscle to be passively stretched beyond its
to tendons on each end; this allows them to focus their power on
normal resting length. As an example, the triceps brachii
small, bony targets. Examples are the brachialis and the
displays extensibility when it is stretched beyond its normal
brachioradialis.
resting length by the biceps brachii and other elbow flexors
Strap muscles are more uniform in diameter with essentially all their
contracting to achieve full elbow flexion. Elasticity is the ability
fibers arranged in a long parallel manner. This also enables a
of muscle to return to its original resting length following
focusing of power on small, bony targets. The sartorius is an
stretching. To continue with the elbow example, the triceps
example.
brachii displays elasticity by returning to its original resting
Radiate muscles are also sometimes described as being triangular,
length when the elbow flexors cease contracting and relax.
fan-shaped, or convergent. They have the combined arrangement
of flat and fusiform muscles, in that they originate on a broad
surface or an aponeurosis and converge onto a tendon. Examples
include the pectoralis major and trapezius.
Muscle terminology
Sphincter or circular muscles are technically endless strap muscles
Locating the muscles, their proximal and distal attachments,
that surround openings and function to close them upon
and their relationship to the joints they cross is critical to
contraction. An example is the orbicularis oris, surrounding the
determining the effects that muscles have on the joints. It is also
mouth.
necessary to understand certain terms as body movement is
Pennate muscles have shorter fibers that are arranged considered.
obliquely to their tendons in a structure
TABLE 2.1 • Muscle shape and fiber arrangement
Fiber
Advantage Shape Appearance Characteristics/description Examples Chapter
arrangement
Usually thin and broad, originating Rectus 2

from broad, fibrous, sheetlike abdominis,
aponeuroses that external
Flat allow them to spread their forces oblique
over a broad area
Tendon Spindle-shaped with central Biceps brachii,

belly that tapers to tendons on each brachialis
end; can focus their power on small,
bony targets
Belly
Fusiform
Produces
greater range
of movement
Parallel (fibers than similar- Tendon
arranged par- size pennate

allel to the muscles; long More uniform in diameter with Sartorius
length of the excursion essentially all their fibers arranged in

muscle) (contract over Strap a long parallel manner; can focus
a great dis- their power on small, bony targets
tance); good
endurance
Combined arrangement of flat and Pectoralis major,
Radiate
fusiform muscles; originate on broad trapezius
(triangular,
aponeuroses and converge to a single
fan-shaped,
point of attachment via a tendon
convergent)
Fibers concentrically arranged Orbicularis oris,

around a body opening; technically orbicularis oculi
Sphincter endless strap muscles surround
(circular) openings and function to close them
upon contraction
Run obliquely from a tendon on one Biceps femoris,

side only extensor digito-
Unipennate rum longus, tibi-
alis posterior
Produces
greater power
Run obliquely from a central tendon Rectus femoris,
Pennate than similar-
on both sides flexor hallucis
(shorter fibers, size parallel
longus
arranged muscles due to Bipennate
obliquely to increased cross-
their tendons) sectional area;
strong muscles;
short excursion Several tendons with fibers running Deltoid
diagonally between
Multipennate them
Modified from Saladin, KS: Anatomy & physiology: the unity of form and function, ed 4, New York, 2007, McGraw-Hill; and Seeley RR, Stephens TD, Tate P:
Anatomy & physiology, ed 7, New York, 2008, McGraw-Hill.
Intrinsic Tendon
Pertaining usually to muscles within or belonging solely to the Tendons are tough yet flexible bands of fibrous connective
pter body part on which they act. The small intrinsic muscles found tissue, often cordlike in appearance, that connect muscles to
entirely within the hand are examples. See page 197. bones and other structures. By providing this connection,
2 tendons transmit the force generated by the contracting muscle
to the bone. In some cases, two muscles may share a common
Extrinsic
tendon, such as the Achilles tendon of the gastrocnemius and
Pertaining usually to muscles that arise or originate outside of soleus muscles. In other cases a muscle may have multiple
(proximal to) the body part on which they act. The forearm tendons connecting it to one or more bones, such as the three
muscles that attach proximally on the distal humerus and insert proximal attachments of the triceps brachii.
on the fingers are examples of extrinsic muscles of the hand.
See Chapter 7.
Aponeurosis
Action
An aponeurosis is a tendinous expansion of dense fibrous
Action is the specific movement of the joint resulting from a
connective tissue that is sheet- or ribbonlike in appearance and
concentric contraction of a muscle that crosses the joint. An
resembles a flattened tendon. Aponeuroses serve as a fascia to
example is the biceps brachii, which has the action of flexion at
bind muscles together or as a means of connecting muscle to
the elbow. In most cases a particular action is caused by a
bone.
group of muscles working together. Any of the muscles in the
group can be said to cause the action, even though it is usually
an effort of the entire group. A particular muscle may cause Fascia
more than one action either at the same joint or at a different
Fascia is a sheet or band of fibrous connective tissue that
joint, depending upon the characteristics of the joints crossed by
envelopes, separates, or binds together parts of the body such
the muscle and the exact location of the muscle and its
as muscles, organs, and other soft-tissue structures of the body.
attachments in relation to the joint(s).
In certain places throughout the body, such as around joints like
the wrist and ankle, fascial tissue forms a
Innervation retinaculum to retain tendons close to the body.

Innervation occurs in the segment of the nervous system
Origin
responsible for providing a stimulus to muscle fibers within a
specific muscle or portion of a muscle. A particular muscle may From a structural perspective, the proximal attachment of a
be innervated by more than one nerve, and a particular nerve muscle or the part that attaches closest to the midline or center
may innervate more than one muscle or portion of a muscle. of the body is usually considered to be the origin. From a
functional and historical perspective, the least movable part or
attachment of the muscle has generally been considered to be
the origin.
Amplitude
The amplitude is the range of muscle fiber length between
Insertion
maximal and minimal lengthening.
Structurally, the distal attachment, or the part that attaches
Gaster (belly or body) farthest from the midline or center of the body, is considered the
The gaster is the central, fleshy portion of the muscle. This insertion. Functionally and historically, the most movable part is
contractile portion of the muscle generally increases in diameter generally considered the insertion.
as the muscle contracts.
When a particular muscle contracts, it tends to pull both As an example, in the biceps curl exercise, the biceps
ends toward the gaster, or middle, of the muscle. Consequently, brachii muscle in the arm has its origin on the scapula (least
if neither of the bones to which a muscle is attached were movable bone) and its insertion on the radius (most movable
stabilized, both bones would move toward each other upon bone). In some movements this process can be reversed. An
contraction. The more common case, however, is that one bone example of this reversal can be seen in the pull-up, where the
is more stabilized by a variety of factors, and as a result the less radius is relatively stable and the scapula moves up. Even
stabilized bone usually moves toward the more stabilized bone though in this example the most movable bone is reversed, the
upon contraction. proximal attachment of
the biceps brachii is always on the scapula and is still such as those applied by another person, object, or resistance,
considered to be the origin, and the insertion is still on the or to the force of gravity in the presence of muscle relaxation.
radius. The biceps brachii would be an extrinsic muscle of the
Chapter
elbow, whereas the brachialis would be intrinsic to the elbow.
For each muscle studied, the origin and insertion are indicated. Concentric contraction
Concentric contractions involve the muscle developing active
2
tension as it shortens and occur when the muscle develops
enough force to overcome the applied resistance. Concentric
Types of muscle contraction (action)
contractions may be thought of as causing movement against
When tension is developed in a muscle as a result of a stimulus, gravity or resistance and are described as positive contractions.
it is known as a contraction. The term muscle contraction may The force developed by the muscle is greater than that of the
be confusing, because in some types of contractions the muscle resistance. This results in the joint angle being changed in the
does not shorten in length as the term contraction direction of the applied muscular force and causes the body part
to move against gravity or external forces. Concentric
indicates. As a result, it has become increasingly common to contractions are used to accelerate the movement of a body
refer to the various types of muscle contractions as muscle segment from a lower speed to a higher speed.
actions instead.
Muscle contractions can be used to cause, control, or prevent
joint movement. To elaborate, muscle contractions can be used
to initiate or accelerate the movement of a body segment, to
slow down or decelerate the movement of a body segment, or Eccentric contraction (muscle action)
to prevent movement of a body segment by external forces. All Eccentric contractions involve the muscle lengthening under
muscle contractions or actions can be classified as either active tension and occur when the muscle gradually lessens in
isometric or isotonic. An isometric contraction occurs when tension to control the descent of the resistance. The weight or
tension is developed within the muscle but the joint angles resistance may be thought of as overcoming the muscle
remain constant. Isometric contractions may be thought of as static contraction, but not to the point that the muscle cannot control
contractions, because a significant amount of active tension the descending movement. Eccentric muscle actions control
may be developed in the muscle to maintain the joint angle in a movement with gravity or resistance and are described as
relatively static or stable position. Isometric contractions may be negative contractions. The force developed by the muscle is
used to stabilize a body segment to prevent it from being moved less than that of the resistance; this results in a change in the
by external forces. joint angle in the direction of the resis tance or external force
and allows the body part to move with gravity or external forces
(resistance). Eccentric contractions are used to decelerate the
movement of a body segment from a faster speed to a slower
Isotonic contractions involve the muscle developing tension speed or stop the movement of a joint already in motion.
to either cause or control joint movement. They may be thought Because the muscle is lengthening as opposed to shortening,
of as dynamic the relatively recent change in terminology from muscle
contractions, because the varying degrees of active tension in contraction to muscle action is becoming more commonly
the muscles are either causing the joint angles to change or accepted.
controlling the joint angle change that is caused by external
forces. The isotonic type of muscle contraction is classified
further as either concentric or eccentric on the basis of whether
shortening or lengthening occurs. Concentric contractions
involve the muscle developing active tension as it shortens, Movement differentiation
whereas eccentric contractions involve the muscle lengthening Some confusion exists regarding body movement and the
under active tension. In Fig. 2.3, A, factors affecting it. Joint movement may occur with muscle
groups on either or both sides of the joint actively contracting or
even without any muscles contracting. Similarly, when no
B, E, and F illustrate isotonic contractions, while movement is occurring there may or may not be muscle
C and D demonstrate isometric contractions. contraction present, depending on the external forces acting on
It is also important to note that movement may occur at any the joint. To further add to the confusion, a variety of terms and
given joint without any muscle contraction whatsoever. Such descriptive phrases are used by different authorities to
movement is referred to as passive and is due solely to external
forces,
m en t
Move
Forearm
movement
pter
Muscle contracts with force greater
Biceps brachii
2 contracting muscle than resistance and

(concentric) shortens (concentric Relaxed
contraction). muscle
Radius
Ulna
n t
e
m
Relaxed Triceps brachii
e
contracting muscle
v
muscle
o
(concentric)
M
A B Forearm
movement
Muscle contracts but does not

Biceps brachii
contracting muscle change length (isometric
(isometric) contraction). Relaxed
muscle
Radius
Ulna

muscle contracting muscle
(isometric)
C D
em en t
M ov
Forearm
movement
Biceps brachii Muscle contracts with force less

contracting muscle than resistance and lengthens
(eccentric) (eccentric Relaxed
contraction). muscle
Radius
Ulna
n t

e
muscle contracting muscle

m
(eccentric)
e
v
E F
o
M
Forearm
movement
FIG. 2.3 • Agonist–antagonist relationship with isotonic and isometric contractions. A, Biceps is agonist in flexing the elbow with a
concentric contraction, and triceps is antagonist; B, Triceps is agonist in extending
the elbow with a concentric contraction, and biceps is antagonist; C, Biceps is maintaining the elbow in a flexed position with an isometric
contraction, and triceps is antagonist; D, Triceps is maintaining the elbow in a flexed position with an isometric contraction, and biceps is
antagonist; E, Biceps is controlling elbow extension with an eccentric contraction, and triceps is antagonist; F, Triceps is controlling elbow
flexion with an eccentric contraction, and biceps is antagonist.
TABLE 2.2 • Muscle contraction and movement matrix
Type of contraction (muscle action)

Definitive and Movement without Chapter
Isotonic
2
descriptive factors Isometric contraction
Concentric Eccentric
Agonist muscle No appreciable Shortening Lengthening Dictated solely by gravity and/or

length change external forces
Antagonist muscle No appreciable Lengthening Shortening Dictated solely by gravity and/or

length change external forces
Joint angle No appreciable In direction of applied In direction of external force Dictated solely by gravity and/or
changes change muscular force (resistance) external forces
Direction of Against immovable Against gravity and/ With gravity and/or Consistent with gravity
body part object or matched or other external force other external force and/ or other external forces
external force (resistance) (resistance)
(resistance)
Motion Prevents motion; Causes motion Controls motion Either no motion or passive
pressure (force) motion as a result of gravity
applied, but no and/or other external forces
resulting motion
Description Static; fixating Dynamic shortening; Dynamic lengthening; Passive; relaxation

positive work negative work
Applied muscle Force 5 resistance Force > resistance Force < resistance No force, all resistance
force versus
resistance
Speed relative to Equal to speed of Faster than the inertia of the Slower than the speed of Consistent with inertia of gravity or
gravity or applied applied resistance resistance applied inertial applied external forces or forces
resistance including the speed of gravity
inertial forces
Acceleration/ Zero acceleration Acceleration Deceleration Either zero or acceleration

deceleration consistent with applied
external forces
Descriptive symbol ( 5) ( 1) ( 2) (0)
Practical Prevents external Initiates movement or Slows down the rate of Passive motion by force
application forces from causing speeds up the rate of movement or stops move- from gravity and/or other ment, “braking
movement movement action” external forces
describe these phenomena. Table 2.2 attempts to provide an a specific technique that may use any or all of the different
exhaustive explanation of the various types of contraction and types of contractions. Isokinetics is a type of dynamic exercise
resulting joint movements. The varying terminology utilized in usually using concentric and/ or eccentric muscle contractions
defining and describing these actions is included. Appendix 5 in which the speed (or velocity) of movement is constant and
provides an algorithm for determining if a muscle or muscle muscular contraction (ideally, maximum contraction) occurs
group is contracting and, if so, the type of contraction. throughout the movement. Biodex, Cybex, and other types of
apparatuses are engineered to allow this type of exercise.
Various exercises may use any one or all of these

contraction types for muscle development. Development of Students well educated in kinesiology should be qualified to
exercise machines has resulted in another type of muscle prescribe exercises and activities for the development of large
exercise known as isokinetics . Isokinetics is not another type of muscles and of muscle groups in the human body. They should
contraction, as some authorities have mistakenly described; be able to read the description of an exercise
rather, it is
or observe an exercise and immediately know the most joint motion opposite to that of the agonist. Using the previous
important muscles being used. Terms describing how muscles example, the quadriceps muscles are antagonists to the
function in joint movements follow. hamstrings in knee flexion.
pter
2 Stabilizers
Role of muscles
Stabilizers surround the joint or body part and contract to fixate
When a muscle contracts, it simply attempts to pull the bones to or stabilize the area to enable another limb or body segment to
which both of its ends are attached toward each other. Usually exert force and move. Known as fixators, they are essential in
this does not happen, however, because one of the bones is establishing a relatively firm base for the more distal joints to
usually more stable than the other. As a result, the less stable work from when carrying out movements. In a biceps curling
bone moves toward the more stable bone. When a muscle that example, the muscles of the scapula and glenohumeral joint
is capable of performing multiple actions contracts, it attempts must contract in order to maintain the shoulder complex and
to perform all of its actions unless other forces, such as those humerus in a relatively static position so that the biceps brachii
provided by other muscles, prevent the undesired actions. can more effectively perform the curls. The antagonists for each
motion of the proximal joint co-contract or contract against each
other to prevent motion. This is an example of proximal
stabilization to enhance the effectiveness of distal joint motion,
which occurs commonly with the upper extremity.
Agonist FIG. 2.3
Agonist muscles, when contracting concentrically, cause joint
motion through a specified plane of motion. Any concentrically
contracting muscle that causes the same joint motion is an
agonist for the motion. However, some muscles, because of
their relative location, size, length, or force generation capacity,
are able to contribute significantly more to the joint movement Synergist
than other agonists. These muscles are known as prime or primary Muscles that assist in the action of an agonist but are not
movers or as muscles most involved. Agonist muscles that necessarily prime movers for the action, known as guiding
contribute significantly less to the joint motion are commonly muscles, assist in refined movement and rule out undesired
referred to as assisters or assistant movers. Consensus among motion. Synergist muscles may be either helping synergists or
all authorities regarding which muscles are primary movers and true synergists. Helping synergists have an action in common
which are weak assistants does not exist in every case. This but also have actions antagonistic to each other. They help
text will emphasize the primary movers. The remaining agonists another muscle move the joint in the desired manner and
or assistants, when listed, will be referred to as weak simultaneously prevent undesired actions. An example involves
contributors to the motion involved. As an example, the the anterior and posterior deltoid. The anterior deltoid acts as an
hamstrings (semitendinosus, semimembranosus, biceps agonist in glenohumeral flexion, while the posterior deltoid acts
femoris), sartorius, gracilis, popliteus, and gastrocnemius are all as an extensor. Helping each other, they work in synergy with
agonists in knee flexion, but most kinesiologists regard only the the middle deltoid to accomplish abduction. True synergists contract
hamstrings as the prime movers. to prevent an undesired joint action of the agonist and have no
direct effect on the agonist action. The finger flexors are
provided true synergy by the wrist extensors when one is
grasping an object. The finger flexors originating on the forearm
and humerus are agonists in both wrist flexion and finger
flexion. The wrist extensors contract to prevent wrist flexion by
the finger flexors. This allows the finger flexors to maintain more
Antagonist FIG. 2.3 of their length and therefore utilize more of their force in flexing
Antagonist muscles have the opposite concentric action from the fingers.
agonists. Referred to as contralateral muscles, antagonists are
located on the opposite side of the joint from the agonist and
work in cooperation with agonist muscles by relaxing and
allowing movement; but when contracting concentrically, they
perform the
Neutralizers Coupling of muscular forces in the body can result in a more

Neutralizers counteract or neutralize the action of other muscles efficient movement. Figure 2.4,
to prevent undesirable movements such as inappropriate B illustrates a force couple in which the middle Chapter
trapezius, lower trapezius, and serratus ante-
2
muscle substitutions. They contract to resist specific actions of
other muscles. As an example, when only the supination action rior all attach at different points on the scapula.
of the biceps brachii is desired, the triceps brachii contracts to Each muscle pulls on the scapula from a differ-
neutralize the flexion action of the biceps brachii. Another ent direction to produce the combined result of upward rotation.
example may be seen in the biceps curl, when only the flexion Another example of muscular force couples is seen in standing,
force of the biceps brachii is desired. When the biceps brachii when the hip flexors (iliopsoas and rectus femoris) are used to
contracts, it normally attempts to both flex the elbow and pull the front of the pelvis downward and the erector spinae are
supinate the forearm. In this case the pronator teres contracts to used to pull the posterior pelvis upward, resulting in anterior
neutralize the supination component of the biceps. pelvic rotation.
Tying the roles of muscles together

Force couples When a muscle with multiple agonist actions contracts, it
Force couples occur when two or more forces are pulling in attempts to perform all its actions. Muscles cannot determine
different directions on an object, causing the object to rotate which actions are appropriate for the task at hand. The resulting
about its axis. Fig. 2.4, A depicts a force couple consisting of actions actually performed depend upon several factors, such
one hand on each side of a steering wheel. One hand pulls the as the motor units activated, joint position at the time of
wheel up and to the right, and the other hand pulls it down and contraction, planes of motion allowed in the joint, axis of rotation
to the left.
Middle
trapezius
Upward
rotation
Lower
trapezius
A B
FIG. 2.4 • Force couples. A, When a person steers with two hands, the hands act as a force couple; B, Two force couples act on the
scapula to rotate it upward. The middle trapezius and lower serratus anterior are
excellent examples. The middle trapezius and lower trapezius also tend to act as a force couple, although their pulls are not in opposite
directions.
possible in the joint, muscle length, and the relative contraction prescribed for the development of each antagonistic muscle
or relaxation of other muscles acting on the joint. In certain group. The return movement to the hanging position at the
instances, two muscles may work in synergy by counteracting elbow joint after chinning is elbow joint extension, but the triceps
pter
their opposing actions to accomplish a common action. and anconeus are not being strengthened. A concentric
2 contraction of the elbow joint flexors occurs, followed by an
eccentric contraction of the same muscles.
As discussed, agonist muscles are primarily responsible for
a given movement, such as those of hip flexion and knee
extension while kicking a ball. In this example, the hamstrings
are antagonistic and relax to allow the kick to occur. This does Reversal of muscle function
not mean that all other muscles in the hip area are uninvolved. A muscle group that is described to perform a given function
The preciseness of the kick depends on the involvement of can contract to control the exact opposite motion. Fig. 2.3, A illustrates
many other muscles. As the lower extremity swings forward, its how the biceps is an agonist by contracting concentrically to flex
route and subsequent angle at the point of contact depend on a the elbow. The triceps is an antagonist to elbow flexion, and the
certain amount of relative contraction or relaxation in the hip pronator teres is considered to be a synergist to the biceps in
abductors, adductors, internal rotators, and external rotators. this example. If the biceps were to slowly lengthen and control
These muscles act in a synergistic fashion to guide the lower elbow extension, as in Fig. 2.3, E, it would still be the agonist,
extremity in a precise manner. That is, they are not primarily but it would be contracting eccentrically. Fig. 2.3, B illustrates
responsible for knee extension and hip flexion, but they do how the triceps is an agonist by contracting concentrically to
contribute to the accuracy of the total movement. These guiding extend the elbow. The biceps is an antagonist to elbow
muscles assist in refining the kick and preventing extraneous extension in this example. If the triceps were to slowly lengthen
motions. Additionally, the muscles in the contralateral hip and and control elbow flexion, as in Fig. 2.3, F, it would still be the
pelvic area must be under relative tension to help fixate or agonist, but it would be eccentrically contracting. In both of
stabilize the pelvis on that side in order to provide a relatively these examples, the deltoid, trapezius, and various other
stable pelvis for the hip flexors on the involved side to contract shoulder muscles are serving as stabilizers of the shoulder
against. In kicking the ball, the pectineus and tensor fascia latae area.
are adductors and abductors, respectively, in addition to flexors.
The actions of adduction and abduction are neutralized by each
other, and the common action of the two muscles results in hip
flexion.
Determination of muscle action

The specific action of a muscle may be determined through a
variety of methods. These include considering anatomical lines
of pull, anatomical dissection, palpation, models,
From a practical point of view, it is not essential that electromyography, and electrical stimulation.
individuals know the exact force exerted by each of the elbow
flexors—biceps, brachialis, and brachioradialis—in chinning. It With an understanding of a muscle’s line of pull relative to a
is important to understand that this muscle group is the agonist joint, one may determine the muscle’s action at the joint. (See
or primary mover responsible for elbow joint flexion. Similarly, it lines of pull below.) Although not available to all students,
is important to understand that these muscles contract cadaver dissection of muscles and joints is an excellent way to
concentrically when the chin is pulled up to the bar and that they further understand muscle action.
contract eccentrically when the body is lowered slowly.
Antagonistic muscles produce actions opposite those of the For most of the skeletal muscles, palpation is a very useful
agonist. For example, the muscles that produce extension of the way to determine muscle action. It is done through using the
elbow joint are antagonistic to the muscles that produce flexion sense of touch to feel or examine a muscle as it contracts.
of the elbow joint. It is important to understand that specific Palpation is limited to superficial muscles but is helpful in
exercises need to be furthering an understanding of joint mechanics. Models such as
long rubber bands may be used to facilitate understanding of
lines of pull
and to simulate muscle lengthening or shortening as joints Anterior Quadriceps
move through various ranges of motion.

Rectus femoris Vastus medialis Medial
Chapter
Electromyography (EMG) utilizes either surface electrodes Sartorius
2
Vastus lateralis
Intermuscular
that are placed over the muscle or fine wire/needle electrodes Vastus intermedius septum
placed into the muscle. As the subject then moves the joint and Femur
Adductor longus
contracts the muscles, the EMG unit detects the action Adductor brevis
potentials of the muscles and provides an electronic readout of Gracilis

Biceps femoris Adductor magnus
the contraction intensity and duration. EMG is the most accurate short head
Semimembranosus
way of detecting the presence and extent of muscle activity. Biceps femoris Semitendinosus
long head
Lateral
Electrical muscle stimulation is somewhat a reverse

approach of electromyography. Instead of electricity being used
to detect muscle action, it is used to cause muscle activity.
Surface electrodes are placed over a muscle, and then the Posterior
stimulator causes the muscle to contract. The joint’s actions

may then be observed to see the effect of the muscle’s
contraction on it.
FIG. 2.5 • Lines of pull in relation to the left knee. Biceps
femoris with a posterolateral
relationship enables it to externally rotate the knee;
Lines of pull FIG. 2.5
semitendinosus and semimembranosus have a posteromedial
Combining the knowledge of a particular joint’s functional
relationship enabling them to internally rotate the knee;
design and diarthrodial classification with an understanding of
hamstrings (biceps femoris, semitendinosus, and
the specific location of a musculotendinous unit as it crosses a semimembranosus) all have a posterior relationship enabling
joint is extremely helpful in understanding its action on the joint. them to flex the knee; quadriceps muscles have an anterior
For example, knowing that the rectus femoris has its origin on relationship enabling them to extend the knee.
the anterior inferior iliac spine and its insertion on the tibial
tuberosity via the patella, you can then determine that the
muscle must have an anterior relationship to the knee and hip.
Combining this knowledge with the knowledge that both joints
are capable of sagittal plane movements such as rotate when flexed would allow you to determine that the
flexion/extension, you can then determine that when the rectus semitendinosus and semimembranosus will cause internal
femoris contracts concentrically, it should cause the knee to rotation, whereas the biceps femoris will cause external rotation.
extend and the hip to flex. Knowledge that the knee’s axes of rotation are only frontal and
vertical, but not sagittal, enables you to determine that even
though the semitendinosus and semimembranosus have a
posteromedial line of pull and the biceps femoris has a
posterolateral line of pull, they are not capable of causing knee
Furthermore, knowing that the semitendinosus, adduction and abduction, respectively.
semimembranosus, and biceps femoris all originate on the
ischial tuberosity and that the semitendinosus and
semimembranosus cross the knee posteromedially before
inserting on the tibia, but that the biceps femoris crosses the You can also apply this concept in reverse. For example, if
knee posterolaterally before inserting on the fibula head, you the only action of a muscle such as the brachialis is known to be
may determine that all three muscles have posterior elbow flexion, then you should be able to determine that its line
relationships to the hip and knee, which would enable them to of pull must be anterior to the joint. Additionally, you would know
be hip extensors and knee flexors upon concentric contraction. that the origin of the brachialis must be somewhere on the
The specific knowledge related to their distal attachments and anterior humerus and the insertion must be somewhere on the
the knee’s ability to anterior ulna.
Consider all the following factors and their relationships as movement as aggregate muscle action but not as specific
you study movements of the body to gain a more thorough muscle activity. Sensory stimuli from the body also are
understanding. interpreted here, to a degree, for the determination of needed
pter
responses.
2
1. Exact locations of bony landmarks to which muscles attach
At the next level, the basal ganglia control the maintenance
proximally and distally and their relationship to joints
of postures and equilibrium and learned movements such as
driving a car. Sensory integration for balance and rhythmic
2. The planes of motion through which a joint is capable of
activities is controlled here.
moving
3. The muscle’s relationship or line of pull relative to the joint’s
The cerebellum is a major integrator of sensory impulses
axes of rotation
and provides feedback relative to motion. It controls the timing
4. As a joint moves through a particular range of motion, the
and intensity of muscle activity to assist in the refinement of
ability of the line of pull of a particular muscle to change
movements.
and even result in the muscle having a different or opposite
action than in the original position
Next, the brain stem integrates all central nervous system
activity through excitation and inhibition of desired
5. The potential effect of other muscles’ relative contraction or
neuromuscular actions and functions in arousal or maintaining a
relaxation on a particular muscle’s ability to cause motion
wakeful state.
6. The effect of a muscle’s relative length on its ability to

Finally, the spinal cord is the common pathway between the
generate force (See muscle length– tension relationship, p.
CNS and the peripheral nervous system (PNS) , which contains
57, and active and passive insufficiency, p. 62.)
all the remaining nerves throughout the body. It has the most
specific control and integrates various simple and complex
7. The effect of the position of other joints on the ability of a
spinal reflexes, as well as cortical and basal ganglia activity.
biarticular or multiarticular muscle to generate force or
allow lengthening (See uniarticular, biarticular, and
multiarticular muscles, p. 61.)
Functionally, the PNS can be divided into sensory and motor
divisions. The sensory or
afferent nerves bring impulses from receptors in the skin, joints,
Neural control of voluntary movement muscles, and other peripheral aspects of the body to the CNS,
while the motor or efferent nerves carry impulses to the outlying
When we discuss muscular activity, we should really state it as regions of the body.
neuromuscular activity, since muscle cannot be active without
nervous innervation. All voluntary movement is a result of the The spinal nerves, illustrated in Fig. 2.6, also provide both
muscular and the nervous systems working together. All muscle motor and sensory function for their respective portions of the
contraction occurs as a result of stimulation from the nervous body and are named for the locations from which they exit the
system. Ultimately, every muscle fiber is innervated by a vertebral column. From each side of the spinal column, there
somatic motor neuron, which, when an appropriate stimulus is are 8 cervical nerves, 12 thoracic nerves, 5 lumbar nerves, 5
provided, results in a muscle contraction. Depending upon a sacral nerves, and 1 coccygeal nerve. Cervical nerves 1
variety of factors, this stimulus may be processed in varying through 4 form the cervical plexus, which is generally
degrees at different levels of the central nervous system (CNS) . The responsible for sensation from the upper part of the shoulders to
CNS, for the purposes of this discussion, may be divided into the back of the head and front of the neck. The cervical plexus
five levels of control. Listed in order from the most general level supplies motor innervation to several muscles of the neck.
of control and the most superiorly located to the most specific Cervical nerves 5 through 8, along with thoracic nerve 1, form
level of control and the most inferiorly located, these levels are the brachial plexus, which supplies motor and sensory function
the cerebral cortex, the basal ganglia, the cerebellum, the brain to the upper extremity and most of the scapula. Thoracic nerves
stem, and the spinal cord. 2 through 12 run directly to specific anatomical locations in the
thorax. All of the lumbar, sacral, and coccygeal nerves form the
lumbosacral plexus, which supplies sensation and motor
The cerebral cortex , the highest level of control, provides for

the creation of voluntary
Cervical plexus (C1–C4)

C 11 Chapter
Ansa cervicalis Atlas (first cervical vertebra)
C 22
Lesser occipital nerve
2
C 33
Transverse cervical nerve C 44 Cervical nerves (8 pairs)
Supraclavicular nerve C 55
C 66
Phrenic nerve Cervical enlargement
C 77
C 88
Brachial plexus (C5–T1) First thoracic vertebra
T1
T1
Axillary nerve
T2
T2
Radial nerve
Musculocutaneous nerve T3
T3
Median nerve T4
T4
Ulnar nerve
T5
T5
T6
T6
Thoracic nerves (12 pairs)
T7
T7
Intercostal (thoracic) nerves
T8
T8
T9
T9
Dura mater
of spinal cord T1
T 01
T1
T 11
Lumbar enlargement
T1
T 21
Lumbar plexus (L1–L4)
First lumbar vertebra
L1
L1
Iliohypogastric nerve
Conus medullaris
Ilioinguinal nerve L2
L2
Genitofemoral nerve L3
L3
Lumbar nerves (5 pairs)
Lateral femoral cutaneous nerve
L4
L4
Femoral nerve Cauda equina

L5
L5
Obturator nerve
S 11
S
Ilium
Sacral plexus (L5–S4) S 22
S
Sacrum
Sciatic Common peroneal nerve S 33
S
Sacral nerves (5 pairs)
nerve Tibial nerve S 44
S
S 55
S
Posterior cutaneous femoral nerve Coccygeal nerves (1 pair)
Pudendal nerve
Filum terminale
Lumbosacral plexus
FIG. 2.6 • Spinal nerve roots and plexuses.
function to the lower trunk and the entire lower extremity and Neurons consist of a neuron cell body ; one or more branching
perineum. projections known as dendrites ,
One aspect of the sensory function of spinal nerves is to which transmit impulses to the neuron and cell body; and an axon
provide feedback to the CNS regarding skin sensation. A , an elongated projection that transmits impulses away from
defined area of skin supplied by a specific spinal nerve is known neuron cell bodies. As shown in Fig. 2.8, neurons are classified
as a into three types, according to the direction in which they
dermatome ( Fig. 2.7). Regarding motor function of spinal transmit impulses. Sensory neurons transmit impulses to the
nerves, a myotome is defined as a muscle or group of muscles spinal cord and brain from all parts of the body, whereas
supplied by a specific spinal nerve. Certain spinal nerves are
also responsible for reflexes. Table 2.3 summarizes the specific
spinal nerve functions. motor neurons transmit impulses away from the brain and spinal
cord to muscle and glandular tissue. Interneurons are central or
The basic functional units of the nervous system responsible connecting neurons that conduct impulses from sensory
for generating and transmitting impulses are nerve cells known neurons to motor neurons.
as neurons .
Functions
C1 Head m o vement C2
pter 2 Diaphragm
movement
2
3 C3
Cervical 4 C2 C4
nerves Neck and shoulder
5 movement C3
C4 T3
6 T4
7 Upper limb
C4
T5
T2
8 movement T6
T3 C6 C7
T7
T1 T4 C5 C8
C5 T8
T5 T2 T2 C5
2 T1 T6 T1 T9
T10
3 T7
T11
T1
T8 C6 T1
C6 T12
4 C6 T9 L1
C7 T10
5
C7 T1 S2
T11
Rib movement T1
6 T12
Thoracic in breathing, C8 S5
C8 L2 Co
nerves 7 vertebral column L1 S3
movement, and C6 S4
8 S3 C8
tone in postural
9 back muscles S4
L2
L2
S3 L2
10 C7
11
L3 L3
L3
12 S2 S2
Hip movement
L1
L4 L4
Lumbar 2
L4 L4 L5
nerves
3
4
Lower limb
5 S1 S1
movement S1
L5
L5
L5 S1
L5 S1
B
Sacral
nerves
Coccygeal
nerves
A Posterior view
FIG. 2.7 • Spinal cord and dermatomal map. A, Nerves and functions of the spinal cord (regions color-coded); B, Letters and
numbers indicate the spinal nerves innervating a given region of skin.
Dendrite
Cell body
Dendrite
Axon
Direction of Node of Ranvier Cell body Cell body
conduction (neurofibril node)
Axon Direction of
Myelin sheath conduction
Axon
Sensory
Axon receptor
Axon Myelin sheath

terminal
Muscle
A B C
Skin
FIG. 2.8 • Neuron anatomy. A, Motor neuron. Note the branched dendrites and the single long axon, which branches only near its tip; B, Sensory
neuron with dendritelike structures projecting from the peripheral end
of the axon; C, Interneuron (from the cortex of the cerebellum) with very highly branched dendrites.
TABLE 2.3 • Spinal nerve root dermatomes, myotomes, reflexes, and functional applications
Nerve Dermatome afferent Myotome efferent

Reflexes Functional application Chapter
root (sensory) (motor)
C1 Touch: Vertex of skull Upper neck muscles None Capital flexion and extension 2
Touch: Temple, Upper neck muscles None Sensation behind the ear and posterior skull Capital
C2
forehead, occiput and upper cervical movements
Cervical plexus
Touch: Entire neck, pos- Trapezius, splenius, terior cheek, None Scapula retraction, neck extension Sensation
C3 temporal capitis to cheek and side of neck
area, under mandible
Touch: Shoulder area, Trapezius, levator None Scapula retraction and elevation Sensation to
C4 clavicular area, upper scapulae clavicle and upper scapula
scapular area
Touch: Deltoid area, Supraspinatus, infraspi- Biceps brachii Shoulder abduction

C5 anterior aspect of entire arm natus, deltoid, biceps Sensation to lateral side of arm and elbow
to base of thumb brachii
Touch: Anterior arm, Biceps, supinator, wrist Biceps Elbow flexion, wrist extension
C6 radial side of hand to thumb extensors brachii, Sensation to lateral side of forearm includ-
and index finger brachioradialis ing thumb and index fingers
Touch: Lateral arm and Triceps brachii, wrist Triceps Elbow extension, wrist flexion
Brachial plexus
C7 forearm to index, long, and flexors brachii Sensation to middle of anterior forearm and long
ring fingers finger
Touch: Medial side of Ulnar deviators, thumb None Wrist ulnar deviation, thumb extension Sensation
C8 forearm to ring and little extensors, thumb adduc- to posterior elbow and medial forearm to little
fingers tors (rarely triceps) fingers
Touch: Medial arm and Intrinsic muscles of the hand None Abduction and adduction of fingers
forearm to wrist except for opponens pollicis Sensation to medial arm and elbow
T1
and abductor pollicis brevis
Touch: Medial side of Intercostal muscles None Sensation to medial upper arm, upper chest, and
upper arm to medial elbow, midscapular area
T2
pectoral, and
midscapular areas
Thoracic
Touch: T3–T6, upper Intercostal muscles, None Sensation to chest, abdomen, and low back
T3– thorax; T5–T7, coastal abdominal muscles
T12 margin; T8–T12, abdo-
men and lumbar region
Proprioception and kinesthesis provided by proprioceptors during neuromuscular activity.

Proprioceptors are internal receptors located in the skin, joints,
The performance of various activities is significantly dependent muscles, and tendons that provide feedback relative to the
upon neurological feedback from the body. Very simply, we use tension, length, and contraction state of muscle, the position of
the various senses to determine a response to our environment, the body and limbs, and movements of the joints. These
as when we use sight to know when to lift our hand to catch a proprioceptors in combination with the other sense organs of
fly ball. We are familiar with the senses of smell, touch, sight, the body are vital in kinesthesis , the conscious awareness of
hearing, and taste. We are also aware of other sensations, such the position and movement of the body in space. For example, if
as pain, pressure, heat, and cold, but we often take for granted standing on one leg with the other knee flexed, you do not have
the sensory feedback to look at your
TABLE 2.3 (continued) • Spinal nerve root dermatomes, myotomes, reflexes, and functional
applications
pter
Nerve Dermatome afferent Myotome efferent
2 root (sensory) (motor)

Reflexes Functional application
Touch: Lower abdomen, Quadratus lumborum groin, None Sensation to low back, over trochanter and groin
lumbar region
L1 from 2nd to 4th vertebrae,
upper and outer aspect of
buttocks
Touch: Lower lumbar Iliopsoas, quadriceps None Hip flexion

L2 region, upper buttock, Sensation to back, front of thigh to knee
anterior aspect of thigh
Touch: Medial aspect of thigh Psoas, quadriceps Patella Hip flexion and knee extension
to knee, anterior aspect of or knee Sensation to back, upper buttock, anterior thigh and
L3 lower 1/3 of the thigh to just extensors knee, medial lower leg
below patella
Touch: Medial aspect Tibialis anterior, exten- Patella Ankle dorsiflexion, transverse
of lower leg and foot, inner sor hallucis and digitorum or knee tarsal/subtalar inversion
L4
border of foot, great toe longus, peroneals extensors Sensation to medial buttock, lateral thigh, medial
leg, dorsum of foot, great toe
Lumbosacral plexus
Touch: Lateral border of leg, Extensor hallucis and None Great toe extension, transverse tarsal/ subtalar
anterior surface of lower leg, digitorum longus, pero- eversion
L5
top of foot to middle three toes neals, gluteus maximus Sensation to upper lateral leg, anterior surface of the
and medius, dorsiflexors lower leg, middle three toes
Touch: Posterior aspect Gastrocnemius, soleus, Achilles reflex Ankle plantar flexion, knee flexion,
of the lower 1/4 of the leg, gluteus maximus and transverse tarsal/subtalar eversion
posterior aspect of the foot, medius, hamstrings, Sensation to lateral leg, lateral foot, lateral two toes,
S1
including the heel, lateral peroneals plantar aspect of foot
border of the foot and sole
Touch: Posterior central Gastrocnemius, soleus, None Ankle plantar flexion and toe flexion Sensation
strip of the leg from below the gluteus maximus, to posterior thigh and upper posterior leg
S2 gluteal fold to 3/4 of the way hamstrings
down the leg
Touch: Groin, medial Intrinsic foot muscles None Sensation to groin and adductor region
S3
thigh to knee
Touch: Perineum, geni- Bladder, rectum None Urinary and bowel control
S4
tals, lower sacrum Sensation to saddle area, genitals, anus
non-weight-bearing leg to know the approximate number of and Krause’s end-bulbs are proprioceptors specific to the joints
degrees that you may have it flexed. The proprioceptors in and and skin.
around the knee provide information so that you are While kinesthesis is concerned with the conscious
kinesthetically aware of your knee position. Muscle spindles and awareness of the body’s position,
Golgi tendon organs (GTO) are proprioceptors specific to the proprioception is the subconscious mechanism by which the
muscles, whereas Meissner’s corpuscles, Ruffini’s corpuscles, body is able to regulate posture and movement by responding
Pacinian corpuscles, to stimuli originating in the proprioceptors embedded in the
joints,
tendons, muscles, and inner ear. When we unexpectedly step significant the reflexive contraction. A more practical example is
on an unlevel or unstable surface, if we have good seen in maintaining posture, as
proprioception the muscles in and about our lower extremity when a student begins to doze off in class. As the Chapter
may respond very quickly by contracting appropriately to head starts to nod forward, a sudden stretch is
prevent a fall or injury. This protective response of the body placed on the neck extensors, which activates the 2
occurs without our having time to make a conscious decision muscle spindles and ultimately results in a sudden
about how to respond. jerk back to an extended position.
The stretch reflex provided by the muscle spindle may be
Muscle spindles (Fig. 2.9), concentrated primarily in the utilized to facilitate a greater response, as in the case of a quick,
muscle belly between the fibers, are sensitive to stretch and short squat before attempting a jump. The quick stretch placed
rate of stretch. Specifically, they insert into the connective tissue upon the muscles in the squat enables the same muscles to
within the muscle and run parallel with the muscle fibers. The generate more force in the subsequent jump off the floor.
number of spindles in a particular muscle varies depending
upon the level of control needed for the area. Consequently, the
concentration of muscle spindles in the hands is much greater The Golgi tendon organs (Fig. 2.11), serially located in the
than in the thigh. tendon close to the muscle– tendon junction, are continuously
sensitive to both muscle tension and active contraction. The
GTO is much less sensitive to stretch than muscle spindles are
When rapid stretch occurs, an impulse is sent to the CNS. and requires a greater stretch to be activated. Tension in
The CNS then activates the motor neurons of the muscle and tendons and consequently in the GTO increases as the muscle
causes it to contract. All muscles possess this myotatic or stretch contracts, which in turn activates the GTO. When the GTO
reflex , stretch threshold is reached, an impulse is sent to the CNS,
but it is most remarkable in the extensor muscles of the which in turn causes the muscle to relax and facilitates
extremities. The knee jerk or patellar tendon reflex is an activation of the antagonists as a protective mechanism. That is,
example, as shown in Fig. 2.10. When the reflex hammer the GTO, through this inverse stretch reflex, protects us from
strikes the patellar tendon, it causes a quick stretch of the excessive contraction by causing the muscle it supplies to relax.
musculotendinous unit of the quadriceps. In response, the As an example, when a weight lifter attempts a very heavy
quadriceps fires and the knee extends. To an extent, the more resistance in the biceps curl and reaches the point of extreme
sudden the tap of the hammer, the more overload, the GTO is activated, the biceps suddenly relaxes,
and the triceps contracts. This is why it appears as if the lifter is
throwing the weight down.
Biceps extension
causes it to stretch.
Pacinian corpuscles, concentrated around joint capsules,

ligaments, and tendon sheaths and beneath the skin, are
Nerve
activated by rapid changes in the joint angle and by pressure
changes affecting the capsule. This activation lasts only briefly
Specialized
muscle fibers and is not effective in detecting constant pressure. Pacinian
(spindle fibers)
corpuscles are helpful in providing feedback regarding the
Spindle sheath
location of a body part in space following quick movements
Motor neurons
such as running or jumping.
Sensory neurons
Skeletal muscle
Ruffini’s corpuscles, located in deep layers of the skin and
the joint capsule, are activated by strong and sudden joint
movements as well as by pressure changes. Compared to
Pacinian corpuscles, their reaction to pressure changes is
slower to develop, but their activation is continued as long as
pressure is maintained. They are essential in detecting even
minute joint position changes and providing information as to
the exact joint angle.
FIG. 2.9 • Muscle spindles.
Axon of sensory neuron Cell body

of sensory neuron
Spinal cord
pter Receptor—ends of sensory neuron
2 Cell body of
Effector—quadriceps femoris
muscle group
Patella
motor neuron
Axon of
motor neuron
Direction of impulse
Patellar
tendon
FIG. 2.10 • Knee jerk, or patellar tendon reflex. A sudden tap on the patellar tendon causes a quick stretch of the quadriceps, which
activates the muscle spindle. The information regarding the stretch is sent via the
axon of the sensory neuron to the spinal cord, where it synapses with a motor neuron that, in turn, carries via its axon a motor response
for the quadriceps to contract.
To brain
1. Golgi tendon organs detect tension applied to a tendon.
2. Sensory neurons conduct action potentials to the spinal cord.

3
3. Sensory neurons synapse with inhibitory interneurons that Sensory
synapse with alpha motor neurons. neuron
4. Inhibition of the alpha motor neurons causes muscle

2
relaxation, relieving the tension applied to the tendon. Inhibitory
4
interneuron
Alpha motor
neuron
Muscle contraction increases
tension applied to tendons. In
response, action
potentials are conducted to the 1
spinal cord.
Sensory
neuron
Golgi
tendon
organ
Golgi
tendon
Tendon Muscle reflex
Golgi tendon organ
FIG. 2.11 • The Golgi tendon organ. Golgi tendon organs are located in series with muscle and serve as “tension monitors” that act as
a protective device for muscle.
TABLE 2.4 • Sensory receptors
Receptors Sensitivity Location Response

Chapter
2
Muscle spindles Subconscious muscle In skeletal muscles among muscle fibers in Initiate rapid contraction of
sense, muscle length parallel with fibers stretched muscle
changes Inhibit development of tension in
antagonistic muscles
Golgi tendon organs Subconscious muscle In tendons, near muscle–tendon junction in Inhibit development of tension in
sense, muscle tension series with muscle fibers stretched muscles
changes Initiate development of tension in
antagonistic muscles
Pacinian corpuscles Rapid changes in Subcutaneous, submucosa, and Provide feedback regarding location of body
joint angles, pressure, subserous tissues around joints and external part in space following quick movements
vibration genitals, mammary glands
Ruffini’s corpuscles Strong, sudden joint Skin and subcutaneous tissue of fingers, Provide feedback as to exact joint angle
movements, touch, collagenous fibers of the joint capsule
pressure
Meissner’s corpuscles Fine touch, vibration In skin Provide feedback regarding touch,
two-point discrimination
Krause’s end-bulbs Touch, thermal change Skin, subcutaneous tissue, lip and eyelid Provide feedback regarding touch
mucosa, external genitals
Meissner’s corpuscles and Krause’s end-bulbs are located Motor Axon branches Myofibrils
neuron
in the skin and in subcutaneous tissues. They are important in
receiving stimuli from touch, but they are not so relevant to our
discussion of kinesthesis. See Table 2.4 for further comparisons
of sensory receptors.
The quality of movement and how we react to position

change are significantly dependent upon proprioceptive
feedback from the muscles and joints. Like the other factors
involving body movement, proprioception may be enhanced
through specific training that utilizes the proprioceptors to a high
degree, such as balancing and functional activities. Attempting
to maintain your balance on one leg, first with the eyes open on
a level surface, may serve as an initial low-level proprioceptive
Neuromuscular
activity, which may eventually progress to a much higher level junction Muscle fiber
such as balancing on an unlevel, unstable surface with your
eyes closed. There are numerous additional proprioceptive FIG. 2.12 • Motor unit. A motor unit consists of a single motor
training activities that are limited only by the imagination and the neuron and all the muscle fibers its
level of proprioception. branches innervate.
motor neuron and all the muscle fibers it innervates. Motor units
function as a single unit. When a particular muscle contracts,
the contraction actually occurs at the muscle fiber level within a
Neuromuscular concepts
particular motor unit. In a typical muscle contraction, the number
Motor units and the all or none principle of motor units responding and consequently the number of
Each muscle cell is connected to a motor neuron at the neuromuscular muscle fibers contracting within the muscle may vary
junction . A motor unit , shown in Fig. 2.12, consists of a single significantly,
from relatively few to virtually all of the muscle fibers, depending

Fewer Motor More Motor
on the number of muscle fibers within each activated motor unit Units Activated Units Activated
and the number of motor units activated (Fig. 2.13). Regardless
pter
of the number involved, the individual muscle fibers within a Muscle
2 given motor unit will fire and contract either maximally or not at
all. This is referred to as the all or none principle .
Motor
unit
fiber
Muscle fiber type

Most agree that humans have three types of muscle fiber—two
subtypes of fast fibers known as type IIa and type IIb (more
recently referred to as type IIx), and a slow fiber known as type
TappingToe Running
I. Fast fibers can produce greater forces due to a greater
shortening velocity but fatigue more quickly than slow fibers.
Slow muscle fibers have a higher resistance to fatigue, but
generally produce less tension than fast fibers.
A B
Factors affecting muscle tension development
The difference between a particular muscle contracting to lift a FIG. 2.13 • The number and size of motor units.
minimal resistance and the same muscle contracting to lift a A, Precise muscle contractions require smaller motor
maximal resistance lies in the number of muscle fibers units; B, Large muscle movements require larger motor units.
recruited. The number of muscle fibers recruited may be
increased by activating those motor units containing a greater
number of muscle fibers, by activating more motor units, or by
increasing the frequency of motor unit activation. The number of
muscle fibers per motor unit varies significantly from fewer than and does not result in a contraction. When the stimulus
10 in muscles requiring a very precise and detailed response, becomes strong enough to produce an action potential in a
such as the muscles of the eye, to as many as a few thousand single motor unit axon, it is known as a threshold stimulus , and
in large muscle groups, such as the quadriceps, that perform all the muscle fibers in the motor unit contract. Stimuli that are
less complex activities. stronger to the point of producing action potentials in additional
motor units are known as submaximal stimuli . For action
potentials to be produced in all the motor units of a particular
muscle, a maximal stimulus is required. As the strength of the
Additionally, recruitment of motor units containing fast stimulus increases from threshold up to maximal, more motor
muscle fibers is helpful in developing greater tension. Finally, units are recruited, and the overall force of the muscle
recruitment of muscle fibers that are at optimal length can help contraction increases in a graded fashion. Increasing the
generate greater muscle tension. Tension development is stimulus beyond maximal has no effect. The effect of increasing
minimized in muscle fibers that are shortened to around 60% of the number of motor units activated is detailed in Fig. 2.14.
their resting length, and muscle fibers stretched beyond 130%
of their resting length are significantly compromised in their
tension development capability. (See Muscle length– tension
relationship, p. 57.)
Greater contraction forces may also be achieved by
increasing the frequency of motor unit activation. To simplify the
For the muscle fibers in a particular motor unit to contract, phases of a single muscle fiber contraction or twitch, a stimulus
the motor unit must first receive a stimulus via an electrical is provided and followed by a brief latent period
signal known as an action potential from the brain and spinal
cord through its axons. If the stimulus is not strong enough to of a few milliseconds. Then the second phase, known as the contraction
cause an action potential, it is known as a subthreshold stimulus phase , begins and the muscle fiber starts shortening. The
contraction phase lasts about 40 milliseconds and is
Chapter
2
Tension
Increasing stimulus strengths
Subthreshold Threshold Maximal

stimulus stimulus stimulus
(no motor (one motor (all motor
units unit responds) units
respond) respond)
Submaximal stimuli Supramaximal stimuli
(increasing numbers of (all motor units respond)
motor units respond)
Time
FIG. 2.14 • Achieving threshold stimulus and the effect on increasing tension of recruiting more motor units. If the stimulus does not reach
threshold, there is no motor unit response. As the stimulus strength increases,
more motor units are recruited until eventually all motor units are recruited and maximal tension of the muscle is generated.
Increasing stimulus strength beyond this point has no effect.
Time twitches combine with the first to produce a sustained

5 ms 40 ms 50 ms contraction. This summation of contractions generates greater
tension than a single contraction would produce on its own. As
the frequency of stimuli increases, the resultant summation
increases accordingly, producing increasingly greater total
Contraction muscle tension. If the stimuli are provided at a frequency high
enough that no relaxation can occur between contractions, then tetanus
Relaxation
results. Fig. 2.16 illustrates the effect of increasing the rate of
Latent stimulation to gain increased muscle tension.
period
Treppe , another phenomenon of muscle contraction, occurs

Stimulus
when multiple maximal stimuli are provided to rested muscle at
a low enough frequency to allow complete relaxation between
05 15 25 35 45 55 65 75 85 95
contractions. Slightly greater tension is produced by the second
Time
stimulus than by the first. A third stimulus produces even
(milliseconds)
greater tension than the second. This staircase effect, illustrated
in Fig. 2.17, occurs only with the first few stimuli, with the
FIG. 2.15 • A recording of a simple twitch. Note the three time resultant contractions after the initial ones resulting in equal
periods (latent period, contraction, and
tension being produced.
relaxation) following the stimulus.
followed by the relaxation phase , which lasts approximately 50

milliseconds. This sequence is illustrated in Fig. 2.15. When Muscle length–tension relationship
successive stimuli are provided before the relaxation phase of Tension in a muscle can be thought of as a pulling force.
the first twitch is complete, the subsequent Tension may be either passive through external applied forces
or active via muscle
muscle is stretched beyond this point, the amount of active

Tetanus tension it can generate decreases significantly. Likewise, there
Simple is a proportional decrease in the ability to develop tension as a
pter twitches
muscle is shortened. When a muscle is shortened to around
2
Force
50% to 60% of its resting length, its ability to develop contractile

tension is essentially reduced to zero.
Summation
In the preparatory phase of most sporting activities, we

Stimuli generally place an optimum stretch on the muscles we intend to
contract forcefully in the subsequent movement or action phase
FIG. 2.16 • Recording showing the change from simple of the skill. The various phases of performing a movement skill
twitches to summation and finally tetanus. are discussed in much greater detail in Chapter 8. This principle
Peaks to the left represent simple twitches. Increasing the may be seen at work when we squat slightly to stretch the calf,
frequency of the stimulus results in a summation of the twitches hamstrings, and quadriceps before contracting them
and finally tetanus. concentrically to jump. If we do not first lengthen these muscles
through squatting slightly, they are unable to generate enough
contractile force to allow us to jump very high. If we squat fully
and lengthen the muscles too much, we lose the ability to
generate as much force and cannot jump as high.
p e
ep
Tr
Tension
We can take advantage of this principle by effectively

reducing the contribution of some muscles in a group by placing
them in a shortened state so that we can isolate the work to
those muscle(s) remaining in the lengthened state. For
example, in hip extension, we may isolate the work of the
Stimuli of constant strength
gluteus maximus as a hip extensor by maximally shortening the
Time (ms) hamstrings with flexion of the knee to reduce their ability to act
as hip extensors. See Figs. 2.18 and 2.19.
FIG. 2.17 • Treppe. When a rested muscle is stimulated
repeatedly with a maximal stimulus
at a frequency that allows complete relaxation between stimuli,
the second contraction produces a slightly greater tension than Total tension
Active tension
the first, and the third contraction produces greater tension than
Passive tension
the second. After a few contractions, the tension produced by all
contractions is equal.
Increasing tension
Resting length
contraction. Passive tension is developed as a muscle is

stretched beyond its normal resting length. As it becomes
stretched further, its passive tension increases similarly to that
0% 100% 130% Resting length
of a rubber band being stretched. Active tension is dependent
Increasing length
on the number of motor units and their respective muscle fibers
recruited in a given contraction. However, the length of the
muscle during the contraction is a factor in the amount of active
FIG. 2.18 • Muscle length–tension relationship. As the length
increases, the amount of active tension
tension the muscle may be able to generate.
that can be developed increases until approximately 130% of the
muscle’s resting length is reached. After this point, further increases
in length result in decreased ability to generate active tension.
Generally, depending on the particular muscle involved, the
Passive tension begins to increase on the muscle lengthened
greatest amount of active tension can be developed when a
beyond its resting length.
muscle is stretched to between 100% and 130% of its resting
length. As a
Eccentric Concentric
Chapter
Isometric
Force
0
Lengthening velocity Shortening velocity
FIG. 2.20 • Muscle–force velocity relationship. From right to

left: When little force is needed
to move relatively light loads, the muscles may contract
concentrically at a relatively high velocity. As the amount of force
A B C
needed increases with greater loads, the velocity of the concentric
FIG. 2.19 • Practical application of the muscle contraction decreases proportionally. The amount of force needed
length–tension relationship involving the calf, continues to increase as the load increases until eventually the load
hamstrings, and quadriceps muscle groups in jumping. A, The cannot be moved, resulting in zero velocity and an isometric
muscles are in a relatively shortened position and consequently are contraction. When the muscle can no longer generate the amount of
not able to generate much tension upon contraction; B, The force needed to maintain the load in a static position, the muscle
muscles are in a more optimally lengthened position to generate begins eccentrically contracting to control the velocity, and it can do
significant tension to jump high; C, The muscles are lengthened too so at a relatively slow velocity. As the amount of force needed
much and are not able to generate as much force as in B. increases to control greater loads, the velocity increases
proportionally.
Muscle force–velocity relationship

When the muscle is either concentrically or eccentrically
contracting, the rate of length change is significantly related to
the amount of force potential. When contracting concentrically to cause movement of an object increases, the velocity of
against a light resistance, the muscle is able to contract at a concentric contraction decreases. Furthermore, there is a
high velocity. As the resistance increases, the maximal velocity somewhat proportional relationship between eccentric velocity
at which the muscle is able to contract decreases. Eventually, and force production. As the force needed to control the
as the load increases, the velocity decreases to zero, resulting movement of an object increases, the velocity of eccentric
in an isometric contraction. lengthening increases, at least until the point at which control is
lost. This is illustrated in Fig. 2.20.
As the load increases even further beyond that which the

muscle can maintain with an isometric contraction, the muscle
begins to lengthen, resulting in an eccentric contraction or Stretch-shortening cycle
action. A slight increase in the load will result in a relatively low In addition to the previously discussed factors affecting the force
velocity of lengthening. As the load increases even further, the generation capabilities of muscle, the sequencing and timing of
velocity of lengthening will increase as well. Eventually, the load contractions can enhance the total amount of force produced.
may increase to the point where the muscle can no longer When a muscle is suddenly stretched, resulting in an eccentric
resist. This will result in uncontrollable lengthening or, more contraction that is followed by a concentric contraction of the
likely, dropping of the load. same muscle, the total force generated in the concentric
contraction is greater than that of an isolated concentric
contraction. This is often referred to as the stretch-shortening
From this explanation you can see that there is an inverse cycle and functions
relationship between concentric velocity and force production.
As the force needed
by integration of the Golgi tendon organ (GTO) and the muscle Dorsal Anterior Quadriceps
spindle. Elastic energy is stored during the eccentric stretch

phase, transitioned, and utilized in the concentric contraction
pter
phase. A stretch reflex is elicited in the eccentric phase of the
2
+
motion, which subsequently increases the activation of the
muscle that was stretched, resulting in a more forceful
concentric contraction. For this to be effective, the transition
Ventral Hamstrings
phase must be immediate or the potential energy gained in the –
eccentric phase will be lost as heat. The shorter the transition

Posterior
phase, the more effective the force production. This is the basis
of plyometric training. An example may be seen when a jumper
moves quickly downward immediately prior to jumping upward,
resulting in a greater jumping height.
Reciprocal inhibition or innervation

As stated earlier, antagonist muscle groups must relax and FIG 2.21 • Reciprocal inhibition. A contraction of the agonist
lengthen when the agonist muscle group contracts. This effect, (quadriceps) will produce relaxation in
called reciprocal innervation, occurs through reciprocal inhibition the antagonist (hamstrings).
of the antagonists. Activation of the motor units of the agonists

causes a reciprocal neural inhibition of the motor units of the
antagonists. This reduction in neural activity of the antagonists
allows them to subsequently lengthen under less tension. This component , also referred to as the vertical component, acts
may be demonstrated by comparing the ease with which one perpendicular to the long axis of the bone (lever). When the line
can stretch the hamstrings while simultaneously contracting the of muscular force is at 90 degrees to the bone on which it
quadriceps with the difficulty of attempting to stretch the attaches, all of the muscular force is rotary force; therefore,
hamstrings without the quadriceps contracted. See Fig. 2.21. 100% of the force is contributing to the movement. That is, all of
the force is being used to rotate the lever about its axis. The
closer the angle of pull to 90 degrees, the greater the rotary
component. At all other degrees of the angle of pull, one of the
other two components of force is operating in addition to the
Angle of pull rotary component. The same rotary component is continuing,
Another factor of considerable importance in using the leverage although with less force, to rotate the lever about its axis. The
system is the angle of pull of the muscles on the bone. The horizontal or nonrotary component is either a stabilizing
angle of pull may be defined as the angle between the line of component or a dislocating component
pull of the muscle and the bone on which it inserts. For the sake
of clarity and consistency, we need to specify that the actual
angle referred to is the angle toward the joint. With every
degree of joint motion, the angle of pull changes. Joint depending on whether the angle of pull is less than or greater
movements and insertion angles involve mostly small angles of than 90 degrees. If the angle is less than 90 degrees, the force
pull. The angle of pull decreases as the bone moves away from is a stabilizing force because its pull directs the bone toward the
its anatomical position through the contraction of the local joint axis. This increases the compressive forces within the joint
muscle group. This range of movement depends on the type of and overall joint stability. If the angle is greater than 90 degrees,
joint and bony structure. the force is dislocating because its pull directs the bone away
from the joint axis (Fig. 2.22). Angles of pull greater than 90
degrees tend to decrease joint compressive forces and increase
the distractive forces, thereby putting more stress on the joint’s
Most muscles work at a small angle of pull, generally less ligamentous structures. There is quite a bit of variance in both
than 50 degrees. The amount of muscular force needed to cases, depending on the actual joint structure.
cause joint movement is affected by the angle of pull. Three
components of muscular force are involved. The rotary
Chapter
2
Angle of pull < 90 degrees
(40 degrees)
Angle of pull = 90 degrees
Angle of pull > 90 degrees

(120 degrees)
FIG. 2.22 • A to C, Components of force due to the angle of pull.
In some activities, it is desirable to have a person begin a the ulna is relatively stabilized, as in a pull-up, the brachialis
movement when the angle of pull is at 90 degrees. Many boys indirectly causes motion at the shoulder even though it does not
and girls are unable to do a chin-up (pull-up) unless they start cross it. In this example the brachialis contracts and pulls the
with the elbow in a position to allow the elbow flexor muscle humerus closer to the ulna as an elbow flexor. Correspondingly,
group to approximate a 90-degree angle with the forearm. the shoulder has to move from flexion to extension for the
pull-up to be accomplished.
This angle makes the chin-up easier because of the more Biarticular muscles are those that cross and act directly on
advantageous angle of pull. The application of this fact can two different joints. Depending on a variety of factors, a
compensate for a lack of sufficient strength. In its range of biarticular muscle may contract to cause, control, or prevent
motion, a muscle pulls a lever through a range characteristic of motion at either one or both of its joints. Biarticular muscles
itself, but it is most effective when approaching and going have two advantages over uniarticular muscles. They can
beyond 90 degrees. An increase in strength is the only solution cause, control, and/or prevent motion at more than one joint,
for muscles that operate at disadvantageous angles of pull and and they may be able to maintain a relatively constant length
require a greater force to operate efficiently. due to “shortening” at one joint and “lengthening” at another
joint. The muscle does not actually shorten at one joint and
lengthen at the other; rather, the concentric shortening of the
muscle to move one joint is offset by motion of the other joint,
Uniarticular, biarticular, and multiarticular muscles which moves its attachment of the muscle farther away. This
Uniarticular muscles are those that cross and act directly only maintenance of a relatively constant length results in the
on the joint that they cross. The brachialis of the elbow is an muscle’s ability to continue to exert force. In the pull-up
example in that it can only pull the humerus and ulna closer to example, the biceps brachii acts as a flexor at the elbow. In the
each other upon concentric contraction. When the humerus is initial stage of the pullup, the biceps brachii is in a relatively
relatively stabilized, as in an elbow curl, the brachialis contracts lengthened
to flex the elbow and pulls the ulna closer to the humerus.
However, when
state at the elbow due to its extended position and in a relatively Due to opposite actions occurring simultaneously at both
shortened state at the shoulder due to its flexed position. To joints of a biarticular muscle,
accomplish the pullup, the biceps brachii contracts countercurrent movement patterns result in substantial
pter
concentrically to flex the elbow, so it effectively “shortens” at the shortening of the biarticular muscle. Substantial lengthening of
2 elbow. Simultaneously, the shoulder is extending during the
pull-up, which effectively “lengthens” the biceps brachii at the
its biarticular antagonist also occurs. This may be observed in
the rectus femoris when kicking a ball. During the forward
shoulder. movement phase of the lower extremity, the rectus femoris is
concentrically contracted to both flex the hip and extend the
The biarticular muscles of the hip and knee provide excellent knee. These two movements, when combined, result in
examples of two different patterns of action. Concurrent movement decreased force production capability in the rectus femoris and
patterns allow the involved biarticular muscle to maintain a increased passive tension or stretch on the hamstring muscles
relatively consistent length because of the same action at both the knee and the hip as the kick nears completion.
(extension) at both its joints. An example occurs within the Countercurrent movement patterns result in active insufficiency
rectus femoris (and also the hamstrings) when both the knee in the contracting agonist muscles and passive insufficiency in
and the hip extend at the same time, as in standing from a the antagonist muscles. See Fig. 2.24, B.
squatting position as shown in Fig. 2.23. If only the knee were to
extend, the rectus femoris would shorten and its ability to exert
force similar to the other quadriceps muscles would decrease,
but its relative length and subsequent force production
capability are maintained due to its relative lengthening at the Multiarticular muscles act on three or more joints due to the
hip joint during extension. line of pull between their origin and insertion crossing multiple
joints. The principles discussed relative to biarticular muscles
also apply to multiarticular muscles.
Active and passive insufficiency

As a muscle shortens, its ability to exert force diminishes, as
discussed earlier. When the muscle becomes shortened to the
point where it cannot generate or maintain active tension,
active insufficiency is reached. As a result, the muscle cannot

shorten any further. If the opposing muscle becomes stretched
to the point where it can no longer lengthen and allow
movement,
passive insufficiency is reached. These principles are most
easily observed in either biarticular or multiarticular muscles
when the full range of motion is attempted in all the joints
crossed by the muscle.
An example is when the rectus femoris contracts

concentrically to both flex the hip and extend the knee. It may
completely perform either action one at a time, as shown in Fig.
A B
2.24, A, but is actively insufficient to obtain full range at both
joints simultaneously, as shown in Fig. 2.24, B.
FIG 2.23 • Example of concurrent movement pattern. When
moving from a squatted position to a
Likewise, the hamstrings will not usually stretch enough to allow
standing position, the concurrent movement pattern of extension at
both maximal hip flexion and maximal knee extension; hence,
the hip and extension at the knee allow the biarticular agonist
they are passively insufficient. It is virtually impossible to
muscles (hamstrings and rectus femoris, respectively) to maintain
actively extend the knee fully when beginning with the hip fully
a relatively consistent length.
flexed, or vice versa.

Extensor indicis
Extensor pollicis brevis Chapter
2
External oblique
Fibularis brevis
Flexor carpi radialis
Flexor digitorum
profundus
Flexor digitorum
superficialis
Flexor pollicus longus
Gastrocnemius
A B Gluteus maximus
Gluteus medius
FIG. 2.24 • Active and passive insufficiency. A,
Iliacus
The rectus femoris is easily able to actively flex the
Iliocostalis thoracis
hip or extend the knee through their respective full ranges of
Infraspinatus
motion individually without fully stretching the hamstrings; B, However,
when one tries to actively flex the hip and simultaneously extend Latissimus dorsi
the knee (countercurrent movement pattern), active insufficiency is Levator scapulae

reached in the rectus femoris and passive insufficiency is reached Longissimus lumborum
in the hamstrings, resulting in the inability to reach full range of Obturator externus
motion in both joints. Palmaris longus
Pectoralis minor
Peroneus tertius
Plantaris
Pronator quadratus
Pronator teres
REVIEW EXERCISES
Psoas major
Rectus abdominis
1. Muscle nomenclature chart
Rectus femoris
Complete the chart by writing in the distinctive Rhomboid
characteristics for which each of the muscles is named, Semimembranous
such as shape, size, number of divisions, fiber direction,
Semitendinosus
location, and/or action. Some muscles have more than one.
Serratus anterior
Refer to Chapters 4,
5, 6, 7, 9, 10, 11, and 12 if needed. Spinalis cervicis
Sternocleidomastoid
Distinctive characteristic(s) for
Muscle name
which it is named Subclavius
Adductor magnus Subscapularis
Biceps brachii Supinator
Biceps femoris Supraspinatus
Brachialis Tensor fasciae latae
Brachioradialis Teres major
Coracobrachialis Tibialis posterior
Deltoid Transversus abdominis
Extensor carpi radialis Trapezius
brevis Triceps brachii

Extensor carpi ulnaris Vastus intermedius
Extensor digiti minimi Vastus lateralis
Extensor digitorum Vastus medialis
2. Muscle shape and fiber arrangement 4. Muscle contraction typing chart

chart
For each of the following exercises, write the type of contraction
pter
For each muscle listed, determine first whether it should be (isometric, concentric, or eccentric), if any, in the cell of the
2 classified as parallel or pennate. Complete the chart by

writing in flat, fusiform, strap, radiate, or sphincter under
muscle group that is contracting. Place a dash in the cell if
there is no contraction occurring. Hint: In some instances you
those you classify as parallel. Write in unipennate, bipennate, may have more than one type of contraction in the same
or multipennate for those you classify as pennate. muscle groups throughout various portions of the exercises. If
so, list them in the order of occurrence.
Muscle Parallel Pennate

Exercise Quadriceps Hamstrings
Adductor longus
a. Lie prone on a table with your knee in full extension.
Adductor magnus
Brachioradialis Maintain your knee in full
extension.
Extensor digitorum
Very slowly flex your knee
Flexor carpi ulnaris
maximally.
Flexor digitorum
longus Maintain your knee in full
flexion.
Gastrocnemius
From the fully flexed position,
Gluteus maximus
extend your knee fully as fast as
Iliopsoas
possible but stop immediately
Infraspinatus before reaching
Latissimus dorsi maximal extension.
Levator scapulae From the fully flexed position,
Palmaris longus very slowly extend
Pronator quadratus your knee fully.
Pronator teres b. Begin sitting on the edge of the table with your knee in full extension.
Rhomboid
Maintain your knee in full
Serratus anterior
extension.
Subscapularis
Triceps brachii
maximally.
Vastus intermedius
Vastus medialis
flexion.
Maintain your knee in

3. Choose a particular sport skill and determine the types of
approximately 90 degrees of
muscle contractions occurring in various major muscle
flexion.
groups throughout the body at different phases of the skill.
slowly extend your
knee fully.
c. Stand on one leg and move the other knee as directed.

extension.

maximally.

slowly extend your
knee fully.

extend your knee fully
as fast as possible.
5. With the wrist in neutral, extend the fingers maximally and close the eyes, and subsequently reassume the position in
attempt to maintain the position and then extend the wrist which you had previously placed him or her. Explain the
maximally. What happens to the fingers and why? neuromechanisms involved in your partner’s being able
Chapter
both to sense the
6. Maximally flex your fingers around a pencil with your wrist in joint position in which you placed him or her 2
neutral. Maintain the maximal finger flexion while you allow and then to reassume the same position.
a partner to grasp your forearm with one hand and use his 5. Stand up straight on one leg on a flat surface with the other
or her other hand to push your wrist into maximal flexion. knee flexed slightly and not in contact with anything. Look
Can you maintain control of the pencil? Explain. You are straight ahead and attempt to maintain your balance in this
walking in a straight line down the street when a stranger position for up to 5 minutes. What do you notice happening
7. bumps into you. You stumble but “catch” your balance. in terms of the muscles in your lower leg? Try this again
Using the information from this chapter and other with the knee of the leg you are standing on slightly flexed.
resources, explain what happened. What differences do you notice? Try it again standing on a
piece of thick foam. Try it in the original position with your
eyes closed. Elaborate on the differences among the
8. Drinking a glass of water is a normal daily activity in which the various attempts.
mind and body are involved in the controlled task. Explain
how the movements happen once you become thirsty, in
terms of the nerve roots, muscle contractions, and angle of 6. Hold a heavy book in your hand with your forearm supinated
pull. and your elbow flexed approximately 90 degrees while
standing. Have a partner suddenly place another heavy
book atop the one you are holding. What is the immediate
LABORATORY EXERCISES result regarding the angle of flexion in your elbow? Explain
why this result occurs.
1. Observe on a fellow student some of the muscles shown in
Figs. 2.1 and 2.2. 7. Sit up very straight on a table with the knees flexed 90
2. With a partner, choose a diarthrodial joint on the body and carry degrees and the feet hanging free. Maintain this position
out each of the following exercises: while flexing the right hip and attempting to cross your legs
a. Familiarize yourself with all of the joint’s various to place the right leg across the left knee. Is this difficult?
movements and list them. What tends to happen to the low back and trunk? How can
b. Determine which muscles or muscle groups are responsible you modify this activity to make it easier?
for each movement you listed in 2a.
c. For the muscles or muscle groups you listed for each 8. Determine your one-repetition maximum for a biceps curl
movement in 2b, determine the type of contraction beginning in full extension and ending in full flexion. Carry
occurring. out each of the following exercises with adequate periods
d. Determine how to change the parameters of gravity for recovery in between:
and/or resistance so that the opposite muscles contract
to control the same movements in 2c. Name the type of a. Begin with your elbow flexed 45 degrees, then have a
contraction occurring. partner hand you a weight slightly heavier than your
one-repetition maximum (about 5 pounds). Attempt to
e. Determine how to change the parameters of movement, lift this weight through the remaining range of flexion.
gravity, and/or resistance so that the same muscles listed Can you reach full flexion? Explain.
in 2c contract differently to control the opposite
movement. Utilizing a reflex hammer or the flexed knuckle b. Begin with your elbow in 90 degrees of flexion. Have
3. of your long finger PIP joint, compare the patellar reflex your partner hand you a slightly heavier weight than in
among several subjects. 8a. Attempt to hold the elbow flexed in this position for
10 seconds. Can you do this? Explain.
4. Request a partner to stand with eyes closed while you
position his or her arms in an odd position at the shoulders, c. Begin with your elbow in full flexion. Have your partner
elbows, and wrists. Ask your partner to describe the exact hand you an even slightly heavier weight than in 8b.
position of each joint while keeping the eyes closed. Then Attempt to slowly lower the weight under control until
have your partner begin in the anatomical position, you reach full extension. Can you do this? Explain.
References Olmsted-Kramer LC, Hertel J: Preventing recurrent lateral ankle

sprains: an evidence-based approach, Athletic Therapy Today
9(2):19–22, 2004.
pter Bernier MR: Perturbation and agility training in the rehabilitation for Powers ME, Buckley BD, Kaminski TW, Hubbard TJ, Ortiz C: Six
2
soccer athletes, Athletic Therapy Today 8(3):20–22, 2003. weeks of strength and proprioception training does not affect muscle fatigue
Blackburn T, Guskiewicz KM, Petschauer MA, Prentice WE: Balance and static balance in functional ankle stability,
and joint stability: the relative contributions of proprioception and muscular strength, Journal Journal of Sport Rehabilitation 13(3):201–227, 2004.
of Sport Rehabilitation 9(4):315–328, 2000. Powers SK, Howley ET: Exercise physiology: theory and application
Carter AM, Kinzey SJ, Chitwood LF, Cole JL: Proprioceptive of fitness and performance, ed 8, New York, 2012, McGraw-Hill.
neuromuscular facilitation decreases muscle activity during the stretch reflex in Rasch PJ: Kinesiology and applied anatomy, ed 7, Philadelphia, 1989,
selected posterior thigh muscles, Journal of Sport Rehabilitation 9(4):269–278, Lea & Febiger.
2000.
Raven PH, Johnson GB, Losos JB, Mason KA, Singer SR: Biology, ed
Chimera N, Swanik K, Swanik C: Effects of plyometric training on 8, New York, 2008, McGraw-Hill.
muscle activation strategies and performance in female athletes.
Riemann BL, Lephart SM: The sensorimotor system, part I: the
Journal of Athletic Training 39(1):24, 2004.
physiological basis of functional joint stability, Journal of Athletic Training 37(1):71–79,
Dover G, Powers ME: Reliability of joint position sense and 2002.
forcereproduction measures during internal and external rotation of the shoulder, Journal
Riemann BL, Lephart SM: The sensorimotor system, part II: the role
of Athletic Training 38(4):304–310, 2003.
of proprioception in motor control and functional joint stability,
Hall SJ: Basic biomechanics, ed 6, New York, 2012, McGraw-Hill. Journal of Athletic Training 37(1):80–84, 2002.
Hamill J, Knutzen KM: Biomechanical basis of human movement, ed Riemann BL, Myers JB, Lephart SM: Sensorimotor system
3, Baltimore, 2008, Lippincott Williams & Wilkins. measurement techniques, Journal of Athletic Training 37(1): 85–98, 2002.
Hamilton N, Weimar W, Luttgens K: Kinesiology: scientific basis of
human motion, ed 12, New York, 2012, McGraw-Hill.
Riemann BL, Tray NC, Lephart SM: Unilateral multiaxial coordination
Knight KL, Ingersoll CD, Bartholomew J: Isotonic contractions might training and ankle kinesthesia, muscle strength, and postural control, Journal
be more effective than isokinetic contractions in developing muscle strength, Journal of Sport Rehabilitation 12(1):13–30, 2003.
of Sport Rehabilitation 10(2):124–131, 2001.
Ross S, Guskiewicz K, Prentice W, Schneider R, Yu B: Comparison
Kreighbaum E, Barthels KM: Biomechanics: a qualitative approach for of biomechanical factors between the kicking and stance limbs,
studying human movement, ed 4, Boston, 1996, Allyn & Bacon. Journal of Sport Rehabilitation 13(2):135–150, 2004.
Lindsay DT: Functional human anatomy, St. Louis, 1996, Mosby. Saladin, KS: Anatomy & physiology: the unity of form and function,
Logan GA, McKinney WC: Anatomic kinesiology, ed 3, Dubuque, IA, ed 5, New York, 2010, McGraw-Hill.
1982, Brown. Sandrey MA: Using eccentric exercise in the treatment of lower
Mader SS: Biology, ed 9, New York, 2007, McGraw-Hill. extremity tendinopathies, Athletic Therapy Today 9(1):58–59, 2004.
McArdle WD, Katch FI, Katch VI: Exercise physiology: nutrition, Seeley RR, Stephens TD, Tate P: Anatomy & physiology, ed 7, New
energy, and human performance, ed 7, Baltimore, 2009, Lippincott York, 2006, McGraw-Hill.
Williams & Wilkins. Shier D, Butler J, Lewis R: Hole’s essentials of human anatomy and
McCrady BJ, Amato HK: Functional strength and proprioception testing physiology, ed 10, New York, 2009, McGraw-Hill.
of the lower extremity, Athletic Therapy Today 9(5):60–61, 2005. Shier D, Butler J, Lewis R: Hole’s human anatomy and physiology, ed
Myers JB, Guskiewicz KM, Schneider, RA, Prentice WE: 12, New York, 2010, McGraw-Hill.
Proprioception and neuromuscular control of the shoulder after muscle fatigue, Journal Van De Graaff KM: Human anatomy, ed 6, New York, 2002,
of Athletic Training 34(4):362–367, 1999. McGraw-Hill.
National Strength and Conditioning Association; Baechle TR, Earle Van De Graaf KM, Fox SI, LaFleur KM: Synopsis of human anatomy
RW: Essentials of strength training and conditioning, ed 2, Champaign, IL, & physiology, Dubuque, IA, 1997, Brown.
2000, Human Kinetics.
Yaggie J, Armstrong WJ: Effects on lower extremity fatigue on indices
Neumann DA: Kinesiology of the musculoskeletal system: foundations of balance, Journal of Sport Rehabilitation 10(2):124–131, 2004.
Norkin CC, Levangie PK: Joint structure and function—a

comprehensive analysis, ed 5, Philadelphia, 2011, Davis. For additional resources and a list of related websites,
Northrip JW, Logan GA, McKinney WC: Analysis of sport motion, ed visit www.mhhe.com/floyd19e.
3, Dubuque, IA, 1983, Brown.
Worksheet Exercises
Chapter
Anterior muscular system worksheet

2
On the anterior muscular system worksheet, label the major superficial muscles on the right and the
deeper muscles on the left.
Superficial Deep
2
20
3
21
22
4 23
24
5 25
6 26
27
7
28
29
30
8
31
9
32
10
33
34
11
12
13 35
14 36
15 37
16 38
17
39
18 40
41
19
Worksheet Exercises
pter
2 For in-Posterior
or out-of-class assignments, or for testing, utilize this tear-out worksheet.
muscular system worksheet
On the posterior muscular system worksheet, label the major superficial muscles on the right and the
deeper muscles on the left.
Deep Superficial
31
1
2
3
32
4
5
6
7
33
8
34
9
35
10
36
11
12
37
13
14
38
15
16 39
17
40
18
19
20
41
21
42
22
43
23
44
24
25
45
26
27
46
28
29
30
C HAPTER 3
B ASIC B IOMECHANICAL
Chapter
3
F ACTORS AND C ONCEPTS
Objectives
I nply, as the1study
Chapter of muscles,
we defined bones, very
kinesiology, and joints
sim-
j To know and understand how knowledge of levers can as they are involved in the science of movement. From this
help improve physical performance general definition we can go into greater depth in exploring the
science of body movement, which primarily includes anatomy,
j To know and understand how the
physiology, and mechanics. For a true understanding of
musculoskeletal system functions as a series of simple
movement, a vast amount of knowledge is needed in all three
machines
areas. The focus of this text is primarily structural and functional
j To know and understand how knowledge of torque and anatomy. We have only very minimally touched on some
lever arm lengths can help improve physical performance physiology in the first two chapters. A much greater study of
physiology as it relates to movement should be addressed in an
exercise physiology course, for which there are many excellent
j To know and understand how knowledge of Newton’s
texts and resources. Likewise, the study of mechanics as it
laws of motion can help improve physical performance
relates to the functional and anatomical analysis of biological
systems, known as biomechanics ,
j To know and understand how knowledge of balance,
equilibrium, and stability can help improve physical
performance
j To know and understand how knowledge of force and should be addressed to a greater degree in a separate course.
momentum can help improve physical performance Human movement is quite complex. In order to make
recommendations for its improvement, we need to study
movements from a biomechanical perspective, both qualitatively
j To know and understand the basic effects of mechanical
and quantitatively. This chapter introduces some basic
loading on body tissues
biomechanical factors and concepts, with the understanding
that many readers will subsequently study these in more depth
in a dedicated course utilizing much more thorough resources.
Many students in kinesiology classes have some

for additional information and study material for this chapter, including: knowledge, from a college or high school physics course, of the
laws that affect motion. These principles and others are
j Self-grading quizzes discussed briefly in this chapter, which should prepare you as
j Anatomy flashcards you begin to apply them to motion in the human body. The more
j Animations you can put these principles and concepts into practical
j Related websites application, the easier it will be to understand them.
Mechanics , the study of physical actions of forces, can be 3. To enhance range of motion and speed of movement so
subdivided into statics and that resistance can be moved farther or faster than the
dynamics . Statics involves the study of systems that are in a applied force
constant state of motion, whether at rest with no motion or 4. To alter the resulting direction of the applied force
moving at a constant velocity without acceleration. In statics all
forces acting on the body are in balance, resulting in the body
Simple machines are the lever, wheel and axle, pulley,
being in equilibrium. Dynamics involves the study of systems in
pter inclined plane, screw, and wedge. The arrangement of the
motion with acceleration. A system in acceleration is
musculoskeletal system provides three types of machines in
3 unbalanced due to unequal forces acting on the body.
Additional components of biomechanical study include kinematics
producing movement: levers, wheel/axles, and pulleys. Each of
these involves a balancing of rotational forces about an axis.
and
The lever is the most common form of simple machine found in
the human body.
kinetics . Kinematics is concerned with the description of motion
and includes consideration of time, displacement, velocity,
acceleration, and space factors of a system’s motion. Kinetics is
the study of forces associated with the motion of a body.
Levers
It may be difficult for a person to visualize his or her body as a
system of levers, but this is actually the case. Human
Types of machines found in the body movement occurs through the organized use of a system of
levers. While the anatomical levers of the body cannot be
As discussed in Chapter 2, we utilize muscles to apply force to
changed, when the system is properly understood they can be
the bones on which they attach to cause, control, or prevent
used more efficiently to maximize the muscular efforts of the
movement in the joints they cross. As is often the case, we
body.
utilize bones such as those in the hand to either hold, push, or
pull on an object while using a series of bones and joints
A lever is defined as a rigid bar that turns about an axis of
throughout the body to apply force via the muscles to affect the
rotation , or fulcrum. The axis is the point of rotation about which
position of the object. In doing so we are using a series of
the lever moves. The lever rotates about the axis as a result of force
simple machines to accomplish the tasks. Machines are used to
increase or multiply the applied force in performing a task or to
(sometimes referred to as effort, E ) being applied to it to cause
provide a mechanical advantage .
its movement against a resistance
(sometimes referred to as load or weight). In the body, the
bones represent the bars, the joints are the axes, and the
The mechanical advantage provided by machines enables us to
muscles contract to apply the force. The amount of resistance
apply a relatively small force, or effort, to move a much greater
can vary from maximal to minimal. In fact, the bones
resistance or to move one point of an object a relatively small
themselves or the weight of the body segment may be the only
distance to result in a relatively large amount of movement of
resistance applied. All lever systems have each of these three
another point of the same object. We can determine mechanical
components in one of three possible arrangements.
advantage by dividing the load by the effort. The mechanical
aspect of each component should be considered with respect to
the component’s machinelike function.
The arrangement or location of three points in relation to one
another determines the type of lever and the application for
which it is best suited. These points are the axis, the point of
Another way of thinking about machines is to note that they
force application (usually the muscle insertion), and the point of
convert smaller amounts of force exerted over a longer distance
resistance application (sometimes the center of gravity of the
to larger amounts of force exerted over a shorter distance. This
lever and sometimes the location of an external resistance).
may be turned around so that a larger amount of force exerted
When the axis ( A) is placed anywhere between the force ( F) and
over a shorter distance is converted to a smaller amount of
the resistance ( R), a first-class lever is produced (Fig. 3.1). In
force over a greater distance. Machines function in four ways:
second-class levers, the resistance is somewhere between the
axis and the force (Fig. 3.2). When the force is placed
somewhere between the axis and the resistance,
1. To balance multiple forces
2. To enhance force in an attempt to reduce the total force
needed to overcome a resistance
a third-class lever is created (Fig. 3.3). Table 3.1 provides a First-class levers
summary of the three classes of levers and the characteristics Typical examples of a first-class lever are the crowbar, the
of each. seesaw, pliers, oars, and the triceps in overhead elbow
The mechanical advantage of levers may be determined extension. In the body an example is when the triceps applies
using the following equations: the force to the olecranon ( F ) in extending the nonsupported
resistance
forearm ( R) at the elbow ( A). Other examples are when the
Mechanical advantage 5 _________ agonist and antagonist muscle groups
force Chapter
or
on either side of a joint axis are contracting simul- 3
_____________ taneously, with the agonist producing the force
Mechanical advantage 5 ___ le_n_g_t_h_of force arm
length of resistance arm and the antagonist supplying the resistance. A
F = Force
B
A = Axis
R = Resistance
FIG. 3.1 • A and B, First-class levers.
A = Axis
R = Resistance
F = Force
FIG. 3.2 • A and B, Second-class levers.
pter
3 A B
R = Resistance
F = Force
A = Axis
FIG. 3.3 • A and B, Third-class levers. Note that the paddle and shovel function as third-class levers only when the top hand does not
apply force but serves as a fixed axis of rotation. If the top hand applied force
and the lower hand acted as the axis, then these would represent first-class levers.
TABLE 3.1 • Classification of levers and characteristics of each
Direction
Arm Functional Relationship Mechanical Practical design Human
Class Illustration Arrangement of force vs.
movement to axis advantage example example
resistance
Erector
spinae
Balanced Axis in extending
Equal to 1 Seesaw
Resistance movements middle the head
F R F–A–R Resistance on cervical
arm and
Axis and force spine
First class force arm
1st between are applied
move in Triceps
force and in same Speed and
A opposite Axis near brachii in
resistance direction range of Less than 1 Scissors
directions force extending
motion
the elbow
Force Axis near Greater Crow
motion resistance than 1 bar
Force Gastrocne-
R F
motion mius and
A–R–F Resistance
Resistance (large soleus in
arm and Wheel
Resistance and force resistance Always plantar
force arm Axis near barrow,
2nd are applied can be greater flexing
A Second class between move in resistance nut-
axis and in opposite moved than 1 the foot to
the same cracker
force directions with rela- raise the
direction
tively small body on
force) the toes
Speed and
F R
range of
A–F–R Resistance Biceps
Resistance motion
arm and brachii
Force and force (requires Shovel-
force arm Axis near Always less and bra-
3rd are applied large force ing dirt,
A Third class between move in force than 1 chialis in
axis and in opposite to move a catapult
the same flexing the
resistance directions relatively
direction elbow
small
resistance)
first-class lever (see Fig. 3.1) is designed basically to produce are designed to produce speed and range of motion. Most of the levers in
balanced movements when the axis is midway between the the human body are of this type, which requires a great deal of force to
force and the resistance (e.g., a seesaw). When the axis is move even a small resistance. Examples include a catapult, a screen door
close to the force, the lever produces speed and range of operated by a short spring, and the application of lifting force to a shovel
motion (e.g., the triceps in elbow extension). When the axis is handle with the lower hand while the upper hand on the shovel handle
close to the resistance, the lever produces force motion (e.g., a serves as the Chapter
crowbar).
In applying the principle of levers to the body, it is important

to remember that the force is applied where the muscle inserts
3
axis of rotation. The biceps brachii is a typical example in the body.
Using the elbow joint ( A)
in the bone, not in the belly of the muscle. For example, in as the axis, the biceps brachii applies force at its insertion on
elbow extension with the shoulder fully flexed and the arm the radial tuberosity ( F ) to rotate the forearm up, with its center
beside the ear, the triceps applies the force to the olecranon of of gravity ( R) serving as the point of resistance application.
the ulna behind the axis of the elbow joint. As the applied force
exceeds the amount of forearm resistance, the elbow extends. The brachialis is an example of true thirdclass leverage. It
pulls on the ulna just below the elbow, and, since the ulna
cannot rotate, the pull is direct and true. The biceps brachii, on
the other hand, supinates the forearm as it flexes, so the
The type of lever may be changed for a given joint and third-class leverage applies to flexion only.
muscle depending on whether the body segment is in contact
with a surface such as a floor or wall. For example, we have Other examples include the hamstrings contracting to flex
demonstrated that the triceps in elbow extension is a first-class the leg at the knee in a standing position and the iliopsoas being
lever with the hand free in space and the arm pushed away used to flex the thigh at the hip.
from the body. If the hand is placed in contact with the floor, as
in performing a push-up to push the body away from the floor,
the same muscle action at this joint now changes the lever to
Factors in use of anatomical levers
second class, because the axis is at the hand and the
resistance is the body weight at the elbow joint. Our anatomical leverage system can be used to gain a
mechanical advantage that will improve simple or complex
physical movements. Some individuals unconsciously develop
habits of using human levers properly, but frequently this is not
the case.
Second-class levers
A second-class lever (see Fig. 3.2) is designed to produce force Torque and length of lever arms
movements, since a large resistance can be moved by a To understand the leverage system, the concept of torque must
relatively small force. Examples of second-class levers include be understood. Torque , or moment of force, is the turning effect
a bottle opener, a wheelbarrow, and a nutcracker. We have just of an eccentric force.
noted the example of the triceps extending the elbow in a Eccentric force is a force that is applied off center or in a
push-up. A similar example of a second-class lever in the body direction not in line with the center of rotation of an object with a
is plantar flexion of the ankle to raise the body on the toes. The fixed axis. In objects without a fixed axis, it is an applied force
ball ( A) of the foot serves as the axis of rotation as the ankle that is not in line with the object’s center of gravity; for rotation
plantar flexors apply force to the calcaneus ( F ) to lift the to occur, an eccentric force must be applied. In the human
resistance of the body at the tibiofibular articulation ( R) with the body, the contracting muscle applies an eccentric force (not to
talus. Opening the mouth against resistance provides another be confused with eccentric contraction) to the bone on which it
example of a second-class lever. There are relatively few other attaches and causes the bone to rotate about an axis at the
examples of second-class levers in the body. joint. The amount of torque can be determined by multiplying
the force magnitude ( amount of force) by the force arm . The
perpendicular distance between the location of force application
and the axis is known as the force arm, moment arm, or torque
arm. The force arm may be best understood as the shortest
distance from the axis
Third-class levers
Third-class levers (see Fig. 3.3), with the force being applied
between the axis and the resistance,
of rotation to the line of action of the force. The greater the force is applied internally, in musculoskeletal discussions the
distance of the force arm, the more torque produced by the force arm may also be referred to as the internal moment arm;
force. A frequent practical application of torque and levers and because the load is applied externally, the resistance arm
occurs when we purposely increase the force arm length in may be referred to as the external moment arm.
order to increase the torque so that we can more easily move a
relatively large resistance. This is commonly referred to as Also, there is a proportional relationship between the force
increasing our leverage. components and the resistance components. That is, for
pter
movement to occur when either of the resistance components
3 It is also important to note the resistance arm ,

which may be defined as the distance between the axis and the
increases, there must be an increase in one or both of the force
components. See Figs. 3.5, 3.6, and 3.7 to see how these
point of resistance application. In discussing the application of relationships apply to
levers, it is necessary to understand the length relationship
between the two lever arms. There is an inverse relationship
between force and the force arm, just as there is between
resistance and the resistance arm. The longer the force arm, A
Resistance
the less force required to move the lever if the resistance and Force arm = 10 arm = 10
resistance arm remain constant, as shown graphically in Fig.
3.4. In addition, if the force and force arm remain constant, a R
greater resistance may be moved by shortening the resistance
arm. Because the muscular F A
F = 20, R = 20, MA = 1
B
Resistance
Relationships among Force, Force Arm, and Resistance
Force arm = 15 arm = 5
Arm with Constant Resistance of 20 kilograms
21
20 R
19 Resistance arm
18
Force F A
17
16 Force arm
15
F = 13.33, R = 40, MA = 3
14
13
C
12
FA & RA in meters
11 Force
10
9
arm = 5 Resistance arm = 15
8
7
R
6
5
4
F A
3
2
1
0
F = 40, R = 13.33, MA = 0.33
0 1 2 3 4 5 6
Force in newtons FIG. 3.5 • First-class levers. A, If the force arm and resistance arm
are equal in length, a force equal to
FIG. 3.4 • Relationships among forces, force arms, and the resistance is required to balance it; B, As the force arm
resistance arms. (The graph assumes a becomes longer, a decreasing amount of force is required to move
constant resistance of 20 kilograms, and as a result the graphical a relatively larger resistance; C, As the force arm becomes shorter,
representations of the resistance arm and force arm lie directly an increasing amount of force is required to move a relatively
over each other.) With the resistance held constant at 20 smaller resistance, but the speed and range of motion that the
kilograms and a resistance arm of 1 meter, the product of the resistance can be moved are increased. Forces (moments) are
(force) 3 ( force arm) must equal 20 newtons. Thus there is an calculated to balance the lever system. The effort and resistance
inverse relationship between the force and the force arm. As the forces sum to zero. If any of the components are moved in relation
force increases in newtons, the force arm length decreases in to one another, then either a greater force or a greater resistance
meters, and vice versa. will be required.
SEBUAH SEBUAH
Angkatan lengan = 20 Lengan resistansi = 20
Lengan resistansi = 10 Angkatan lengan = 10
R F
F R
F = 10, R = 20, MA = 2 F = 20, R = 10, MA = 0,5 SEBUAH Bab

SEBUAH
B B 3
Lengan resistansi = 20
Angkatan lengan = 20
Memaksa
Perlawanan
lengan = 5
lengan = 5
F R F
R
F = 10, R = 40, MA = 4 SEBUAH
F = 40, R = 10, MA = 0,25 SEBUAH
C C
F R
R F
F = 10, R = 13,33, MA = 1,33 SEBUAH
F = 13,33, R = 10, MA = 0,75 SEBUAH
ARA. 3.6 • Tuas kelas dua memiliki keunggulan mekanis positif

karena selalu menggunakan lengan gaya
ARA. 3.7 • Pengungkit kelas tiga. SEBUAH, Gaya yang lebih
besar dari resistansi, apa pun titiknya
menjadi lebih panjang dari lengan resistansi dan sangat cocok untuk
aplikasi gaya, diperlukan karena lengan tahanan selalu lebih panjang;
memindahkan resistansi yang lebih besar dengan gaya yang lebih kecil. SEBUAH,
B, Memindahkan aplikasi titik gaya lebih dekat ke sumbu
Menempatkan resistansi setengah jalan antara sumbu dan aplikasi titik
meningkatkan jangkauan gerak dan kecepatan tetapi membutuhkan
gaya memberikan keuntungan mekanis 2; B, Memindahkan resistansi lebih
lebih banyak gaya; C, Memindahkan aplikasi titik gaya lebih dekat ke
dekat ke sumbu meningkatkan keuntungan mekanis tetapi mengurangi
resistansi akan mengurangi gaya yang dibutuhkan tetapi juga
jarak perpindahan resistansi;
mengurangi kecepatan dan rentang gerak. Gaya (momen) dihitung
untuk menyeimbangkan sistem tuas. Upaya dan kekuatan
C, Semakin dekat resistansi diposisikan ke titik penerapan gaya,
perlawanan berjumlah nol. Jika salah satu komponen dipindahkan
semakin kecil keuntungan mekanisnya tetapi semakin besar jarak
dalam kaitannya satu sama lain, maka diperlukan gaya yang lebih
resistansi dipindahkan. Gaya (momen) dihitung untuk
besar atau hambatan yang lebih besar.
menyeimbangkan sistem tuas. Upaya dan kekuatan perlawanan
berjumlah nol. Jika salah satu komponen dipindahkan dalam kaitannya
satu sama lain, maka diperlukan gaya yang lebih besar atau hambatan
yang lebih besar.
pengungkit kelas pertama, kedua, dan ketiga, masing-masing. otot-otot yang bekerja pada persendian. Dalam Contoh B, kita dapat dan
Bahkan sedikit variasi dalam lokasi gaya dan hambatan penting sering kali memperpendek lengan tahanan untuk meningkatkan
dalam menentukan keunggulan mekanis (MA) dan gaya efektif kemampuan kita untuk menggerakkan suatu objek. Saat mencoba beban
otot. Hal ini dapat diilustrasikan dengan rumus sederhana yang maksimal dalam latihan biceps curl, kita mungkin melepaskan pergelangan
ditunjukkan pada Gambar 3.8, menggunakan otot biseps brachii tangan untuk memindahkan beban sedikit lebih dekat, yang
di setiap contoh. memperpendek lengan tahanan. Contoh C sangat mudah karena kita jelas
dapat mengurangi gaya yang dibutuhkan dengan mengurangi hambatan.
Dalam Contoh A, satu-satunya cara untuk memindahkan
3 penyisipan bisep brakii adalah dengan pembedahan, jadi ini

tidak praktis. Dalam beberapa kondisi ortopedi, perlekatan Sistem pengungkit dalam tubuh manusia dibangun untuk
tendon dipindahkan melalui pembedahan untuk mengubah kecepatan dan jangkauan gerak dengan mengorbankan gaya.
gaya dinamis Lengan gaya pendek dan lengan tahan panjang membutuhkan
kekuatan otot yang besar untuk menghasilkan gerakan. Di
lengan bawah, perlekatan otot bisep dan trisep dengan jelas
Persamaan tuas untuk anak yang melakukan bisep ikal
menggambarkan hal ini, karena lengan gaya bisep adalah 1
Persamaan tuas
hingga 2 inci dan trisep kurang dari 1 inci. Banyak contoh
F x FA = R x RA serupa ditemukan di seluruh tubuh. Dari sudut pandang praktis,
(Memaksa) x (Angkatan = (Resistensi) x (Resistensi ini berarti bahwa sistem otot harus kuat untuk mensuplai tenaga
lengan) lengan)
yang diperlukan untuk pergerakan tubuh, terutama dalam
Contoh Awal
aktivitas olahraga yang berat.
F x 0,1 = 45 newton x 0,25 meter F x 0,1 =
11,25 newton-meter
F = 112,5 newton
Ketika kita berbicara tentang pengaruh manusia dalam kaitannya
Contoh A - Memperpanjang lengan gaya dengan keterampilan olahraga, biasanya kita mengacu pada beberapa
pengungkit. Misalnya, melempar bola melibatkan tuas di sendi bahu,
Tingkatkan FA dengan menggerakkan penyisipan ke arah distal 0,05 meter:
siku, dan pergelangan tangan serta dari bawah ke atas melalui
ekstremitas bawah dan batang tubuh. Bahkan bisa dikatakan ada satu
F x 0,15 = 45 newton x 0,25 meter F x 0,15 =
11,25 newton-meter tuas yang panjang dari kaki hingga tangan.
F = 75 newton
Peningkatan penyisipan dari sumbu sebesar 0,05 meter menghasilkan Semakin panjang tuasnya, semakin efektif tuasnya dalam memberikan
pengurangan yang substansial dalam gaya yang diperlukan untuk kecepatan. Seorang pemain tenis dapat memukul bola tenis lebih keras
menggerakkan tahanan. (memberikan lebih banyak kekuatan padanya) dengan penggerak lengan
lurus daripada dengan siku tertekuk, karena tuas (termasuk raket) lebih
Contoh B - Memperpendek lengan tahanan
panjang dan bergerak lebih cepat.
Kurangi RA dengan menggerakkan aplikasi titik resistansi
secara proksimal 0,05 meter: Gbr. 3.9 menunjukkan bahwa tuas yang lebih panjang (Z1) bergerak lebih
F x 0,1 = 45 newton x 0,2 meter F x 0,1 = 9 cepat daripada tuas yang lebih pendek (S1) dalam menempuh jumlah derajat
newton-meter yang sama. Dalam kegiatan olahraga yang memungkinkan untuk menambah
F = 90 newton
panjang tuas dengan raket atau pemukul, prinsip yang sama berlaku.
Penurunan aplikasi tahanan dari sumbu sebesar 0,05 meter
menghasilkan pengurangan gaya yang diperlukan untuk
menggerakkan tahanan. Dalam bisbol, hoki, golf, hoki lapangan, dan olahraga lainnya,
pengungkit yang panjang menghasilkan gaya yang lebih linier dan
Contoh C - Mengurangi resistansi dengan demikian kinerja lebih baik. Namun, untuk dapat
sepenuhnya mengeksekusi gerakan dalam waktu sesingkat
Kurangi R dengan mengurangi resistansi 1 newton:
mungkin, terkadang diinginkan untuk memiliki lengan tuas yang
F x 0,1 = 44 newton x 0,25 meter F x 0,1 = 11 pendek. Misalnya, penangkap bisbol yang mencoba melempar pelari
newton-meter keluar di base kedua tidak harus melempar bola agar bergerak
F = 110 newton secepat pelempar mencoba melakukan pukulan. Dalam kasus
Menurunkan jumlah hambatan dapat menurunkan jumlah gaya yang penangkap, lebih penting untuk memulai dan menyelesaikan
dibutuhkan untuk menggerakkan tuas.
lemparan secepat mungkin daripada memberikan kecepatan
sebanyak mungkin ke bola. Pitcher, ketika mencoba melempar bola
ARA. 3.8 • Perhitungan torsi dengan contoh modifikasi pada
dengan kecepatan lebih dari 90 mil per jam, akan melakukannya
lengan gaya, lengan tahanan, dan
perlawanan.
Z1 roda dan poros untuk bertindak sebagai tuas kelas dua untuk mendapatkan
gerakan gaya.
__f _ whee_l
Keuntungan mekanis = _ra_d_i_u_s_o _______
jari-jari poros
S1 Dalam hal ini keuntungan mekanis selalu lebih dari 1. Penerapan

contoh ini menggunakan bagian terluar sebuah mobil Bab
3
setir untuk memutar mekanisme kemudi. Sebelum pengembangan
power steer-
Namun, roda kemudi memiliki diameter yang jauh lebih besar dari
z
s sekarang untuk memberi pengemudi lebih banyak keuntungan
x mekanis. Contoh dalam tubuh yang menerapkan gaya pada roda

terjadi ketika kita mencoba memaksa bahu seseorang secara
manual ke rotasi internal saat dia memegangnya dalam rotasi
ARA. 3.9 • Panjang tuas. Ujung tuas yang lebih panjang (Z1) bergerak lebih eksternal secara isometrik. Humerus bertindak sebagai poros, dan
cepat daripada tuas yang lebih pendek (S1) tangan serta pergelangan tangan orang tersebut terletak di dekat
ketika dipindahkan dengan jumlah derajat yang sama dalam jumlah waktu bagian luar roda saat siku diangkat kira-kira 90 derajat. Jika kita
yang sama. Semakin jauh resistansi dari sumbu, semakin jauh ia digerakkan gagal mencoba untuk mematahkan kekuatan kontraksi rotator
dan semakin banyak gaya yang disalurkan, mengakibatkan resistansi
eksternal dengan mendorong secara internal di lengan bawah, kita
bergerak dengan kecepatan yang lebih besar. Prinsip yang sama berlaku
dapat meningkatkan daya ungkit atau keuntungan mekanis dan
dalam olahraga di mana dimungkinkan untuk menambah panjang tuas
kemungkinan keberhasilan kita dengan menerapkan gaya lebih
dengan raket atau pemukul.
dekat ke tangan dan pergelangan tangan.
memanfaatkan tubuhnya sebagai sistem tuas yang lebih panjang di seluruh

rentang gerakan yang lebih besar untuk memberikan kecepatan pada bola.
5 '' Jari-jari roda 5 '' Jari-jari roda
Jari-jari poros 1 '' Jari-jari poros 1 ''
Roda dan as
Roda dan as digunakan terutama untuk meningkatkan rentang
gerak dan kecepatan gerakan dalam sistem muskuloskeletal.
Roda dan poros pada dasarnya berfungsi sebagai bentuk
pengungkit. Saat roda atau porosnya berputar, yang lain juga Memutar poros memberikan
Memutar roda memberikan keuntungan keuntungan kecepatan dan rentang
harus berputar. Keduanya menyelesaikan satu putaran pada gerak gaya karena mampu menerapkan gerak karena mampu menggerakkan
saat bersamaan. Bagian tengah roda dan poros keduanya gaya yang relatif kecil untuk bagian luar roda lebih jauh pada
menggerakkan tahanan yang lebih besar. kecepatan putaran poros.
sesuai dengan titik tumpu. Jari-jari roda dan sumbu sama
dengan lengan gaya. Jika jari-jari roda lebih besar dari jari-jari
sumbu roda, maka roda memiliki keunggulan mekanis Angkatan lengan = 5 Angkatan lengan = 1
dibandingkan sumbu karena gaya lengan yang lebih panjang. Lengan resistensi = 1 Lengan resistansi = 5
Keuntungan mekanis = 5 Kelas Keuntungan mekanis = 0,20 Kelas
Artinya, gaya yang relatif lebih kecil dapat diterapkan pada roda pengungkit = ke-2 pengungkit = 3
untuk menggerakkan resistansi yang relatif lebih besar yang
SEBUAH B
diterapkan pada poros. Sederhananya, jika jari-jari roda lima
kali lipat jari-jari poros, kemudian roda memiliki keunggulan
mekanis 5 banding 1 dibandingkan porosnya, seperti yang
ARA. 3.10 • Roda dan poros. SEBUAH, Keuntungan mekanis diperoleh
dengan menerapkan gaya ke luar
ditunjukkan pada Gambar 3.10. Keuntungan mekanis roda dan
roda untuk lebih mudah memindahkan resistansi besar;
poros untuk skenario ini dapat dihitung dengan
B, Keuntungan mekanis dalam menerapkan gaya pada sumbu selalu kurang
mempertimbangkan jari-jari roda di atas jari-jari poros. Aplikasi
dari 1 dan membutuhkan gaya yang relatif besar, tetapi keuntungannya
ini memungkinkan
adalah dapat menggerakkan roda yang lebih besar dengan jarak yang relatif
lebih jauh dengan kecepatan yang relatif lebih besar daripada sumbu.
Jika penerapan gaya dibalik sehingga diterapkan pada Dalam tubuh manusia, contoh yang sangat baik diberikan
poros, maka keuntungan mekanis dihasilkan dari putaran roda oleh maleolus lateral, yang bertindak sebagai katrol di mana
yang lebih jauh dengan kecepatan yang lebih besar. tendon peroneus longus berjalan. Saat otot ini berkontraksi, ia
Menggunakan contoh yang sama, jika jari-jari roda lima kali menarik ke arah perutnya, yang mengarah ke lutut. Karena
lebih besar dari jari-jari sumbu, bagian luar roda akan berputar penggunaan malleolus lateral sebagai katrol (Gbr. 3.12), gaya
dengan kecepatan lima kali lipat kecepatan sumbu. Selain itu, ditransmisikan ke aspek plantar kaki, mengakibatkan gerakan
jarak putaran luar roda akan menjadi lima kali lipat jarak bagian kaki ke bawah dan ke luar. Contoh lain dalam tubuh manusia
luar poros. Aplikasi ini memungkinkan roda dan poros bertindak termasuk katrol pada aspek volar falang untuk mengarahkan
3 sebagai tuas kelas tiga untuk mendapatkan kecepatan dan

rentang gerak. Keuntungan mekanis roda dan poros untuk
gaya tendon fleksor.
skenario ini dapat dihitung dengan mempertimbangkan jari-jari

poros di atas jari-jari roda.
Keuntungan mekanis = _r_a_d_i_u_s_o_f__th_e__a_x_l_e_

radius roda
MA = 1 MA = 2
Dalam hal ini keuntungan mekanis selalu kurang dari 1. Ini
adalah prinsip yang digunakan dalam drivetrain sebuah mobil
untuk memutar poros, yang selanjutnya memutar ban satu
putaran untuk setiap putaran poros. Kami menggunakan mesin
mobil yang bertenaga untuk memasok tenaga guna
meningkatkan kecepatan ban dan selanjutnya membawa kami
dalam jarak yang jauh. Contoh otot yang menerapkan gaya ke
50 50 kg
poros untuk menghasilkan rentang gerak dan kecepatan yang kg bobot 25
50 kg
lebih besar dapat dilihat lagi di ekstremitas atas, dalam kasus kg
bobot
rotator internal yang menempel pada humerus. Dengan humerus
yang bertindak sebagai poros dan tangan serta pergelangan SEBUAH B
tangan terletak di luar roda (saat siku diangkat kira-kira 90
derajat), rotator internal memberikan gaya pada humerus. ARA. 3.11 • SEBUAH, Katrol tunggal; B, Katrol bergerak
Dengan rotator internal yang secara konsentris memutar humerus majemuk.
secara internal dalam jumlah yang relatif kecil, tangan dan
pergelangan tangan akan menempuh jarak yang sangat jauh.
Menggunakan roda dan poros dengan cara ini memungkinkan
kita untuk secara signifikan meningkatkan kecepatan melempar
benda.
Katrol
Katrol tunggal memiliki poros tetap dan berfungsi untuk mengubah
arah efektif penerapan gaya. Katrol tunggal memiliki keuntungan
mekanis 1, seperti yang ditunjukkan pada Gambar 3.11, SEBUAH. Banyak
mesin berat menggunakan katrol untuk mengubah arah gaya
resistif. Katrol dapat digerakkan dan dapat digabungkan untuk
membentuk katrol majemuk untuk lebih meningkatkan keuntungan
mekanis. Setiap tali tambahan yang dihubungkan ke katrol bergerak
meningkatkan keuntungan mekanis sebesar 1, seperti yang
ditunjukkan pada Gambar 3.11, B.
ARA. 3.12 • Katrol. Maleolus lateral berfungsi sebagai katrol untuk
tendon peroneus longus.
Hukum gerak dan aktivitas fisik

Gerak merupakan hal mendasar dalam pendidikan jasmani dan
aktivitas olahraga. Gerak tubuh umumnya dihasilkan, atau
setidaknya dimulai, oleh suatu tindakan sistem otot. Gerakan tidak
dapat terjadi tanpa suatu gaya, dan sistem otot adalah sumber
tenaga dalam tubuh manusia. Dengan demikian, pengembangan
sistem otot sangat diperlukan untuk gerakan. Bab
Pada dasarnya ada dua jenis gerak: gerakan linier dan gerakan
3
sudut . Gerak linier, disebut juga gerak penerjemahan, adalah
gerak sepanjang garis. Jika gerakannya di sepanjang garis
lurus, itu benar seperti garis lurus gerak, sedangkan gerak
sepanjang garis lengkung dikenal sebagai lengkung gerakan.
Gerakan sudut, juga dikenal sebagai gerakan berputar,
melibatkan rotasi di sekitar sumbu. Dalam tubuh manusia, ARA. 3.13 • Jalur pusat rotasi sesaat untuk lutut selama ekstensi.
sumbu rotasi disediakan oleh berbagai sendi. Dalam arti
tertentu, kedua jenis gerakan ini saling terkait, karena gerakan
sudut sendi dapat menghasilkan gerakan berjalan linier. Dalam
banyak aktivitas olahraga, gerakan sudut kumulatif sendi tubuh Pemindahan adalah perubahan posisi atau letak suatu objek
memberikan gerakan linier ke objek yang dilempar (bola, dari titik acuan aslinya, sedangkan jarak , atau jalur pergerakan,
tembakan) atau objek yang dipukul dengan instrumen adalah jumlah panjang sebenarnya yang diukur untuk
(pemukul, raket). Penting juga untuk mempertimbangkan file pusat menempuh perjalanan. Jadi sebuah benda mungkin telah
rotasi , yang merupakan titik atau garis di mana semua titik lain menempuh jarak 10 meter di sepanjang jalur linier dalam dua
dalam tubuh bergerak. Dalam engsel pintu, sumbu rotasi arah atau lebih, tetapi dipindahkan dari titik referensi aslinya
ditetapkan dan semua titik pintu memiliki busur rotasi yang hanya sejauh 6 meter. Gambar 3.14 memberikan contoh. Perpindahan
sama di sekitar bagian tengah engsel. Tetapi pada sendi-sendi sudut adalah perubahan lokasi tubuh yang berputar. Perpindahan
tubuh, sumbu biasanya tidak tetap, karena gerakan asesorisnya linier
seperti yang didiskusikan pada Bab 1. Akibatnya, lokasi dari
pusat rotasi berubah seiring perubahan sudut sendi. Jadi kita adalah jarak yang ditempuh sistem dalam garis lurus.
harus mempertimbangkan
SEBUAH
pusat rotasi sesaat , yang merupakan pusat rotasi pada saat 4.24
3
tertentu selama pergerakan. Lihat Gambar 3.13.
Pengukuran kuantitas — skalar versus vektor B 3 C
Untuk membahas ukuran-ukuran gerak, kami menugaskan

mereka sejumlah ukuran. Besaran matematis yang digunakan
untuk mendeskripsikan gerakan dapat dibagi menjadi skalar ARA. 3.14 • Pemindahan. Jika jalur pergerakan dari A ke B dan
atau vektor. Skalar Kuantitas dijelaskan dengan besaran (atau kemudian dari B ke C, jaraknya
tertutup AB 1 BC, tetapi perpindahannya adalah jarak dari A ke C,
nilai numerik) saja, seperti kecepatan dalam mil per jam atau
atau AC. Jika setiap sel berukuran 1 meter persegi, maka AB
meter per detik. Besaran skalar lainnya adalah panjang, luas,
adalah 3 meter dan BC adalah 3 meter, sehingga jarak yang
volume, massa, waktu, massa jenis, suhu, tekanan, energi,
ditempuh adalah 6 meter. Menggunakan Teorema Pythagoras
kerja, dan daya. Vektor
(dalam segitiga siku-siku, kuadrat ukuran hipotenusa sama dengan
jumlah kuadrat ukuran kaki, atau Sebuah 2 1 b 2 5 c 2), Kemudian kita
besaran dijelaskan oleh besaran dan arah, seperti kecepatan
dapat menentukan perpindahan (AC) menjadi 4,24 meter dengan
dalam mil per jam ke arah timur. Besaran vektor lainnya adalah
AB 2 1 SM 2 5 AC 2.
percepatan, arah, perpindahan, gaya, gaya hambat,
momentum, gaya angkat, berat, dan gaya dorong.
Kami terkadang khawatir tentang waktu yang dibutuhkan agar

perpindahan terjadi. Mempercepat adalah seberapa cepat suatu
benda bergerak, atau jarak suatu benda bergerak dalam jumlah waktu
tertentu. Kecepatan , tingkat di mana suatu benda mengubah
posisinya, termasuk arah dan menggambarkan tingkat perpindahan.
Tinjauan singkat tentang hukum gerak Newton akan

menunjukkan banyak aplikasi hukum ini untuk kegiatan
3 pendidikan jasmani dan olahraga. Hukum Newton menjelaskan

semua karakteristik gerak, dan merupakan dasar untuk
memahami gerakan manusia.
Hukum inersia
Sebuah benda yang bergerak cenderung tetap bergerak dengan
ARA. 3.15 • Contoh hukum gerak pertama Newton. Pemain ski
kecepatan yang sama dalam garis lurus kecuali jika dipengaruhi oleh terus mengudara di luar angkasa
suatu gaya; tubuh saat istirahat cenderung tetap diam kecuali jika karena inersia yang terbentuk sebelumnya.
ditindaki oleh suatu kekuatan.
Kelembaman dapat digambarkan sebagai perlawanan terhadap tindakan
atau perubahan. Dalam hal pergerakan manusia, aktivitas akan sangat mahal untuk cadangan energi. Hal ini sebagian
kelembaman mengacu pada resistensi terhadap akselerasi atau menjelaskan mengapa aktivitas seperti bola tangan dan bola basket
deselerasi. Inersia adalah kecenderungan keadaan gerak saat ini jauh lebih melelahkan daripada joging dan menari.
untuk dipertahankan, baik segmen benda bergerak dengan

kecepatan tertentu atau tidak bergerak.
Hukum percepatan
Otot menghasilkan gaya yang diperlukan untuk memulai gerakan, Perubahan percepatan benda terjadi ke arah yang sama
menghentikan gerakan, mempercepat gerakan, memperlambat gerakan, dengan gaya yang menyebabkannya. Perubahan percepatan
atau mengubah arah gerakan. Dengan kata lain, kelembaman adalah berbanding lurus dengan gaya yang menyebabkannya dan
keengganan untuk mengubah status; hanya kekuatan yang bisa berbanding terbalik dengan massa benda.
melakukannya. Semakin besar massa suatu benda, semakin besar
kelembamannya. Oleh karena itu, semakin besar massanya, semakin Percepatan dapat didefinisikan sebagai laju perubahan kecepatan.
besar gaya yang dibutuhkan untuk secara signifikan mengubah inersia Untuk mencapai kecepatan dalam menggerakan tubuh, biasanya
suatu benda. Banyak contoh undang-undang ini ditemukan dalam diperlukan suatu gaya otot yang kuat. Massa , jumlah materi dalam tubuh,
kegiatan pendidikan jasmani. Seorang sprinter di blok start harus mempengaruhi kecepatan dan percepatan gerakan fisik. Tenaga yang jauh
memberikan tenaga yang cukup besar untuk mengatasi inersia istirahat. lebih besar dibutuhkan dari otot untuk mempercepat pria berbobot 80
Pelari di lintasan dalam ruangan harus mengerahkan tenaga yang cukup kilogram daripada mempercepat pria 58 kilogram dengan kecepatan lari
besar untuk mengatasi kelembaman bergerak dan berhenti sebelum yang sama. Juga, dimungkinkan untuk mempercepat sebuah bola bisbol
menabrak dinding. Gbr. 3.15 memberikan contoh bagaimana pemain ski lebih cepat daripada sebuah tembakan karena perbedaan massa. Gaya
yang sedang bergerak tetap bergerak meskipun mengudara setelah yang dibutuhkan untuk berlari dengan kecepatan setengah kurang dari
bermain ski dari bukit. Kita secara rutin mengalami gaya inersia ketika gaya yang dibutuhkan untuk berlari dengan kecepatan tertinggi. Untuk
tubuh bagian atas kita cenderung bergerak maju jika kita mengendarai memberikan kecepatan pada bola atau benda, perlu dilakukan percepatan
mobil pada batas kecepatan lalu tiba-tiba harus melambat. Bola dan dengan cepat pada bagian tubuh yang menahan benda tersebut. Sepak
benda lain yang terlempar atau dipukul membutuhkan tenaga untuk bola, bola basket, trek, dan hoki lapangan adalah beberapa olahraga yang
menghentikannya. Memulai, menghentikan, dan mengubah arah — menuntut kecepatan dan akselerasi.
bagian dari banyak aktivitas fisik — memberikan banyak contoh hukum

kelembaman yang diterapkan pada gerakan tubuh.
Hukum reaksi
Untuk setiap tindakan ada reaksi yang berlawanan dan setara.
Karena gaya diperlukan untuk mengubah kelembaman, jelas bahwa
setiap aktivitas yang dilakukan dengan kecepatan tetap dalam arah yang Saat kita menempatkan gaya pada permukaan pendukung dengan
konsisten akan menghemat energi dan bahwa setiap langkah atau arah berjalan di atasnya, permukaan tersebut memberikan resistansi yang sama
yang tidak teratur. kembali ke arah yang berlawanan dengan
SEBUAH B C D
5k
g
5 kg
10 kg 5 kg 5 kg 5 kg
Statis Kinetis Berguling

gesekan gesekan gesekan
Bab
ARA. 3.17 • Gesekan. SEBUAH, Friksi statis; B, Gesekan statis juga, tetapi kurang dari pada SEBUAH
karena ada lebih sedikit 3
massa (berat); C, Gesekan kinetik selalu lebih kecil dari gesekan statis; D, Gesekan
gelinding selalu lebih kecil dari gesekan kinetik.
ARA. 3.16 • Contoh hukum gerak ketiga Newton. Untuk

mempercepat ke depan, pejalan harus mendorong
ke belakang. Perhatikan bahwa bagian depan tapak di pasir lebih
tertekan daripada bagian belakang. mulai bergerak, sedangkan gesekan kinetik adalah gesekan antara
dua benda yang saling bergesekan. Gesekan statis selalu lebih
besar dari gesekan kinetik. Akibatnya, selalu lebih sulit untuk
telapak kaki kita. Kaki kita mendorong ke bawah dan ke belakang, memulai menyeret objek melintasi permukaan daripada terus
sedangkan permukaan mendorong ke atas dan ke depan. Gaya menyeretnya. Gesekan statis dapat ditingkatkan dengan
permukaan yang bereaksi terhadap gaya yang kita tempatkan di atasnya meningkatkan gaya normal atau tegak lurus yang menekan kedua
disebut sebagai gaya reaksi tanah . benda bersama-sama, seperti dengan menambahkan lebih banyak
Kami menyediakan gaya aksi, sedangkan permukaan beban ke satu benda yang duduk di atas benda lain. Untuk
menyediakan gaya reaksi. Lebih mudah berlari di trek yang menentukan besarnya gaya gesek, kita harus mempertimbangkan
keras daripada di pantai berpasir karena perbedaan gaya reaksi gaya yang menekan kedua benda bersama dan gaya koefisien
tanah dari kedua permukaan. Trek menahan tenaga penggerak gesekan , yang tergantung pada kekerasan dan kekasaran tekstur
pelari, dan reaksinya mendorong pelari ke depan. Pasir permukaan. Koefisien gesekan adalah rasio gaya yang dibutuhkan
menghilangkan gaya pelari, dan gaya reaksi juga berkurang, untuk mengatasi gesekan dengan gaya yang menahan permukaan. Gesekan
dengan hilangnya gaya maju dan kecepatan (Gbr. 3.16). Pelari bergulir ( Gambar 3.17, D) adalah resistansi terhadap benda yang
cepat menerapkan gaya lebih dari 1335 Newton pada balok berguling di permukaan, seperti bola yang menggelinding di
awal, yang menahan dengan gaya yang sama. Ketika suatu lapangan atau ban yang menggelinding di tanah. Gesekan guling
benda terbang, seperti dalam lompatan, gerakan satu bagian selalu jauh lebih kecil daripada gesekan statis atau kinetik.
tubuh menghasilkan reaksi di bagian lain karena tidak ada
permukaan resistif yang menyuplai gaya reaksi.
Keseimbangan, keseimbangan, dan stabilitas

Gesekan
Keseimbangan adalah kemampuan untuk mengontrol
Gesekan adalah gaya yang dihasilkan dari resistansi antara keseimbangan, baik statis maupun dinamis. Sehubungan dengan
permukaan dua benda yang bergerak satu sama lain. Bergantung pergerakan manusia, keseimbangan mengacu pada keadaan
pada aktivitas yang terlibat, kita mungkin menginginkan peningkatan percepatan nol, di mana tidak ada perubahan kecepatan atau arah
atau penurunan gesekan. Dalam berlari, kita bergantung pada gaya benda. Kesetimbangan dapat berupa statis atau dinamis. Jika
gesekan antara kaki kita dan tanah sehingga kita dapat mengerahkan tubuh diam atau tidak bergerak sama sekali, itu masuk keseimbangan
tenaga ke tanah dan mendorong diri kita sendiri ke depan. Jika statis . Ekuilibrium dinamis terjadi
gesekan berkurang karena permukaan licin atau sepatu, kita
cenderung tergelincir. Dalam skating, kami menginginkan ketika semua gaya yang diterapkan dan gaya inersia yang bekerja pada
pengurangan gesekan sehingga kami dapat meluncur di atas es benda yang bergerak seimbang, menghasilkan gerakan dengan
dengan sedikit hambatan. Gesekan selanjutnya dapat dicirikan kecepatan atau arah yang tidak berubah. Agar kita dapat mengontrol
sebagai statis atau kinetik. Lihat Gambar 3.17, A, B, dan C. Friksi keseimbangan dan karenanya mencapai keseimbangan, kita perlu
statis adalah besarnya gesekan antara dua benda yang belum memaksimalkan stabilitas . Stabilitas adalah resistensi terhadap
perubahan percepatan tubuh atau, lebih tepatnya, resistensi terhadap
gangguan keseimbangan tubuh. Stabilitas dapat ditingkatkan 5. Seseorang memiliki keseimbangan tergantung di mana pusat
dengan menentukan tubuh gravitasi dalam kaitannya dengan dasar penyangga.
Pusat gravitasi dan mengubahnya dengan tepat. Pusat gravitasi Keseimbangan berkurang jika pusat gravitasi berada di dekat
adalah titik di mana semua massa dan berat benda seimbang tepi alas. Namun, ketika mengantisipasi gaya yang datang,
atau merata ke segala arah. Secara umum, pusat gravitasi stabilitas dapat ditingkatkan dengan menempatkan pusat
manusia terletak di sekitar umbilikus. gravitasi lebih dekat ke sisi alas penyangga yang diharapkan
menerima gaya.
3 Keseimbangan penting untuk tubuh istirahat serta untuk tubuh

yang bergerak. Umumnya, keseimbangan diinginkan, tetapi ada
6. Untuk mengantisipasi gaya yang akan datang, stabilitas
dapat ditingkatkan dengan memperbesar ukuran alas
keadaan di mana gerakan meningkat ketika tubuh cenderung penyangga ke arah gaya yang diantisipasi.
tidak seimbang. Berikut adalah faktor umum tertentu yang berlaku
untuk meningkatkan keseimbangan, memaksimalkan stabilitas, 7. Keseimbangan dapat ditingkatkan dengan meningkatkan
dan pada akhirnya mencapai keseimbangan. gesekan antara benda dan permukaan yang dihubunginya.
8. Rotasi tentang sumbu membantu keseimbangan. Sepeda yang

1. Seseorang memiliki keseimbangan ketika pusat gravitasi
bergerak lebih mudah untuk diseimbangkan daripada sepeda statis.
berada dalam dasar penyangga (Gbr. 3.18).
9. Fungsi fisiologis kinestetik berkontribusi pada keseimbangan.
Saluran setengah lingkaran dari telinga bagian dalam, penglihatan,
2. Seseorang memiliki keseimbangan dalam proporsi langsung dengan
sentuhan (tekanan), dan indra kinestetik semuanya memberikan
ukuran alasnya. Semakin besar basis dukungan, semakin banyak
informasi keseimbangan kepada pemain. Keseimbangan dan
keseimbangan.
komponen keseimbangan dan stabilitasnya sangat penting dalam
3. Seseorang memiliki keseimbangan tergantung dari berat
semua gerakan. Semua dipengaruhi oleh gaya gravitasi yang
(massanya). Semakin besar bobotnya, semakin seimbang.
konstan, serta oleh kelembaman. Berjalan digambarkan sebagai
4. Seseorang memiliki keseimbangan tergantung pada ketinggian
aktivitas di mana seseorang melempar tubuh ke dalam dan ke luar
pusat gravitasi. Semakin rendah pusat gravitasi, semakin
keseimbangan dengan setiap langkah. Dalam gerakan lari cepat di
seimbang.
mana inersia bergerak tinggi, individu harus menurunkan pusat
gravitasi untuk menjaga keseimbangan saat berhenti atau mengubah
arah. Sebaliknya, dalam aktivitas lompat, individu berusaha
menaikkan pusat gravitasi setinggi mungkin.
SEBUAH C
Memaksa
B
Otot adalah sumber kekuatan utama yang menghasilkan atau
mengubah gerakan suatu segmen tubuh, seluruh tubuh, atau suatu
benda terlempar, dipukul, atau dihentikan. Seperti dibahas
sebelumnya, berbagai faktor mempengaruhi kemampuan otot untuk
mengerahkan kekuatan. Kami jelas perlu memahami berbagai faktor
ini. Dan kita harus memanfaatkan pengetahuan ini dalam mengelola
faktor-faktor dengan benar untuk mengkondisikan otot kita secara
D E
tepat untuk mencapai respons yang diinginkan dalam menghadapi
kekuatan internal dan eksternal. Akibatnya, kita biasanya
ARA. 3.18 • Basis dukungan. Dasar penyangga termasuk menginginkan otot yang lebih kuat agar mampu menghasilkan lebih
bagian tubuh yang bersentuhan dengan
banyak tenaga untuk pengerahan tenaga maksimal dan
permukaan pendukung dan area intervensi. A, B,
berkelanjutan.
dan C, Beban ditopang oleh kaki; D, Beban ditopang oleh dahi dan
tangan selama headstand; E, Beban ditopang oleh tangan dan kaki
Pasukan baik mendorong atau menarik suatu benda untuk
saat tubuh dalam posisi jongkok. Tanda silang yang dilingkari
mempengaruhi gerakan atau bentuk. Tanpa gaya yang bekerja pada
menunjukkan titik perpotongan garis gravitasi dengan alas
suatu benda, tidak ada gerakan. Gaya adalah hasil kali percepatan
penyangga.
waktu massa. Massa segmen tubuh atau seluruh tubuh dikalikan
dengan
kecepatan percepatan menentukan gaya. Jelas, dalam sepak bola

ini sangat penting, namun sama pentingnya dengan aktivitas lain
yang hanya menggunakan sebagian tubuh manusia. Dalam
melempar bola, gaya yang diterapkan pada bola sama dengan
massa lengan dikalikan kecepatan percepatan lengan. Juga,
seperti dibahas sebelumnya, leverage itu penting.
Bongkar Ketegangan Kompresi Mencukur
Bab
Gaya = massa × percepatan

F=m×a
3
Kualitas gerak, atau, lebih ilmiah lagi, momentum , yang sama dengan
kecepatan waktu massa, penting dalam aktivitas keterampilan. Semakin besar Pembengkokan Torsi Gabungan (torsi
momentumnya, semakin besar resistansi terhadap perubahan dalam & kompresi)
kelembaman atau keadaan gerak. Dengan kata lain, orang yang lebih besar
dengan massa lebih besar yang bergerak dengan kecepatan yang sama ARA. 3.19 • Gaya pemuatan mekanis.
dengan orang yang lebih kecil akan memiliki lebih banyak momentum. Di sisi
lain, orang dengan massa lebih sedikit yang bergerak dengan kecepatan lebih
tinggi mungkin memiliki momentum lebih banyak daripada orang dengan Gaya eksternal dihasilkan dari luar tubuh dan berasal dari gravitasi,
massa lebih besar yang bergerak dengan kecepatan lebih rendah. Momentum kelembaman, atau kontak langsung. Semua jaringan, dalam derajat
dapat diubah oleh impuls , yang merupakan produk kekuatan dan waktu. yang berbeda-beda, menolak perubahan bentuknya. Jelas, deformasi
jaringan dapat terjadi akibat gaya eksternal, tetapi kami juga memiliki
kemampuan untuk menghasilkan gaya internal yang cukup besar
Tidak perlu menerapkan gaya maksimal dan dengan demikian untuk mematahkan tulang, mengislokasi sendi, dan mengganggu otot
meningkatkan momentum bola atau benda yang dipukul dalam dan jaringan ikat. Untuk mencegah cedera atau kerusakan akibat
semua situasi. Dalam kinerja yang terampil, pengaturan jumlah deformasi jaringan, kita harus menggunakan tubuh untuk menyerap
kekuatan diperlukan. Penilaian mengenai jumlah kekuatan yang energi baik dari gaya internal maupun eksternal. Sejalan dengan ini,
dibutuhkan untuk melempar softball pada jarak tertentu, memukul adalah keuntungan kita untuk menyerap kekuatan seperti itu pada
bola golf sejauh 200 yard, atau memukul bola tenis melintasi net dan aspek yang lebih besar dari tubuh kita daripada yang lebih kecil, dan
masuk ke lapangan adalah penting. untuk menyebarkan laju penyerapan dalam periode waktu yang lebih
lama. Selain itu, semakin kuat dan sehat kita, semakin besar
Dalam aktivitas yang melibatkan gerakan berbagai sendi, kemungkinan kita mampu menahan beban mekanis yang berlebihan
seperti melempar bola atau menembak, harus ada penjumlahan dan deformasi jaringan yang berlebihan. Ketegangan (peregangan
gaya dari awal gerakan di segmen bawah tubuh hingga atau regangan), kompresi, geser, tekukan, dan torsi (puntiran) adalah
memutar badan dan gerakan di bahu, siku , dan sendi semua gaya yang bekerja secara individual atau dalam kombinasi
pergelangan tangan. Kecepatan pukulan tongkat golf adalah untuk memberikan beban mekanis yang dapat mengakibatkan
hasil penjumlahan kekuatan dari ekstremitas bawah, batang deformasi jaringan yang berlebihan. Gambar 3.19 mengilustrasikan
tubuh, bahu, lengan, dan pergelangan tangan. Melempar peluru gaya mekanis yang bekerja pada jaringan tubuh.
dan lempar cakram dan lembing adalah contoh bagus lainnya
yang menunjukkan bahwa penjumlahan gaya itu penting.
Dasar-dasar pemuatan mekanis Aplikasi fungsional

Saat kita menggunakan sistem muskuloskeletal untuk mengerahkan Dalam pelaksanaan berbagai keterampilan olahraga, banyak
kekuatan pada tubuh untuk bergerak dan berinteraksi dengan tanah penerapan hukum leverage, gerak, dan keseimbangan dapat
dan benda atau orang lain, beban mekanis yang signifikan dihasilkan ditemukan. Keterampilan yang umum dalam banyak aktivitas adalah
dan diserap oleh jaringan tubuh. Gaya yang menyebabkan beban ini melempar. Benda yang dilempar mungkin sejenis bola, tetapi sering
mungkin internal atau eksternal. Hanya otot yang dapat secara aktif kali merupakan benda dengan ukuran atau bentuk lain, seperti batu,
menghasilkan gaya internal, tetapi ketegangan pada tendon, beanbag, Frisbee, discus, atau lembing. Analisis singkat tentang
jaringan ikat, ligamen, dan kapsul sendi dapat secara pasif beberapa prinsip mekanis dasar yang terlibat dalam keterampilan
menghasilkan gaya internal. melempar akan membantu menunjukkan
pentingnya memahami penerapan prinsip-prinsip ini. Banyak aktivitas pengungkit menguntungkan karena membutuhkan lebih sedikit waktu total untuk
yang melibatkan prinsip-prinsip ini dan seringkali prinsip mekanis melepaskan bola.
lainnya. Gerakan adalah dasar untuk melempar ketika gerakan sudut Keseimbangan, atau keseimbangan, adalah faktor dalam
(Gbr. 2.21) dari pengungkit (tulang) tubuh (badan, bahu, siku, dan melempar ketika tubuh diputar ke belakang pada awal lemparan.
pergelangan tangan) digunakan untuk memberikan gerakan linier Gerakan ini menggerakkan tubuh hampir tidak seimbang ke
pada bola saat dilepaskan. belakang, dan keseimbangan kemudian berubah lagi di tubuh
dengan gerakan maju. Keseimbangan kembali dibentuk dengan
Hukum gerak Newton berlaku dalam melempar karena tindak lanjut, ketika kaki direntangkan dan lutut serta batang tubuh
3 inersia individu dan inersia bola (lihat hal. 82) harus diatasi
dengan penerapan gaya. Otot-otot tubuh memberikan tenaga
difleksikan untuk menurunkan pusat gravitasi.
untuk menggerakkan bagian tubuh dan memegang bola di

tangan. Itu hukum percepatan ( Hukum kedua Newton) mulai
Ringkasan
bekerja dengan gaya otot yang diperlukan untuk mempercepat
lengan, pergelangan tangan, dan tangan. Semakin besar gaya Pembahasan sebelumnya adalah gambaran singkat tentang
(percepatan kali massa) yang dihasilkan seseorang, semakin beberapa faktor yang mempengaruhi gerakan. Analisis gerak
cepat lengan akan bergerak dan, dengan demikian, semakin manusia berdasarkan hukum fisika menimbulkan masalah:
besar kecepatan yang akan diberikan ke bola. Reaksi kaki Seberapa komprehensifkah analisis itu? Ini bisa menjadi sangat
terhadap permukaan tempat orang itu berdiri menggambarkan kompleks, terutama ketika gerakan tubuh dikombinasikan dengan
penerapan hukum reaksi . manipulasi objek di tangan yang terlibat dalam melempar,
menendang, memukul, atau menangkap.
Faktor leverage sangat penting dalam melempar bola atau Faktor-faktor ini menjadi terlibat ketika kita mencoba
benda. Untuk semua keperluan praktis, tubuh dari kaki hingga menganalisis aktivitas yang umum untuk program pendidikan
jari-jari dapat dianggap sebagai satu tuas panjang. Semakin jasmani kita — sepak bola, bisbol, bola basket, trek dan lapangan,
panjang tuas, baik dari panjang tubuh alami atau dari gerakan hoki lapangan, dan renang, untuk menyebutkan beberapa. Namun,
tubuh ke posisi mundur yang diperpanjang (seperti dalam untuk memiliki pandangan yang lengkap tentang faktor-faktor mana
melempar softball, dengan perpanjangan sendi bahu dan siku), yang mengendalikan pergerakan manusia, kita harus memiliki
semakin besar busur yang dilaluinya untuk mempercepat dan pengetahuan kerja tentang prinsip fisiologis dan biomekanik
dengan demikian, semakin besar kecepatan yang diberikan ke kinesiologi.
benda yang dilempar.
Di luar cakupan buku ini untuk membuat analisis rinci tentang
Dalam keadaan tertentu, ketika bola akan dilempar hanya kegiatan lain. Beberapa sumber yang mempertimbangkan masalah
dalam jarak pendek, seperti dalam bisbol ketika dilempar oleh tersebut secara rinci tercantum dalam referensi.
penangkap ke dasar, short
TINJAUAN DAN LATIHAN LABORATORIUM
1. Bagan identifikasi komponen tuas
Tentukan dan buat daftar dua contoh praktis pengungkit (dalam tubuh atau kehidupan sehari-hari) untuk setiap kelas pengungkit. Jangan gunakan contoh yang
sudah dibahas dalam bab ini. Untuk setiap contoh, identifikasi gaya, sumbu, dan hambatan. Juga jelaskan keuntungan menggunakan setiap tuas — yaitu, apakah
itu untuk mencapai keseimbangan, gaya, gerakan, kecepatan, atau jangkauan gerak.
Bab
Kelas tuas Contoh Memaksa Sumbu Perlawanan Keuntungan diberikan 3

1st
1st
2nd
2nd
2. Pengungkit anatomi dapat meningkatkan kinerja fisik. Jelaskan Bagan kalkulasi komponen sistem tuas
bagaimana ini terjadi dengan menggunakan informasi yang telah
Anda pelajari sehubungan dengan melempar. Jika otot bisep Komponen tuas Variabel
3. Anda masuk ke lengan bawah 2 inci di bawah siku, jarak dari siku Memaksa Sumbu 25 Tombol
ke telapak tangan adalah 18 inci, dan Anda mengangkat beban Tuas
diterapkan ditempatkan perlawanan FA RA Angkatan MA
kelas
seberat 20 pon, berapa banyak tenaga yang harus dikerahkan di di ditempatkan di
otot Anda untuk mencapai gerakan siku?
Sebuah. 0 2 20
b. 0 9 15
4. Jika berat sebuah benda adalah 50 kilogram dan keuntungan
mekanik Anda adalah 4, berapa gaya yang Anda perlukan untuk
c. 3 17 13
mengangkat benda dengan sistem tuas?
d. 8 4 19
5. Untuk bagan kalkulasi komponen sistem tuas, susun
komponen tuas seperti yang tercantum untuk setiap tugas e. 12 0 18
a. melalui j. Tentukan kelas tuas dan hitung nilai untuk

f. 19 9 3
lengan gaya (FA), lengan tahanan (RA), gaya, dan
keuntungan mekanis (MA). Anda mungkin ingin
g. 16 2 7
menggambar berbagai pengaturan komponen pada
selembar kertas terpisah. h. 13 20 4
saya. 8 17 1
R F j. 20 4 11
SEBUAH
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
6. Kelas tuas apa yang dimaksud dengan roda kemudi mobil?
Setiap garis vertikal pada bilah tuas mewakili titik-titik di mana 7. Sebutkan dua roda dan sumbu berbeda di mana gaya diterapkan
komponen akan disusun, dengan titik akhir kiri mewakili 0 dan ke roda. Dari pengamatan Anda, perkirakan mana dari
titik akhir kanan mewakili 20. keduanya yang memiliki keunggulan mekanis lebih besar.
8. Sebutkan dua roda dan sumbu berbeda di mana gaya diterapkan 14. Identifikasi contoh praktis dari hukum reaksi Newton. Jelaskan
pada sumbu. Dari pengamatan Anda, perkirakan mana dari bagaimana contoh tersebut menggambarkan hukum.
keduanya yang memiliki keunggulan mekanis lebih besar.
15. Jika seorang pemain baseball mencapai triple dan berlari mengitari base
9. Saat mencoba melepas sekrup, apakah lebih mudah menggunakan obeng ke base ketiga, berapa perpindahannya? Petunjuk: Jarak dari setiap
dengan pegangan yang lebih besar pada gagangnya? Mengapa? pangkalan ke pangkalan berikutnya adalah 90 kaki.
10. Jika pemasangan katrol memiliki lima tali pendukung, berapakah MA dari 16. Pilih salah satu kegiatan olahraga dan jelaskan bagaimana adanya
3 11.
pemasangannya?
Berapakah gaya yang dibutuhkan untuk mengangkat suatu

terlalu banyak gesekan menjadi masalah dalam kegiatan tersebut.
benda dalam sistem katrol jika berat benda yang diangkat 17. Pilih aktivitas olahraga dan jelaskan bagaimana kehadiran gesekan
adalah 200 kg dan jumlah tali penopangnya empat? yang terlalu sedikit menjadi masalah dalam aktivitas tersebut.
12. Identifikasi contoh praktis hukum inersia Newton. Jelaskan 18. Dengan menggunakan gaya dasar pembebanan mekanis yaitu
bagaimana contoh tersebut menggambarkan hukum. kompresi, torsi, dan geser, gambarkan setiap gaya dengan
menggunakan contoh dari sepak bola atau bola voli.
13. Identifikasi contoh praktis hukum percepatan Newton. Jelaskan
bagaimana contoh tersebut menggambarkan hukum.
19. Bagan perbandingan tugas hukum gerak
Untuk bagan ini, asumsikan bahwa Anda memiliki keterampilan, kekuatan, dll. Untuk dapat melakukan setiap tugas berpasangan. Lingkari tugas yang akan
lebih mudah dilakukan berdasarkan hukum gerak Newton dan jelaskan alasannya.
Tugas berpasangan Penjelasan
Sebuah.Lempar bola bisbol 60 mph ATAU Lempar bola 60 mph.
b. Menendang bola bowling 40 yard ATAU Menendang bola sepak 40 yard.
c. Pukul bola whifflake di atas pagar 320 yard ATAU Pukul bola bisbol di atas pagar
320 yard.
d. Tangkap tembakan yang dilemparkan pada kecepatan 60 mph ATAU Tangkap softball
yang dilemparkan pada kecepatan 60 mph.
e. Tangani lari punggung seberat 240 pon yang berlari ke arah Anda dengan kecepatan penuh
ATAU Tangani lari punggung seberat 200 pon yang berlari ke arah Anda dengan kecepatan
penuh.
f. Lari lari 40 yard dalam 4,5 detik di lapangan basah ATAU Lari lari 40 yard
dalam 4,5 detik di lapangan kering.
20. Kembangkan proyek khusus dan laporan kelas oleh individu atau p. Seketika y. Restitusi
kelompok kecil siswa tentang analisis mekanis dari semua pusat z. Mempercepat
keterampilan yang terlibat dalam hal berikut: rotasi A A. Berputar
q. Pengaruh bb. Stabilitas
Sebuah. Bola basket g. Golf r. Mengangkat cc. Dorongan
b. Baseball h. Olahraga senam s. Linear DD. Torsi
c. Tarian saya. Sepak bola pemindahan ee. Kecepatan
d. Menyelam j. Renang t. Massa ff. Komposisi vektor Bab
k. Tenis
3
e. Sepak bola u. Momentum gg. Resolusi vektor
f. Hoki lapangan l. Gulat v. Gerakan hh. Bobot
21. Kembangkan proyek jangka dan laporan kelas khusus oleh individu w. Proyektil ii. Kerja
atau kelompok kecil siswa tentang faktor-faktor yang bergerak x. Sudut rebound
berikut:
Sebuah. Percepatan h. Menyeret
22. Kembangkan peragaan, proyek jangka, atau laporan khusus
b. Aerodinamika saya. Keseimbangan
oleh individu atau kelompok kecil siswa mengenai kegiatan
c. Angular j. Memaksa
berikut:
pemindahan k. Gesekan Sebuah. Pengangkatan f. Melompat
d. Keseimbangan l. Gravitasi b. Pelemparan g. Jatuh
e. Basis pendukung m. Hidrodinamika c. Kedudukan h. Duduk
f. Kemampuan mengapung n. Impuls d. Berjalan saya. Mendorong dan menarik
g. Pusat Hai. Kelembaman e. Lari j. Menyolok
gravitasi
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Broer MR, Zernicke RF: Efisiensi pergerakan manusia, ed 3, Piscopo J, Baley J: Kinesiologi: ilmu gerak, New York,
Philadelphia, 1979, Saunders. 1981, Wiley.
Bunn JW: Prinsip ilmiah pembinaan, ed 2, Englewood Cliffs, Prentice KAMI: Prinsip pelatihan atletik: berbasis kompetensi
NJ, 1972, Prentice-Hall. pendekatan, ed 15, New York, 2014, McGraw-Hill.
Cooper JM, Adrian M, Glassow RB: Kinesiologi, ed 5, St. Louis, 1982, Rasch PJ: Kinesiologi dan anatomi terapan, ed 7, Philadelphia, 1989,
Mosby. Lea & Febiger.
Donatelli R, Wolf SL: Biomekanik kaki dan pergelangan kaki, Scott MG: Analisis gerak manusia, ed 2, New York, 1963,
Philadelphia, 1990, Davis. Appleton-Century-Crofts.
Hall SJ: Biomekanik dasar, ed 6, New York, 2012, McGraw-Hill. Segedy A: Efek sendi kawat gigi memicu lonjakan penelitian, Biomekanik,
Hamill J, Knutzen KM: Dasar biomekanik pergerakan manusia, Februari 2005.

ed 3, Baltimore, 2008, Lippincott Williams & Wilkins. Weineck J: Anatomi fungsional dalam olahraga, ed 2, St. Louis, 1990,
Hamilton N, Weimar W, Luttgens K: Kinesiologi: dasar ilmiah dari Mosby.

gerak manusia, ed 12, New York, 2012, McGraw-Hill. WC Whiting, Zermicke R: Biomekanik cedera muskuloskeletal,
Hinson M: Kinesiologi, ed 4, New York, 1981, McGraw-Hill. ed 2, Champaign, IL, 2008, Human Kinetics.
Kegerreis S, Jenkins WL, Malone TR: Cedera lempar, Cedera Olahraga Wirhed R: Kemampuan atletik dan anatomi gerak, ed 3, St. Louis,
Pengelolaan 2: 4, 1989. 2006, Mosby Elsevier.
Kelley DL: Kinesiologi: dasar-dasar deskripsi gerak,

Englewood Cliffs, NJ, 1971, Prentice-Hall.
Kreighbaum E, Barthels KM: Biomekanik: pendekatan kualitatif untuk

mempelajari gerakan manusia, ed 4, New York, 1996, Allyn & Bacon.
Logan GA, McKinney WC: Kinesiologi anatomi, ed 3, New York,

1982, McGraw-Hill.
McCreary EK, Kendall FP, Rodgers MM, Provance PG, Romani Untuk sumber daya tambahan dan daftar situs web terkait,
WA: Otot: menguji dan berfungsi dengan postur dan nyeri, ed 5, Philadelphia, kunjungi www.mhhe.com/floyd19e.
2005, Lippincott Williams & Wilkins.
C HAPTER 4
T DIA S HOULDER G IRDLE
Bab
4
Tujuan
T korset
Dia bahu ekstremitas
seluruh untuk digunakan sebagai alas
atas bergantung pada
j Untuk mengidentifikasi pada kerangka fitur tulang fungsi. Satu-satunya perlekatan ekstremitas atas ke kerangka
penting dari korset bahu aksial adalah melalui skapula dan perlekatannya melalui
klavikula pada sendi sternoklavikularis. Untuk meningkatkan
j Untuk memberi label pada bagan kerangka fitur tulang pemahaman tentang bagaimana sendi bahu dan sisa
penting dari korset bahu ekstremitas atas bergantung pada korset bahu, kita akan
membahasnya secara terpisah dari struktur lainnya.
j Untuk menggambar pada bagan kerangka otot-otot korset
bahu dan menunjukkan gerakan korset bahu menggunakan
panah
Penjelasan singkat tentang tulang terpenting di daerah bahu
akan membantu Anda memahami struktur kerangka dan
j Untuk mendemonstrasikan, menggunakan subjek manusia, hubungannya dengan sistem otot.
semua gerakan korset bahu dan daftar bidang gerakan
masing-masing dan sumbu rotasinya
Tulang
j Untuk meraba otot-otot korset bahu pada subjek manusia dan Dua tulang terutama terlibat dalam gerakan korset bahu. Mereka
membuat daftar antagonisnya adalah skapula dan klavikula, yang umumnya bergerak sebagai
satu kesatuan. Tautan tulang satu-satunya ke kerangka aksial
j Untuk meraba sendi korset bahu pada subjek manusia
disediakan oleh artikulasi klavikula dengan sternum. Penanda
selama setiap gerakan melalui berbagai gerakan
tulang kunci untuk mempelajari korset bahu adalah manubrium,
klavikula, proses korakoid, proses akromion, fossa glenoid,
j Untuk menentukan, melalui analisis, gerakan korset bahu batas lateral, sudut inferior, batas medial, sudut superior, dan
dan otot yang terlibat dalam keterampilan dan latihan yang tulang belakang skapula (Gambar 4.1, 4.2, 4.3, dan 4.4).
dipilih
Sendi
Saat menganalisis gerakan bahu girdle (scapulothoracic), penting
Sumber Daya Pusat Pembelajaran Online untuk disadari bahwa skapula bergerak pada tulang rusuk sebagai
konsekuensi dari gerakan sendi yang benar-benar terjadi pada sendi
sternoklavikularis dan pada tingkat yang lebih rendah pada sendi
fl oyd19e untuk informasi tambahan dan bahan pelajaran untuk bab ini, akromioklavikularis (lihat Gambar 4.1 dan 4.3) ).
termasuk:
Sternoclavicular (SC)
j Kuis penilaian mandiri
j Kartu anatomi Ini diklasifikasikan sebagai sendi antrodial (multiaaksial).
j Animasi Sehubungan dengan manubrium sternum, klavikula bergerak ke
j Situs web terkait anterior 15 derajat dengan protraksi dan bergerak ke posterior 15
derajat dengan retraksi.
Unggul
acromioclavicular
ligamen Ligamen trapesium Coracoclavicular
Ligamen konoid ligamen
Acromion
proses Perbatasan superior Depan
Sternoklavikula superior
ligamen
sudut
Interclavicular
Suprascapular
ligamen
takik
Coracoid
proses
Manubrium
Glenoid
rongga
(fossa)
4 Lateral
Kostoklavikular
ligamen
(ketiak)
Tulang dada
berbatasan
Berlangganan
fossa
Medial (tulang belakang)

berbatasan
Sudut inferior
ARA. 4.1 • Korset bahu kanan, tampak anterior.
gerakan sendi bahu. Selain dukungan kuat yang diberikan oleh

ligamen coracoclavicular (conoid dan trapezoid), ligamen
Abadi
Akromial
akhir
acromioclavicular superior dan inferior memberikan stabilitas
akhir
pada sendi yang sering mengalami cedera ini. Sendi
Tuberkulum kerucut
coracoclavicular, diklasifikasikan sebagai sendi
(a) Tampilan superior
tipe-syndesmotic, berfungsi melalui ligamen-ligamennya untuk
meningkatkan stabilitas dari sendi akromioklavikularis.
Tuberkulum kerucut
Abadi Scapulothoracic
Akromial akhir
akhir Sendi ini bukan sendi sinovial yang sebenarnya, karena tidak
memiliki fitur sinovial yang teratur dan fakta bahwa
(b) Tampilan inferior
pergerakannya sangat bergantung pada sendi sternoklavikula
dan akromioklavikular. Meskipun gerakan skapula terjadi
Gambar 4.2 • Klavikula kanan. SEBUAH, Pemandangan superior; B, Tampilan inferior.
sebagai akibat dari gerakan pada sendi SC dan AC, skapula
dapat digambarkan memiliki jangkauan total gerakan
abduksi-adduksi 25 derajat, rotasi ke atas-ke bawah 60 derajat,
Beberapa rotasi klavikula di sepanjang porosnya selama dan elevasi 55 derajat- depresi. Sendi scapulothoracic didukung
berbagai gerakan korset bahu menghasilkan sedikit gerakan secara dinamis oleh otot-ototnya dan tidak memiliki dukungan
meluncur berputar pada sendi sternoklavikula. Di anterior ligamen, karena tidak memiliki fitur sinovial.
didukung oleh ligamentum sternoklavikularis anterior dan di
bagian posterior oleh ligamentum sternoklavikula posterior.
Ligamen costoclavicular dan interclavicular juga memberikan Tidak ada artikulasi yang khas antara skapula anterior dan
stabilitas terhadap perpindahan yang superior. tulang rusuk posterior. Di antara dua struktur tulang ini adalah
otot serratus anterior yang berasal dari sembilan tulang rusuk
atas secara lateral dan berjalan tepat di belakang tulang rusuk
Acromioclavicular (AC) posterior untuk dimasukkan ke batas medial skapula. Segera
Sendi ini diklasifikasikan sebagai sendi artrodial. Ini memiliki total posterior serratus anterior adalah otot subskapularis (lihat Bab
gerakan meluncur dan rotasi 20 hingga 30 derajat yang 5) pada skapula anterior.
menyertai korset bahu lainnya dan
Suprascapular Belakang Depan

Tulang selangka takik Sendi akromioklavikularis
Perbatasan superior Acromion
proses
Unggul
Acromion Coracoid
sudut
proses proses
Supraspinous
fossa Tulang belakang
Rongga glenoid
(fossa)
Glenoid
Tulang belakang rongga (fossa)
tulang belikat
Infraspinous Lateral (aksila)
Bab
berbatasan
fossa
4
Medial (tulang belakang) Lateral (aksila) Inferior
berbatasan berbatasan sudut
Belakang
permukaan B
SEBUAH
Sudut inferior
ARA. 4.3 • Skapula kanan. SEBUAH, Tampilan posterior; B, Tampilan lateral.
Acromioclavicular Trapezius m. Trapezius m.

bersama
Acromioclavicular
bersama
Deltoid m.
Deltoid m.
Tulang belakang
tulang belikat
Tulang selangka
Pectoralis
mayor m.
Sudut inferior
dari skapula
ARA. 4.4 • Anatomi permukaan korset bahu kanan, tampak anterior dan posterior.
Gerakan GAMBAR. 4.5, 4.6 glenoid fossa (lateral), atau proses akromion (anterior). Semua
gerakan ini memiliki titik penting di mana klavikula bergabung
Dalam menganalisis gerakan korset bahu, seringkali membantu dengan tulang dada di sendi sternoklavikula.
untuk fokus pada landmark tulang skapular tertentu, seperti
g belikat sudut inferior (posterior),
ikan
g belikat
ksi
g belikat
gian
Penculikan Adduksi Ketinggian
(penggambaran) (pencabutan)
SEBUAH B C
g belikat
esi
g belikat
s
i
Depresi Rotasi ke atas Rotasi ke bawah

D E F
g belikat ARA. 4.5 • Gerakan korset bahu.

wah
i
Gerakan korset bahu dapat digambarkan sebagai gerakan Rotasi ke bawah: Mengembalikan sudut inferior secara medial dan
skapula, tetapi penting untuk diingat bahwa ke mana pun inferior ke arah tulang belakang dan fossa glenoid ke posisi
skapula pergi, klavikula mengikuti. Gambar. 4.5 dan 4.6 normalnya, seperti dalam membawa lengan ke samping. (Setelah
menunjukkan gerakan korset bahu. skapula kembali ke posisi anatomisnya, rotasi ke bawah lebih jauh
sebenarnya menghasilkan sudut superior yang bergerak sedikit ke
superomedial.)
Penculikan (protraksi): Gerakan skapula secara lateral menjauhi
tulang belakang, seperti saat meraih benda di depan tubuh
Untuk menyelesaikan beberapa gerakan korset bahu yang telah disebutkan
Adduksi (retraksi): Gerakan skapula ke arah medial kolom tulang sebelumnya, skapula harus berputar atau miring pada porosnya. Meskipun ini
belakang, seperti dalam menjepit tulang belikat bukan gerakan utama korset bahu, gerakan ini diperlukan agar skapula dapat
bergerak secara normal sepanjang jangkauannya Bab
Ketinggian: Gerakan skapula ke atas atau superior, seperti

saat mengangkat bahu
Depresi: Gerakan skapula ke bawah atau inferior, seperti
gerakan selama gerakan korset bahu.
4
Kemiringan lateral (kemiringan keluar): Gerakan berurutan selama
kembali ke posisi normal dari mengangkat bahu
penculikan di mana skapula berputar di sekitar sumbu vertikalnya,
menghasilkan gerakan posterior batas medial dan gerakan
Rotasi ke atas: Memutar fossa glenoid ke atas dan menggerakkan
anterior batas lateral
sudut inferior ke arah superior dan lateral menjauh dari tulang
belakang untuk membantu mengangkat lengan ke samping
Kemiringan medial (kemiringan ke dalam): Kembali dari kemiringan
lateral; gerakan konsekuensial selama adduksi ekstrim di mana
skapula berputar tentang sumbu vertikalnya, menghasilkan
gerakan anterior batas medial dan gerakan posterior batas lateral
Ketinggian
Kemiringan anterior (kemiringan ke atas): Gerakan rotasi skapula

akibat sumbu frontal yang terjadi selama hiperekstensi sendi
Adduksi Penculikan
Ke atas glenohumeral, mengakibatkan batas superior bergerak ke
rotasi
anteroinferior dan sudut inferior bergerak ke posterosuperior.
Depresi Ke bawah
Rhomboids rotasi
Trapezius
Kemiringan posterior (kemiringan ke bawah): Gerakan rotasi
(atas dan tengah)
Skapula levator
skapula akibat sumbu frontal terjadi selama hiperfleksi sendi
glenohumeral, mengakibatkan batas superior bergerak ke
posteroinferior dan sudut inferior bergerak ke anterosuperior
Rhomboids Serratus
Trapezius depan
(tengah Pectoralis
dan lebih rendah) minor Sinergi dengan otot-otot sendi glenohumeral
r)
Sendi bahu dan korset bahu bekerja sama dalam melakukan

e
w
T
r a
l s
p e z i aktivitas ekstremitas atas. Penting untuk dipahami bahwa

r
u
( m d
i d d l e a n
o
gerakan korset bahu tidak bergantung pada sendi bahu dan

i
S err
a tu s a n t e
r
ototnya. Namun, otot-otot korset bahu sangat penting dalam

r
n s
o
d
o memberikan efek penstabil skapula, sehingga otot-otot sendi

h o m b
i
R m
i
c t o r a li
P e s
Trapezius (lebih rendah) bahu akan memiliki dasar yang stabil untuk mengerahkan
Pectoralis minor tenaga untuk gerakan kuat yang melibatkan humerus.
Akibatnya, otot korset bahu berkontraksi untuk
mempertahankan skapula dalam posisi yang relatif statis
selama banyak tindakan sendi bahu.
Saat sendi bahu mengalami rentang gerak yang lebih
ARA. 4.6 • Tindakan otot skapular. Tampilan posterior dengan aksi. ekstrim, otot skapular berkontraksi untuk menggerakkan korset
bahu sehingga fossa glenoidnya berada pada posisi yang lebih
tepat.
dari mana humerus bisa bergerak. Tanpa gerakan skapula yang postur bahu ke depan, yang juga berkontribusi terhadap peningkatan
menyertainya, kita hanya dapat menaikkan humerus sekitar 90 kifosis (peningkatan cembung posterior tulang belakang dada) dan
hingga 120 derajat dari total abduksi dan fleks bahu bahu. Ini kepala depan dengan peningkatan lordosis (peningkatan cekung
bekerja melalui aksi otot-otot yang tepat dari kedua sendi yang posterior tulang belakang leher). Lihat Bab 12. Hal ini, pada gilirannya,
bekerja secara sinergi untuk mencapai aksi yang diinginkan dari memberi lebih banyak tekanan pada otot-otot tulang belakang posterior
seluruh ekstremitas atas. Misalnya, jika kita ingin mengangkat dan juga menempatkan sendi glenohumeral pada posisi yang kurang
tangan ke samping setinggi mungkin, otot serratus anterior dan berfungsi dan lebih terganggu. Untuk menghindari hal ini, kita harus
trapezius (serat tengah dan bawah) memutar ke atas skapula secara rutin melatih postur yang baik, dimulai dengan lordotic lumbal
sebagai supraspinatus dan deltoid memulai penculikan yang sesuai, dan korset bahu kita tetap tepat di atas panggul kita, bukan
glenohumeral. Sinergi antara skapula dan otot sendi bahu ini ke depan. Ini akan memudahkan untuk mempertahankan kepala dan
meningkatkan pergerakan seluruh ekstremitas atas. Diskusi tulang belakang leher di atas batang tubuh dalam posisi seimbang yang
lebih lanjut tentang interaksi dan kerja tim antara sendi-sendi ini benar. Manfaat tambahan dari postur skapula dan tulang belakang yang
4
disediakan di awal Bab 5, dengan Tabel 5. 1 daftar gerakan baik adalah inspirasi yang lebih mudah karena bobot dan massa yang
korset bahu yang biasanya menyertai gerakan sendi bahu. lebih sedikit di atas tulang rusuk dan rongga toraks.
Diskusi tambahan tentang ritme scapulohumeral disediakan di
Bab 5 di bawah Joint.
Scapular winging relatif jarang tetapi dapat mempengaruhi

aktivitas fungsional normal dari ekstremitas atas. Paling sering itu
mempengaruhi serratus anterior, mengarah ke sayap medial saat
mendorong ke depan atau mengangkat lengan. Kelumpuhan atau
kelumpuhan serratus anterior biasanya disebabkan oleh cedera
saraf toraks panjang, yang dapat memiliki berbagai penyebab. Jauh
Otot
lebih jarang, trapezius dan / atau rhomboid mungkin terpengaruh,
Ada lima otot yang terutama terlibat dalam gerakan korset menyebabkan sayap samping.
bahu, seperti yang ditunjukkan pada Gambar 4.7: pectoralis
minor, serratus anterior, trapezius, rhomboid, dan levator
scapulae. Untuk menghindari kebingungan, akan sangat Otot ikat pinggang — lokasi dan tindakan
membantu untuk mengelompokkan otot-otot korset bahu secara
Depan
terpisah dari sendi bahu. Otot subklavius juga termasuk dalam
Pectoralis minor — penculikan, ke bawah
kelompok ini, tetapi tidak dianggap sebagai penggerak utama
rotasi, dan depresi
dalam tindakan apa pun dari korset bahu. Kelima otot korset
Subclavius — depresi dan penculikan
bahu berasal dari kerangka aksial, dengan penyisipannya
Posterior dan lateral
terletak di skapula dan / atau klavikula. Otot korset bahu tidak
Serratus anterior — abduksi dan rotasi ke atas
menempel pada humerus, juga tidak menyebabkan aksi sendi
bahu. Pectoralis minor dan subclavius terletak di anterior
Belakang
berhubungan dengan batang. Serratus anterior terletak di
Trapezius
anterior skapula tetapi di posterior dan lateral batang tubuh.
Serat atas — peninggian dan ekstensi serta rotasi
kepala di leher
Serat tengah — elevasi, adduksi, dan rotasi ke atas
Serat bawah — adduksi, depresi, dan rotasi ke atas
Otot korset bahu sangat penting dalam memberikan stabilitas

Rhomboid — adduksi, rotasi ke bawah, dan elevasi
dinamis dari skapula sehingga dapat berfungsi sebagai basis
dukungan relatif untuk aktivitas sendi bahu seperti melempar,
Levator scapulae — elevasi
memukul, dan memblokir.
Otot skapula juga berperan dalam postur tulang belakang. Penting untuk dipahami bahwa otot mungkin tidak selalu
Biasanya, karena postur tubuh yang buruk dan cara kita menggunakan aktif sepanjang rentang gerak absolut yang dianggap sebagai
otot-otot kita sepanjang hidup, kita cenderung mengembangkan postur agonis.
bahu ke depan yang mengakibatkan busur derajat dan depresor skapula
menjadi lebih kuat dan ketat serta retraktor menjadi lebih lemah. Hal ini Tabel 4.1 memberikan rincian rinci tentang otot-otot yang
menyebabkan depresi dan protraksi lebih lanjut, atau bertanggung jawab atas gerakan utama korset bahu.
Subclavius
Pectoralis mayor (potong)

Coracoid
proses
Tendon supraspinatus
Pectoralis Tiga dari empat
minor (potong) Berlangganan ularis manset rotator
otot
Subscapularis
Teres minor
Pectoralis
mayor (potong)
Bisep brachii Teres mayor (potong)
Pectoralis minor
Latissimus dorsi Latissimus dorsi (potong) Bab
Serratus anterior
Perut bagian luar
miring 4
SEBUAH
Levator
skapula
Trapezius
Rhomboideus
Serviks ketujuh
minor Tulang iga
ruas
Tulang belikat
Serratus
depan
Rhomboideus
utama
Humerus
B C
ARA. 4.7 • Otot bekerja pada skapula. SEBUAH, Tampak anterior: Pektoralis mayor diangkat di kedua sisi;
B, Tampak posterior: Trapezius dilepas di sebelah kanan untuk memperlihatkan otot yang lebih dalam; C, Tampilan lateral: The
serratus anterior.
TABEL 4.1 • Otot agonis pada korset bahu
Pesawat dari
Otot Asal Insersi Tindakan gerakan Rabaan Persarafan
Penculikan Melintang Sulit, tetapi di bawah otot pektoralis

mayor dan hanya lebih rendah dari
Ke bawah proses korakoid selama melawan
Anterior muscle
Permukaan anterior Pro korakoid Medial

Pectoralis rotasi
dari tulang rusuk ke-3 cess dari saraf dada
minor Frontal depresi; ditingkatkan dengan
sampai ke-5 tulang belikat (C8 dan T1)
menempatkan tangan subjek di belakang
Depresi punggung dan membuatnya secara aktif
mengangkat tangan
Sisi depan dan lateral dada di
4
Penculikan Melintang
bawah rusuk ke-5 dan ke-6 tepat di
proksimal asalnya selama
Posterior and lateral muscle
Aspek anterior penculikan;

Permukaan dari keseluruhan paling baik dicapai dengan sendi
Serratus Dada panjang
atas 9 tulang rusuk di sepanjang sisi dada glenohumeral yang melengkung 90
depan Ke atas saraf (C5 – C7)
perbatasan medial Frontal derajat; dalam posisi yang sama
rotasi
dari skapula palpasi serat atas antara batas lateral
pectoralis mayor dan latissimus dorsi
di ketiak
Ketinggian
Frontal Antara oksipital

Dasar tengkorak, Ke atas
Aspek posterior tonjolan dan C6 dan lateral ke
Trapezius berhubung dgn tengkuk rotasi
dari lateral akromion,
atas tonjolan, dan
3 dari Perpanjangan terutama selama elevasi
serat ligamen posterior Sagittal
tulang selangka kepala di leher dan ekstensi kepala di leher
leher
Rotasi
Melintang
kepala di leher Tulang belakang
tambahan
Perbatasan medial
Ketinggian Frontal
Proses berputar dari akromion tersebut Dari C7 ke T3 dan lateral ke proses saraf dan akromion
Trapezius
dari 7 serviks dan proses dan 3 atas Adduksi Melintang dan cabang skapular tulang belakang, terutama selama
tengah C3 dan C4
toraks perbatasan superior
serat Ke atas Frontal
tulang belakang dari skapula adduksi
rotasi
tulang belakang
Melintang
Adduksi Ruang Segitiga Dari T4 hingga T12 dan aspek medial
Posterior muscles
Proses berputar
Trapezius di dasar Depresi tulang belakang skapula, terutama
dari tanggal 4 sampai 12
serat yang lebih rendah skapula Frontal selama depresi
vertebra toraks Ke atas
tulang belakang dan adduksi
rotasi
Adduksi Melintang Kesulitan karena bagian dalam

trapezius, tetapi dapat teraba melalui
trapezius selama adduksi; dicapai
Proses spinosus Batas medial serviks ke-7
dengan baik Dorsal
dari skapula, dan 5 toraks pertama di inferior Ke bawah
Rhomboids tangan ipsilateral subjek di belakang saraf skapular bagian belakang untuk
vertebra rotasi
Frontal mengendurkan trapezius (C5)
tulang belakang scapular
dan aktifkan rhomboid saat subjek
mengangkat tangannya dari belakang
Ketinggian
Perbatasan medial Sulit dipalpasi karena letaknya yang

Dorsal
Pro melintang dari skapula dalam hingga trapezius; teraba paling baik
scapular
Levator cesses dari dari pada insersi tepat di medial dari sudut
Ketinggian Frontal saraf C5 dan
skapula bagian atas 4 serviks sudut superior superior skapula, terutama selama sedikit
cabang dari
tulang belakang ke skapula peninggian
C3 dan C4
tulang belakang
catatan: Subklavius tidak terdaftar karena bukan penggerak utama dalam gerakan korset bahu.
Saraf
Otot-otot korset bahu dipersarafi terutama dari saraf pleksus
serviks dan pleksus brakialis, seperti yang diilustrasikan pada
Gambar. 4.8 dan 4.9. Trapezius dipersarafi oleh saraf aksesori
tulang belakang dan dari cabang C3 dan C4. Selain memasok
trapezius, C3 dan C4 juga menginervasi skapula levator.
Skapula levator menerima persarafan lebih lanjut dari saraf
skapula punggung yang berasal dari C5. Saraf skapula
punggung juga menginervasi rhomboid. Saraf toraks panjang Akar: C5, C6, C7, C8, T1 Batang:
berasal dari C5, C6, dan C7 dan menginervasi serratus anterior. divisi anterior atas, tengah, bawah
C5
Saraf dada medial muncul dari C8 dan T1 untuk menginervasi Bab
pektoralis minor. Divisi posterior
Kabel: posterior, lateral, medial

T1 4
Cabang: Saraf ketiak
Saraf radial
Saraf muskulokutaneus
Saraf median C4
Saraf ulnaris
Akar (ventral rami)
Ranting C5
Saraf lain (bukan bagian dari

C1
pleksus serviks)
Saraf skapula punggung Atas
C4
bagasi
Saraf suprascapular
C6
Saraf subklavia
C1 Kabel lateral Tengah

bagasi
Kabel posterior
Saraf hipoglosus (XII) C7
Saraf ketiak
C2
Saraf aksesori (XI) Saraf radial Panjang
toraks
Musculo- saraf
Saraf oksipital minor
Yg berhubung dgn kulit
Saraf untuk saraf C8
C3
otot sternokleidomastoid
Medial dan
Menurunkan
Saraf aurikuler lebih besar lateral
bagasi
Akar unggul dada
ansa cervicalis saraf
T1
Serviks melintang C4
Median
saraf saraf
Untuk Kabel medial
brakialis Saraf ulnaris
Ansa cervicalis
kekusutan
Saraf untuk Brakialis medial
otot trapezius C5 saraf kulit
Akar inferior
• Pleksus brakialis, pandangan anterior. Akar pleksus

dari ansa cervicalis
ARA. 4.9
dibentuk oleh rami ventral
Saraf supraclavicular
Saraf frenikus dari saraf tulang belakang C5-T1 dan bergabung untuk membentuk
batang atas, tengah, dan bawah. Setiap batang terbagi menjadi divisi
anterior dan posterior. Divisi bergabung bersama untuk membentuk
ARA. 4.8 • Pleksus serviks, pandangan anterior. Akar pleksus kabel posterior, lateral, dan medial dari mana saraf pleksus brakialis
dibentuk oleh rami ventral mayor muncul.
saraf tulang belakang C1 – C4.
Otot trapezius ARA. 4.10 Tindakan
(tra-pe ́zi-us) Serat atas: peninggian skapula, rotasi ke atas, dan ekstensi serta
rotasi kepala di leher
Asal
Serat atas: dasar tengkorak, tonjolan oksipital, dan ligamen leher Serat tengah: elevasi, rotasi ke atas, dan adduksi (retraksi)
g belikat
gian posterior skapula
Serat tengah: proses spinosus vertebra toraks ketujuh dan tiga Serat bawah: depresi, adduksi (retraksi), dan rotasi ke atas dari
vertebra toraks atas skapula
Serat bawah: proses spinosus dari vertebra toraks keempat

Rabaan
sampai kedua belas
Serat atas: antara tonjolan oksipital dan C6 dan lateral ke
akromion, terutama selama elevasi dan ekstensi kepala di leher
4 Insersi
Serat atas: aspek posterior dari sepertiga lateral
tulang selangka
Serat tengah: dari C7 ke T3 dan lateral ke proses akromion dan
tulang belakang skapula, terutama selama adduksi
Serat tengah: batas medial dari proses akromion dan batas

atas tulang belakang skapula Serat bawah: ruang segitiga di
dasar tulang belakang skapula Serat bawah: dari T4 ke T12 dan aspek medial tulang belakang
skapula, terutama selama depresi dan adduksi
ks
njangan
ks
i
a sepihak
Serat atas O, Dasar tengkorak, tonjolan

oksipital, posterior
ligamen leher, proses spinosus
serviks (C7) dan semua vertebra
Elevasi (serat atas dan tengah)
toraks (T1-T12)
Serat tengah
I, aspek posterior sepertiga lateral
g belikat klavikula, batas medial proses
akromion dan batas atas tulang
s
belakang skapula, ruang segitiga
si Adduksi
(serat tengah dan bawah)
di dasar tulang belakang skapula
Rotasi ke atas
(serat tengah dan bawah)
g belikat Depresi
ksi (serat lebih rendah)
Serat lebih rendah
g belikat
esi
ARA. 4.10 • Otot trapezius, tampak posterior. O, Asal; I, Penyisipan.
Persarafan oleh otot trapezius, sedangkan otot deltoid menahan lengan pada posisi
Saraf aksesori tulang belakang (saraf kranial XI) dan cabang itu. Otot digunakan dengan kuat saat mengangkat dengan tangan, seperti
C3, C4 saat mengambil gerobak yang berat. Trapezius harus mencegah skapula
tertarik ke bawah. Membawa benda di ujung bahu juga memanggil otot ini
Aplikasi, penguatan, dan fl eksibilitas untuk bermain. Penguatan serat atas dan tengah dapat dicapai melalui
Serat atas adalah bagian otot yang tipis dan relatif lemah. latihan angkat bahu. Serat tengah dan bawah dapat diperkuat melalui
Mereka memberikan beberapa peninggian klavikula. Karena latihan mendayung membungkuk dan sendi bahu dari posisi tengkurap. Itu Bab
asalnya di dasar tengkorak, mereka membantu perluasan
kepala.
Serat tengah lebih kuat dan lebih tebal dan memberikan
elevasi yang kuat, rotasi ke atas, dan adduksi (retraksi) dari
skapula. Jarang sekali bagian otot ini lemah, karena begitu aktif
dalam memposisikan bahu untuk fungsi dan postur tubuh.
4
Serat bawah dapat ditekankan dengan latihan retraksi bahu dengan dada
Akibatnya, seringkali menjadi sumber kelembutan dan bangga yang berusaha dilakukan
ketidaknyamanan karena ketegangan kronis. siku di saku celana belakang dengan depresi. Penurunan tubuh
secara paralel juga berguna untuk memperkuat otot trapezius
Serat bawah membantu dalam adduksi (retraksi) dan bawah. Lihat Lampiran 3 untuk latihan yang lebih umum
memutar skapula ke atas. Porsi ini biasanya lemah, terutama digunakan untuk mengatasi trapezius dan otot lain di bab ini.
pada individu yang aktivitasnya menuntut jumlah penculikan
skapula yang signifikan. Untuk meregangkan trapezius, setiap bagian perlu ditangani
secara spesifik. Serat atas dapat diregangkan dengan menggunakan
Saat semua bagian trapezius bekerja bersama, mereka satu tangan untuk menarik kepala dan leher ke depan ke dalam
cenderung tertarik ke atas dan adduksi pada saat bersamaan. gerakan fleks atau sedikit ke samping sementara tangan ipsilateral
Ini mungkin terlihat saat mengangkat pegangan gerobak diikat di bawah tepi meja untuk mempertahankan skapula dalam
dorong. Tindakan khas dari otot trapezius adalah fiksasi skapula tekanan. Serat tengah direntangkan sampai batas tertentu dengan
untuk tindakan deltoid. Tindakan terus menerus dalam rotasi ke prosedur yang digunakan untuk serat atas, tetapi mereka dapat
atas dari skapula memungkinkan lengan diangkat ke atas direntangkan lebih jauh dengan menggunakan pasangan untuk
kepala. Otot selalu digunakan untuk mencegah fossa glenoid menarik skapula secara pasif ke dalam protraksi penuh. Serat yang
tertarik ke bawah selama mengangkat benda dengan lengan. Ini lebih rendah mungkin paling baik direntangkan dengan subjek dalam
juga biasanya terlihat dalam aksi selama memegang sebuah posisi berbaring miring sementara pasangannya memegang tepi
objek di atas kepala. Memegang lengan di samping secara lateral dan sudut inferior skapula dan memindahkannya secara pasif
horizontal menunjukkan fiksasi skapula yang khas ke ketinggian dan protraksi maksimal.
Otot skapula levator ARA. 4.11 Persarafan

(le-va´ ́tor scap ́u-lae) Saraf skapularis punggung C5 dan cabang C3 dan C4
Asal Aplikasi, penguatan, dan fl eksibilitas

Proses melintang dari empat vertebra serviks atas Mengangkat bahu akan memanggil otot skapula levator,
g belikat
gian
bersama dengan otot trapezius bagian atas. Fiksasi skapula
oleh otot minor pektoralis memungkinkan otot skapula levator di
Insersi kedua sisi memanjangkan leher atau membengkok ke samping
Batas medial skapula dari sudut superior ke tulang belakang jika digunakan pada satu sisi saja.
skapula
Skapula levator mungkin paling baik diregangkan dengan
Tindakan
memutar kepala kira-kira 45 derajat secara kontralateral dan
4 Meninggikan margin medial skapula Rotasi ke bawah

yang lemah
mengeluarkan tulang belakang leher secara aktif sambil
mempertahankan skapula dalam posisi yang rileks dan tertekan.
Adduksi lemah
Seperti trapezius, levator scapulae adalah tempat yang
Rabaan sangat umum untuk rasa sesak, nyeri tekan, dan
Sulit dipalpasi karena letaknya yang dalam hingga trapezius; teraba ketidaknyamanan akibat ketegangan kronis dan dari membawa
paling baik pada insersi tepat di medial sudut superior skapula, barang dengan tali di bahu.
terutama selama sedikit peninggian
g belikat
wah
i
g belikat
ksi O, proses melintang
dari empat vertebra serviks
atas (C1 – C4)
Ketinggian
I, Perbatasan medial
skapula dari
sudut superior untuk
tulang belakang scapular
ARA. 4.11 • Otot levator scapulae, tampak posterior. O, Asal; I, Penyisipan.

Otot rhomboid — mayor Persarafan

Saraf skapula punggung (C5)
dan minor ARA. 4.12
(rom ́boyd)
Aplikasi, penguatan, dan fl eksibilitas
Tulang belikat
Otot-otot rhomboid mengikat skapula sebagai adduksi (retraksi) ketika
Asal adduksi
otot-otot sendi bahu adduct atau memperpanjang lengan. Otot-otot ini
Proses spinosus vertebra toraks ketujuh dan kelima
digunakan dengan kuat dalam dagu. Saat seseorang menggantung dari
palang horizontal, digantung oleh tangan, skapula cenderung ditarik dari
bagian atas dada. Saat gerakan dagu dimulai, otot rhomboid-lah yang
Insersi memutar medial Bab
Perbatasan medial skapula, di bawah tulang belakang skapula
Tindakan
perbatasan skapula ke bawah dan kembali ke arah 4
tulang belakang. Catat posisi menguntungkan mereka untuk dilakukan
Otot romboid mayor dan minor bekerja sama. Adduksi (retraksi): ini. Terkait dengan ini, romboid bekerja dengan cara yang sama
tarik skapula ke arah tulang belakang untuk mencegah sayap skapula.
Otot trapezius dan rhomboid yang bekerja bersama
Rotasi ke bawah: dari posisi diputar ke atas; menggambar menghasilkan adduksi dengan sedikit peninggian skapula.
skapula menjadi rotasi ke bawah Elevation: sedikit gerakan ke Untuk mencegah peningkatan ini, otot latissimus dorsi dipanggil
atas yang menyertai adduksi untuk bekerja.
Chin-up, dips, dan bend-over rowing adalah latihan yang sangat baik untuk
mengembangkan kekuatan pada otot ini. Rhomboid dapat diregangkan dengan
Rabaan pas- Tulang belikat
Sulit untuk dipalpasi karena letaknya yang dalam di trapezius, tetapi menggerakkan skapula menjadi protraksi penuh ke bawah
rotasi
dapat teraba melalui trapezius yang relaks selama adduksi. Hal ini sambil mempertahankan depresi. Rotasi ke atas juga dapat
paling baik dilakukan dengan menempatkan tangan ipsilateral membantu peregangan ini.
subjek di belakang punggung (rotasi internal glenohumeral dan
rotasi ke bawah skapula), yang melemaskan trapezius dan
membuat rhomboid beraksi saat subjek mengangkat tangan dari
belakang.
Tulang belikat
ketinggian
O, proses Spinous
dari serviks terakhir (C7) dan
lima vertebra toraks pertama
(T1-T5)
I, Perbatasan medial
Ketinggian skapula di bawah
tulang belakang
Adduksi
Ke bawah
rotasi
ARA. 4.12 • Otot romboid (mayor dan minor), tampak posterior. O, Asal; I, Penyisipan.

Otot anterior serratus ARA. 4.13 Persarafan

(ser-a ́tus an-tir ́e-or) Saraf toraks panjang (C5 – C7)

g belikat
Permukaan sembilan tulang rusuk bagian atas di sisi dada Otot serratus anterior biasanya digunakan dalam gerakan
ikan
menarik skapula ke depan dengan sedikit rotasi ke atas, seperti
Insersi melempar bola bisbol, meninju dalam tinju, menembak dan
Aspek anterior dari seluruh panjang batas medial skapula menjaga dalam bola basket, dan menangani dalam sepak bola.
Ia bekerja bersama dengan otot utama pectoralis dalam aksi
khas, seperti melempar bola bisbol.
Tindakan
Abduction (protraction): menggambar batas medial Otot serratus anterior sangat berguna dalam melakukan
4 skapula dari vertebra

Rotasi ke atas: lebih panjang, serat lebih rendah cenderung menarik
push-up, terutama dalam gerakan 5 hingga 10 derajat terakhir.
Bench press dan overhead press adalah latihan yang bagus
sudut inferior skapula lebih jauh dari vertebra, sehingga memutar untuk otot ini. Kondisi skapula bersayap biasanya terjadi akibat
skapula sedikit ke atas kelemahan rhomboid dan / atau serratus anterior. Kelemahan
serratus anterior dapat terjadi akibat cedera pada saraf toraks
Rabaan panjang.
Sisi depan dan lateral dada di bawah rusuk kelima dan keenam
tepat di proksimal asalnya selama abduksi, yang paling baik Serratus anterior dapat diregangkan dengan berdiri,
dilakukan dari posisi terlentang dengan sendi glenohumeral dalam menghadap sudut dan menempatkan masing-masing tangan
90 derajat kelengkungan. Serat atas dapat teraba pada posisi setinggi bahu di kedua dinding. Saat Anda bersandar dan
g belikat yang sama antara batas lateral pectoralis mayor dan latissimus mencoba menempatkan hidung di sudut, kedua skapula
s
dorsi di ketiak. didorong ke posisi adduksi, yang meregangkan serratus
i
anterior.
I, Aspek anterior dari seluruh

panjang batas medial skapula
Penculikan
O, Permukaan dari
sembilan tulang rusuk bagian atas Rotasi ke atas
di sisi dada
SEBUAH B
Tampilan lateral Tampilan lateral dengan skapula yang direfleksikan ke posterior
untuk mengungkapkan permukaan anterior
ARA. 4.13 • Otot anterior serratus, tampak lateral. O, Asal; I, Penyisipan.

Otot minor pectoralis ARA. 4.14 Aplikasi, penguatan, dan fl eksibilitas
(pek-to-ra ́lis mi ́nor) Otot minor pektoralis digunakan, bersama dengan otot serratus anterior,
dalam abduksi sejati (protraksi) tanpa rotasi. Ini terlihat terutama pada
Asal gerakan-gerakan seperti push-up yang mana Tulang belikat
Permukaan anterior dari rusuk ketiga sampai kelima

penculikan benar dari skapula diperlukan. Sana- penculikan
Insersi kedepan, serratus anterior menarik skapula ke depan dengan kecenderungan ke
Proses korakoid skapula arah rotasi ke atas, pectoralis minor menarik ke depan dengan kecenderungan ke
arah rotasi ke bawah, dan keduanya menarik bersama-sama memberikan
Tindakan penculikan yang sebenarnya. Otot-otot ini akan terlihat bekerja bersama di
sebagian besar gerakan Bab
Penculikan (protraksi): menarik skapula ke depan dan cenderung
memiringkan batas bawah menjauh dari tulang rusuk Rotasi ke
bawah: saat menculik, skapula tertarik ke bawah mendorong dengan tangan.
Pectoralis minor paling banyak digunakan pada depresi- 4
Depresi: ketika skapula diputar ke atas, ini membantu dalam Memutar dan memutar skapula ke bawah dari posisi yang diputar ke
depresi atas, seperti dalam mendorong tubuh ke atas pada batang celup atau
di badan celup.
Rabaan Pectoralis minor sering kencang karena terlalu sering digunakan dalam
Sulit untuk dipalpasi, tetapi dapat dipalpasi di bawah otot pektoralis aktivitas penculikan, yang dapat mengarah ke bahu ke depan dan membulat.
mayor dan hanya inferior dari proses korakoid selama melawan Hasilnya, peregangan dapat diindikasikan, yang dapat dilakukan dengan
push-up dinding di sudut seperti yang digunakan untuk meregangkan serratus
depresi. Hal ini dapat ditingkatkan dengan menempatkan tangan
anterior. Tambahan- Tulang belikat
subjek di belakang punggung dan membuatnya secara aktif
mengangkat tangan, yang menyebabkan rotasi ke bawah.
ke bawah
sekutu, berbaring telentang dengan handuk yang digulung tepat di bawah rotasi
tulang belakang dada sementara pasangan mendorong masing-masing

Persarafan skapula menjadi tempat retraksi otot ini pada peregangan.
Saraf dada medial (C8 – T1)
Tulang belikat
depresi
Penculikan I, proses Coracoid

dari skapula
Ke bawah
rotasi O, permukaan anterior dari rusuk ketiga
sampai kelima
Depresi
ARA. 4.14 • Otot minor pektoralis, pandangan anterior. O, Asal; I, Penyisipan.

Otot subclavius ARA. 4.15 posisi berputar agak ke atas dan humerus ditopang dalam posisi
keluar sebagian secara pasif. Depresi aktif ringan dan abduksi
(sub-klá ve-us)
skapula dapat meningkatkan palpasi.
g belikat
Asal
esi
Aspek superior dari tulang rusuk pertama di persimpangannya dengan tulang
Persarafan
rawan kosta
Serat saraf dari C5 dan C6
Insersi
Alur inferior di bagian tengah klavikula
Subklavius menarik klavikula ke arah anterior dan inferior ke
arah sternum. Selain membantu menculik dan menekan
Tindakan
klavikula dan korset bahu, ia memiliki peran yang signifikan
Stabilisasi dan perlindungan sternoklavikula
4 bersama
dalam melindungi dan menstabilkan sendi sternoklavikularis
selama gerakan ekstremitas atas. Ini mungkin diperkuat selama
Depresi
aktivitas di mana ada depresi aktif, seperti penurunan, atau
Penculikan (protraksi)
penculikan aktif, seperti push-up. Elevasi dan retraksi ekstrim
dari korset bahu memberikan regangan pada subklavius.
Rabaan
Sulit dibedakan dari pektoralis mayor, tetapi dapat teraba tepat di
inferior sepertiga tengah klavikula dengan subjek berbaring di
g belikat
samping dan di
ikan
Otot subclavius
I, alur inferior di bagian

Penculikan tengah
Depresi
tulang selangka
O, aspek Unggul dari tulang rusuk
pertama di nya
persimpangan dengan nya
tulang rawan kosta
ARA. 4.15 • Otot subclavius, pandangan anterior. O, Asal; I, Penyisipan.

TINJAU LATIHAN
1. Buat daftar bidang di mana setiap gerakan korset bahu

berikut terjadi. Sebutkan sumbu rotasi masing-masing
untuk setiap gerakan di setiap bidang.
Sebuah. Adduksi d. Rotasi ke bawah

b. Penculikan e. Ketinggian
c. Rotasi ke atas f. Depresi
2. Bagan analisis otot • Korset bahu

Bab
Lengkapi grafik dengan membuat daftar otot-otot yang terutama terlibat dalam setiap gerakan.
4
Penculikan Adduksi
Ketinggian Depresi
Rotasi ke atas Rotasi ke bawah
3. Grafik aksi otot antagonis • Korset bahu
Complete the chart by listing the muscle(s) or parts of muscles that are antagonist in their actions to the muscles in the left column.
Agonist Antagonist
Serratus anterior
Trapezius (upper fibers)
Trapezius (middle fibers)
Trapezius (lower fibers)
Rhomboid
Levator scapulae
Pectoralis minor

LABORATORY EXERCISES c. Rhomboid major and minor Levator

d. scapulae
e. Pectoralis minor
1. Locate the following prominent skeletal features on a human
Note: “How” means palpating during active contraction
skeleton and on a subject:
and possibly resisting a primary movement of the
a. Scapula
muscle. Some muscles have several primary
1. Medial border
movements, such as the trapezius with rotation upward
2. Inferior angle
and adduction. “Where” refers to the location on the body
3. Superior angle
where the muscle can be felt. Palpate the
4. Coracoid process
sternoclavicular and acromioclavicular joint movements
5. Spine of scapula
3. and the muscles primarily involved while demonstrating
6. Glenoid cavity
the following shoulder girdle movements:
pter 7. Acromion process
8. Supraspinatus fossa
4 9. Infraspinatus fossa
a. Adduction
b. Clavicle
b. Abduction
1. Sternal end
c. Rotation upward
2. Acromial end
d. Rotation downward
c. Joints
e. Elevation
1. Sternoclavicular joint
f. Depression
2. Acromioclavicular joint
2. Describe how and where you palpate the following muscles
on a human subject:
a. Serratus anterior
b. Trapezius
4. Shoulder girdle movement analysis chart
After analyzing each exercise in the chart, break each into two primary movement phases, such as a lifting phase and a lowering
phase. For each phase, determine the shoulder girdle movements occurring, and then list the shoulder girdle muscles primarily
responsible for causing/controlling those movements. Beside each muscle in each movement, indicate the type of contraction as
follows: I—isometric; C—concentric; E—eccentric.
Initial movement (lifting) phase Secondary movement (lowering) phase

Exercise
Movement(s) Agonist(s)—(contraction type) Movement(s) Agonist(s)—(contraction type)
Push-up
Chin-up
Bench press
Dip
Lat pull
Overhead press
Prone row
Barbell shrugs

5. Shoulder girdle sport skill analysis chart
Analyze each skill in the chart and list the movements of the right and left shoulder girdle in each phase of the skill. You may prefer to
list the initial position the shoulder girdle is in for the stance phase. After each movement, list the shoulder girdle muscle(s) primarily
responsible for causing/controlling that movement. Beside each muscle in each movement, indicate the type of contraction as follows:
I—isometric; C—concentric; E—eccentric. It may be desirable to review the concepts for analysis in Chapter 8 for the various phases.
Exercise Stance phase Preparatory phase Movement phase Follow-through phase
(R)
Baseball pitch Chapter
(L)
4
(R)
Volleyball
serve
(L)
(R)
Tennis serve
(L)
(R)
Softball pitch
(L)
(R)
Tennis
backhand
(L)
(R)
Batting
(L)
(R)
Bowling
(L)
(R)
Basketball free
throw
(L)

References Rasch PJ: Kinesiology and applied anatomy, ed 7, Philadelphia, 1989,

Lea & Febiger.
Seeley RR, Stephens TD, Tate P: Anatomy & physiology, ed 8,

Andrews JR, Zarins B, Wilk KE: Injuries in baseball, Philadelphia, Dubuque, IA, 2008, McGraw-Hill.
1998, Lippincott-Raven.
Smith LK, Weiss EL, Lehmkuhl LD: Brunnstrom’s clinical kinesiology,
DePalma MJ, Johnson EW: Detecting and treating shoulder ed 5, Philadelphia, 1996, Davis.
impingement syndrome: the role of scapulothoracic dyskinesis,
Sobush DC, et al: The Lennie test for measuring scapula position
The Physician and Sportsmedicine 31(7), 2003.
in healthy young adult females: a reliability and validity study,
Field D: Anatomy: palpation and surface markings, ed 3, Oxford, Journal of Orthopedic and Sports Physical Therapy 23:39, January
2001, Butterworth-Heinemann. 1996.
Hislop HJ, Montgomery J: Daniels and Worthingham’s muscle testing: Soderburg GL: Kinesiology—application to pathological motion,
techniques of manual examination, ed 8, Philadelphia, 2007, Saunders. Baltimore, 1986, Williams & Wilkins.
Van De Graaff KM: Human anatomy, ed 6, Dubuque, IA, 2002,

pter
Johnson RJ: Acromioclavicular joint injuries: identifying and treating McGraw-Hill.
4
“separated shoulder” and other conditions, Harmon K, Rubin A,
Wilk KE, Reinold MM, Andrews JR, eds: The athlete’s shoulder, ed 2,
eds: The Physician and Sportsmedicine 29(11), 2001.
Philadelphia, 2009, Churchill Livingstone Elsevier.
Loftice JW, Fleisig GS, Wilk KE, Reinold MM, Chmielewski T, Escamilla
Williams CC: Posterior sternoclavicular joint dislocation emergencies
RF, Andrews JR, eds: Conditioning program for baseball pitchers,
series, Howe WB, ed.: The Physician and Sportsmedicine
Birmingham, AL, 2004, American Sports Medicine Institute.
27(2), 1999.
McMurtrie H, Rikel JK: The coloring review guide to human anatomy,
New York, 1991, McGraw-Hill.
Muscolino JE: The muscular system manual: the skeletal muscles of

the human body, ed 3, St. Louis, 2010, Elsevier Mosby.
Neumann DA: Kinesiology of the musculoskeletal system: foundations

for physical rehabilitation, ed 2, St. Louis, 2010, Mosby. For additional resources and a list of related websites,
Norkin CC, Levangie PK: Joint structure and function—a visit www.mhhe.com/floyd19e.
comprehensive analysis, ed 5, Philadelphia, 2011, Davis.

Worksheet Exercises
Worksheet 1
Using crayons or colored markers, draw and label on the worksheet the following muscles. Indicate the origin and insertion of each muscle
with an “O” and an “I,” respectively, and draw in the origin and insertion on the contralateral side of the skeleton.
a. Trapezius
b. Rhomboid major and minor Chapter
4
c. Serratus anterior
d. Levator scapulae
e. Pectoralis minor

Worksheet Exercises
Worksheet 2
Label each of lines 1 through 6 on the drawing with the letter, from the following list, that corresponds to the movements of the shoulder girdle
indicated by the arrow.
a. Adduction (retraction)
b. Abduction (protraction)
pter c. Rotation upward
4 d. Rotation downward
e. Elevation
f. Depression
4 6
On the lines below, which correspond to the numbers of the arrows above, list the muscle(s) or parts of
muscles primarily responsible for causing each movement.
1.
2.
3.
4.
5.
6.

C HAPTER 5
T HE S HOULDER J OINT
Objectives
T to the
he onlyaxial skeletonofisthe
attachment viashoulder
the scapula
jointand
5
Chapter
j To identify on a human skeleton or human subject selected its attachment through the clavicle at the ster-
bony structures of the shoulder joint noclavicular joint. Movements of the shoulder
joint are many and varied. It is unusual to have movement of the
j To label on a skeletal chart selected bony structures
humerus without scapula movement. When the humerus is
of the shoulder joint
flexed above shoulder level, the scapula is elevated, rotated
j To draw on a skeletal chart the muscles of the shoulder upward, and abducted. With glenohumeral abduction above
joint and indicate, using arrows, shoulder joint shoulder level, the scapula is elevated and rotated upward.
movements Adduction of the humerus results in depression and rotation
j To demonstrate with a fellow student all the movements of downward, whereas extension of the humerus results in
the shoulder joints and list their respective planes and depression, rotation downward, and adduction of the scapula.
axes of rotation The scapula abducts with humeral internal rotation and
horizontal adduction. The scapula adducts with external rotation
j To learn and understand how movements of the scapula
and horizontal abduction of the humerus. For a summary of
accompany movements of the humerus in achieving movement of
the entire shoulder complex
these movements and the muscles primarily responsible for
them, refer to Table 5.1.
j To determine and list the muscles of the shoulder
joint and their antagonists
j To organize and list the muscles that produce the

movements of the shoulder girdle and the shoulder joint
Because the shoulder joint has such a wide range of motion
j To determine, through analysis, the shoulder joint in so many different planes, it also has a significant amount of
movements and muscles involved in selected skills and laxity, which often results in instability problems such as rotator
exercises cuff impingement, subluxations, and dislocations. The price of
mobility is reduced stability. The concept that the more mobile a
joint is, the less stable it is and that the more stable it is, the less
mobile it is applies generally throughout the body, but
Online Learning Center Resources particularly in the shoulder joint. See the section on stability and
mobility of diarthrodial joints in Chapter 1.
j Self-grading quizzes
j Animations
j Related websites

TABLE 5.1 • Pairing of shoulder girdle and shoulder joint movements. When the muscles of the shoulder joint
(second column) perform the actions in the first column through any substantial range of motion, the muscles of the
shoulder girdle (fourth column) work in concert by performing the actions in the third column.
Shoulder joint actions Shoulder joint agonists Shoulder girdle actions Shoulder girdle agonists
Serratus anterior, middle

Supraspinatus, deltoid, upper
Abduction Upward rotation/elevation and lower trapezius, levator
pectoralis major
scapulae, rhomboids
Latissimus dorsi, teres major, lower

Adduction Downward rotation Pectoralis minor, rhomboids
pectoralis major
Levator scapulae, serratus

Anterior deltoid, upper pectoralis major,
Flexion Elevation/upward rotation anterior, upper and middle
coracobrachialis
trapezius, rhomboids
pter
Latissimus dorsi, teres major, lower
Depression/downward
5
Pectoralis minor, lower
Extension pectoralis major, posterior deltoid
rotation trapezius
Latissimus dorsi, teres major, pectoralis Serratus anterior, pectoralis

Internal rotation Abduction (protraction)
major, subscapularis minor
Middle and lower trapezius,

External rotation Infraspinatus, teres minor Adduction (retraction)
rhomboids
Middle and posterior deltoid, Middle and lower trapezius,

Horizontal abduction Adduction (retraction)
infraspinatus, teres minor rhomboids
Pectoralis major, anterior deltoid, Serratus anterior, pectoralis

Horizontal adduction Abduction (protraction)
coracobrachialis minor
Diagonal abduction Posterior deltoid, infraspinatus, Adduction (retraction)/ Trapezius, rhomboids, serratus
(overhand activities) teres minor upward rotation/elevation anterior, levator scapulae
Abduction (protraction)/
Diagonal adduction Pectoralis major, anterior deltoid, Serratus anterior, pectoralis
depression/downward
(overhand activities) coracobrachialis minor
rotation
Bones classified as enarthrodial (see Fig. 5.1). As such, it moves in all

planes and is the most movable joint in the body. It is similar to
The scapula, clavicle, and humerus serve as attachments for the hip in its joint classification; however, the socket provided by
most of the muscles of the shoulder joint. Learning the specific the glenoid fossa is much shallower and relatively small in
location and importance of certain bony landmarks is critical to comparison to the rather large humeral head. Its stability is
understanding the functions of the shoulder complex. Some of enhanced slightly by the glenoid labrum (see Fig. 5.5), a
these scapular landmarks are the supraspinous fossa, cartilaginous ring that surrounds the glenoid fossa just inside its
infraspinous fossa, subscapular fossa, spine of the scapula, periphery. It is further stabilized by the glenohumeral ligaments,
glenoid cavity, coracoid process, acr omion process, and especially anteriorly and inferiorly. The anterior glenohumeral
inferior angle. Humeral landmarks are the head, greater ligaments become taut as external rotation, extension,
tubercle, lesser tubercle, intertubercular groove, and deltoid abduction, and horizontal abduction occur, whereas the very
tuberosity (Figs. 5.1 and 5.2, and review Figs. 4.1 and 4.3). thin posterior capsular ligaments become taut in internal
rotation, flexion, and horizontal adduction. In recent years the
importance of the inferior glenohumeral ligament in providing
both anterior and posterior stability has come to light (Figs. 5.3
Joint and 5.4). It is,
The shoulder joint, specifically known as the glenohumeral joint,

is a multiaxial ball-and-socket joint

Suprascapular notch
Acromioclavicular joint
Superior border
Acromion process
Superior angle
Clavicle
Coracoid
process
Humeral head
Greater
tubercle
Lesser
tubercle Subscapular
fossa
Intertubercular
(bicipital) groove
Chapter
Scapula
Glenoid
cavity
(fossa)
5
Medial (vertebral)
border
Humerus
Deltoid Lateral (axillary)

tuberosity border
Inferior angle
FIG. 5.1 • Right glenohumeral joint, anterior view.
however, important to note that, due to the wide range of motion 100 degrees of flexion, 70 to 90 degrees of internal and external
involved in the glenohumeral joint, the ligaments are quite lax rotation, 45 degrees of horizontal abduction, and 135 degrees of
until the extreme ranges of motion are reached. This relative horizontal adduction. If the shoulder girdle is free to move, then
lack of static stability provided by the ligaments emphasizes the the total range of the combined joints is 170 to 180 degrees of
need for optimal dynamic stability to be provided by muscles abduction, 170 to 180 degrees of flexion, and 140 to 150
such as the rotator cuff group. Stability is sacrificed to gain degrees of horizontal adduction.
mobility.
As discussed in Chapter 4 and emphasized in Table 5.1, the
Movement of the humerus from the side position is common glenohumeral joint is paired with the shoulder girdle to
in throwing, tackling, and striking activities. Flexion and accomplish the total shoulder range of motion. As an example,
extension of the shoulder joint are performed frequently when the 170 to 180 degrees of total abduction includes
supporting body weight in a hanging position or in a movement approximately 60 degrees of scapula upward rotation, 25
from a prone position on the ground. degrees of scapula elevation, and 95 degrees of glenohumeral
abduction. These respective actions do not necessarily happen
Determining the exact range of each movement for the in a totally sequential fashion, but this synergistic relationship is
glenohumeral joint is difficult because of the accompanying often referred to as scapulohumeral rhythm. While the exact
shoulder girdle movement. However, if the shoulder girdle is number of degrees in one segment compared to another may
prevented from moving, then the glenohumeral joint movements vary within and between individuals, the generally accepted
are generally thought to be in the following ranges: 90 to 100 ratio is 2 to 1; that is, for every 2 degrees of glenohumeral
degrees of abduction, 0 degrees adduction (prevented by the motion, there is 1 degree of scapula motion.
trunk) or 75 degrees anterior to the trunk, 40 to 60 degrees of
extension, 90 to

Greater Supraspinatus tendon

Greater
tubercle Head
tubercle
Acromion process
Coracoid
Lesser Anatomical process
tubercle neck Subdeltoid
bursa Coracohumeral
Surgical
neck ligament
Intertubercular Nutrient Infraspinatus Biceps tendon
groove foramen tendon
Superior
glenohumeral
Glenoid fossa
Deltoid ligament
tuberosity Deltoid
Glenoid labrum Subscapularis
tuberosity
tendon
Teres minor
Middle glenohumeral
tendon
ligament
Cut edge of Inferior
synovial glenohumeral
membrane ligament
pter
• Right glenohumeral joint, lateral view with humerus

5 Coronoid
fossa
FIG. 5.4
removed.
Radial Medial Lateral
fossa supracondylar supracondylar
ridge ridge
Lateral
epicondyle Medial Lateral its wide range of motion, and the lack of strength and
epicondyle epicondyle
Capitulum endurance in the muscles, which are essential in providing
Olecranon
dynamic stability to the joint. As a result, anterior or
Trochlea fossa
anteroinferior glenohumeral subluxations and dislocations are
A B
quite common with physical activity. Although posterior
FIG. 5.2 • The right humerus. A, Anterior view; dislocations are fairly rare, shoulder problems due to posterior
B, Posterior view. instability are somewhat commonplace.
Another frequent injury is to the rotator cuff. The

Acromioclavicular subscapularis, supraspinatus, infraspinatus, and teres minor
Coracohumeral
joint muscles make up the rotator cuff. They are small muscles
ligament
whose tendons cross the front, top, and rear of the head of the
Supraspinatus Superior humerus to attach on the lesser and greater tubercles,
tendon (cut) glenohumeral respectively. Their point of insertion enables them to rotate the
ligament
humerus, an essential movement in this freely movable joint.
Most important, however, is the vital role that the rotator cuff
muscles play in maintaining the humeral head in correct
approximation within the glenoid fossa while the more powerful
Coracoid
muscles of the joint move the humerus through its wide range of
process
motion.
Inferior glenohumeral ligament

In recent years the phenomenon of glenohumeral internal
Middle glenohumeral ligament
rotation deficit, or GIRD, has received attention. GIRD
represents a difference in internal rotation range of motion
FIG. 5.3 • Glenohumeral ligaments, anterior view. between an individual’s throwing and nonthrowing shoulders.
Studies have demonstrated that overhead athletes who had a
GIRD of greater than 20% had a higher risk of injury than those
The shoulder joint is frequently injured because of its who did not. Appropriate stretching exercises may be used to
anatomical design. A number of factors contribute to its injury regain the amount of internal rotation necessary to improve
rate, including the shallowness of the glenoid fossa, the laxity of performance and reduce the likelihood of injury.
the ligamentous structures necessary to accommodate

Acromion
Supraspinatus tendon
Subdeltoid
bursa Capsular ligament
Glenoid labrum
Deltoid
muscle Synovial
membrane
Glenoid cavity
of scapula
Glenoid labrum
Humerus
FIG. 5.5 • The right glenohumeral joint, frontal section. Chapter
SAGITTAL PLANE
FRONTAL PLANE
180 8 HORIZONTAL PLANE
180 8
180 8
Horizontal
abduction
H
o r
B
n
o
ri i z
Neutral 0 8
cc
90 8 90 8
ttii
u
A
e
d
b
a
xx c c
o
tt kk n
e
n
n w tt
o
a
ii
xx
ss ll
ii a
60 8 o rr a
el
d
f lf
n d 130 8
n
du cc
o
d
rr
a cc t ti i
ii
rrw
tt
F o A d d u o n
08 08 90 8
A Neutral B Neutral C
90 8
HORIZONTAL PLANE
Neutral
08
External rotation
(outward)
Internal rotation External rotation

08
(inward) (outward)
Neutral
Internal rotation
(inward)
90 8 90 8
90 8
D E
FIG. 5.6 • Range of motion of the shoulder. A, Flexion and extension; B, Abduction and adduction;
C, Horizontal abduction and adduction; D, Internal and external rotation with the arm at the side of the
body; E, Internal and external rotation with the arm abducted to 90 degrees.

Movements FIGS. 5.6, 5.7 Internal rotation: Movement of the humerus in the transverse plane
medially around its long axis toward the midline
Flexion: Movement of the humerus straight anteriorly from any
point in the sagittal plane
Horizontal abduction (extension): Movement of the humerus in a
Extension: Movement of the humerus straight posteriorly from any horizontal or transverse plane away from the chest
der point in the sagittal plane, sometimes referred to as
n
hyperextension
Horizontal adduction (flexion): Movement of the humerus in a
Abduction: Upward lateral movement of the humerus in the frontal horizontal or transverse plane toward and across the chest
plane out to the side, away from the body
Diagonal abduction: Movement of the humerus in a diagonal

der
Adduction: Downward movement of the humerus in the frontal plane away from the midline of the body
ion plane medially toward the body from abduction
Diagonal adduction: Movement of the humerus in a diagonal

External rotation: Movement of the humerus laterally in the plane toward the midline of the body
transverse plane around its long axis away from the midline
pter
der
tion
der
tion
Flexion Extension
A B
Abduction Adduction
C D
FIG. 5.7 • Movements of the shoulder joint.

Shoulder
internal
rotation
Shoulder
external
rotation

E F
Chapter
Shoulder
horizontal
abduction
Horizontal adduction Shoulder

Horizontal abduction
horizontal
G H
adduction
Diagonal adduction
Diagonal abduction
I J
FIG. 5.7 (continued) • Movements of the shoulder joint.

Muscles to organize the muscles according to their general location. The

pectoralis major, coracobrachialis, and subscapularis are
In attempting to learn and understand the muscles of the anterior muscles. The deltoid and supraspinatus are located
glenohumeral joint, it may be helpful to group them according to superiorly. The latissimus dorsi, teres major, infraspinatus, and
their location and function. Muscles that originate on the teres minor are located posteriorly. Table 5.1 (p. 114) lists the
scapula and clavicle and insert on the humerus may be thought glenohumeral joint movements and the muscles primarily
of as muscles intrinsic to the glenohumeral joint, whereas responsible for them, and Table 5.2 provides the action of each
muscles originating on the trunk and inserting on the humerus muscle.
are considered extrinsic to the joint. The intrinsic muscles
include the deltoid, the coracobrachialis, the teres major, and The biceps brachii and triceps brachii (long head) are also
the rotator cuff group, which is composed of the subscapularis, involved in glenohumeral movements. Primarily, the biceps
the supraspinatus, the infraspinatus, and the teres minor. brachii assists in flexing and horizontally adducting the
Extrinsic glenohumeral muscles are the latissimus dorsi and the shoulder, whereas the long head of the triceps brachii assists in
pectoralis major. It may also be helpful extension and horizontal abduction. Further discussion of these
muscles appears in Chapter 6.
pter
5
TABLE 5.2 • Agonist muscles of the glenohumeral joint
Plane of
Muscle Origin Insertion Action motion Palpation Innervation
Flat tendon Internal rotation

Transverse From medial end of the
Pectoralis 2 or 3 inches Horizontal adduction
Medial half of clavicle to the intertubercular Lateral pectoral groove of the
major wide to lateral
anterior surface Diagonal adduction Diagonal humerus, nerve (C5, C6,
upper lip of intertuber-
of clavicle Flexion Sagittal during flexion and adduction C7) from the
fibers cular groove of
anatomical position
humerus Abduction Frontal
Anterior Internal rotation

surface Flat tendon 2 or Horizontal adduction 3 inches Transverse From the lower ribs and
Pectoralis of costal wide sternum to the
major cartilages of to lateral lip of Diagonal adduction Diagonal intertubercular groove Medial pectoral
lower first six ribs, intertubercular of the humerus, during resisted nerve (C8, T1)
Extension from
fibers and adjoining groove of Sagittal extension from a flexed position
flexed position
portion of humerus
sternum Adduction Frontal
Mostly inaccessible, lateral

Anterior muscles
portion may be palpated on supine

Internal rotation Transverse
subject (arm in slight flexion and
adduction with elbow lying across
Entire anterior abdomen); pull medial Upper
Sub- surface of Lesser tubercle and lower
Adduction Frontal
scapularis subscapular of humerus border laterally with one hand subscapular
fossa while palpating nerve (C5, C6)
between the scapula and rib
cage with other hand (subject
Extension Sagittal
actively internally
rotates)
The belly may be palpated high up

Horizontal
Transverse on the medial arm just posterior to
Middle of adduction
Coracoid the short head of the biceps brachii Musculotaneous
Coraco- medial border
process of and toward the coracoid process, nerve (C5, C6,
brachialis of humeral
scapula particularly with C7)
shaft
Diagonal adduction Diagonal
resisted adduction

TABLE 5.2 (continued) • Agonist muscles of the glenohumeral joint
Abduction Frontal
Deltoid Flexion Sagittal From the clavicle toward the anterior
Deltoid
Anterior lateral tuberosity humerus during
anterior Horizontal adduction
third of clavicle on lateral Transverse resisted flexion or horizontal
fibers
humerus Internal rotation adduction
Diagonal adduction Diagonal
From the lateral border of the

Deltoid Deltoid Abduction Frontal Axillary
Lateral aspect acromion down toward the deltoid
middle tuberosity on nerve (C5, C6)
of acromion tuberosity during resisted abduction
fibers lateral humerus Horizontal abduction Transverse
Superior muscles
Abduction Frontal From the lower lip of the spine of the

Deltoid Inferior edge Deltoid scapula toward the posterior
posterior of spine of tuberosity on Transverse humerus
fibers scapula lateral humerus External rotation during resisted extension or
Diagonal abduction Diagonal horizontal abduction
Chapter
Above the spine of the scapula
Medial
Superiorly on
in supraspinous
fossa during initial
5
Supra- two-thirds of Suprascapula
greater tubercle Abduction Frontal abduction in the scapula plane;
spinatus supraspinous nerve (C5)
of humerus tendon may be palpated just off
fossa
acromion on greater tubercle
Tendon may be palpated as it passes

Posterior crest Extension Sagittal under the teres major at the posterior
of ilium, back axillary wall, particularly during
of sacrum Medial side of resisted
and spinous intertubercular extension and internal
Adduction Frontal
processes groove of rotation. The muscle can be palpated
Latissimus Thoracodorsal
of lumbar humerus, just in the upper lumbar/ lower thoracic
dorsi (C6, C7, C8)
and lower anterior to the area during extension from a flexed
six thoracic insertion of the Internal rotation
vertebrae, slips teres major from position and throughout most of its
Transverse
lower length during resisted adduction from
three ribs Horizontal abduction a slightly abducted position
Just above the latissimus dorsi

Medial lip of Extension Sagittal
Posteriorly on and below the teres minor on the
Posterior muscles
intertubercular
inferior third of posterior scapula surface,
groove of Lower
Teres lateral border moving
humerus, just Adduction Frontal subscapular
major of scapula and diagonally upward and
posterior to the nerve (C5, C6)
just superior to laterally from the inferior angle of
insertion of the
inferior angle Transverse the scapula during resisted internal
latissimus dorsi Internal rotation
rotation
External rotation Just below the spine of the scapula

Infraspinous Transverse
Posteriorly on passing upward
Infra- fossa just Horizontal abduction Suprascapula
greater tubercle and laterally to the humerus during
spinatus below spine Extension Sagittal nerve (C5, C6)
of humerus resisted external
of scapula
Diagonal abduction Diagonal rotation
External rotation Just above the teres major on the

Posteriorly
Transverse posterior scapula surface, moving
on upper and Horizontal
Posteriorly on diagonally
Teres middle aspect abduction Axillary nerve
greater tubercle upward and laterally from the
minor of lateral (C5, C6)
of humerus Extension Sagittal inferior angle of the scapula
border of
during resisted
scapula Diagonal abduction Diagonal external rotation
Note: The biceps brachii assists in flexion, horizontal adduction, and diagonal adduction, while the long head of the triceps brachii assists in extension, adduction, horizontal
abduction, and diagonal abduction. Because they are covered in Chapter 6, neither is listed above.

Shoulder joint muscles—location Muscle identification

Anterior Figs. 5.8 and 5.9 identify the anterior and posterior muscles of
Pectoralis major the shoulder joint and shoulder girdle. Compare Fig. 5.8 with
Coracobrachialis Fig. 5.10 and Fig. 5.9 with Fig. 5.11, and refer to Table 5.2 for a
Subscapularis detailed breakdown of the agonist muscles for the glenohumeral
Superior joint.
Deltoid
Supraspinatus
Posterior
Latissimus dorsi
Teres major
Infraspinatus
Teres minor
pter
Biceps brachii m.
Biceps brachii m.
Trapezius m.
Trapezius m.
Deltoid m. Deltoid m.
Pectoralis
major m.
Triceps
Triceps brachii m.
brachii m.
Teres major m.
Latissimus dorsi m.
Latissimus
dorsi m.
Serratus anterior m.
FIG. 5.8 • Anterior shoulder joint and shoulder girdle FIG. 5.9 • Posterior shoulder joint and shoulder girdle
muscles. muscles.

Trapezius
Sternocleidomastoid
Pectoralis minor Deltoid
Internal intercostal
Pectoralis major
External intercostal
Serratus anterior
Rectus abdominis Linea alba

(band of connective tissue)
Chapter
Internal oblique External oblique
Transversus abdominis
Aponeurosis of external oblique
5
Trapezius
Clavicle
Subscapularis
Deltoid
Coracobrachialis
Medial border
of scapula Subscapularis
Short head of
biceps brachii
Long head of
biceps brachii
Brachialis
B C
FIG. 5.10 • Anterior muscles of the shoulder. A, The right pectoralis major is removed to show the pectoralis minor and serratus anterior; B, Muscles
of the anterior right shoulder and arm, with the rib cage removed;
C, Subscapularis.

Levator scapulae Levator scapulae
Supraspinatus
Spine of scapula
Deltoid
Infraspinatus
Infraspinatus
Teres minor
Teres major
Teres major
Long head of
pter triceps brachii
5
Lateral head of
triceps brachii
A
B
Trapezius Levator scapulae

Supraspinatus
Deltoid Infraspinatus
Supraspinatus Teres minor
Teres major
Rhomboid minor
Rhomboid major
Latissimus dorsi
Teres minor
C D
FIG. 5.11 • Posterior muscles of the shoulder. A, The right trapezius and deltoid are removed to show the underlying muscles; B, Levator
scapulae, infraspinatus, and teres major; C, Supraspinatus and teres minor;
D, Muscles of the posterior surface of the scapula and arm.

Nerves FIGS. 5.12, 5.13 over the deltoid region of the arm is provided sensation by the
axillary nerve. Both the upper and lower subscapular nerves
The muscles of the shoulder joint are all innervated by the arising from C5 and C6 innervate the subscapularis, while only
nerves of the brachial plexus. The pectoralis major is innervated the lower subscapular nerve supplies the teres major. The
by the pectoral nerves. Specifically, the lateral pectoral nerve supraspinatus and infraspinatus are innervated by the
arising from C5, C6, and C7 innervates the clavicular head, suprascapular nerve, which originates from C5 and C6. The
while the medial pectoral nerve arising from C8 and T1 musculocutaneous nerve, as seen in Fig. 5.13, branches from
innervates the sternal head. The thoracodorsal nerve, arising C5, C6, and C7 and innervates the coracobrachialis. It supplies
from C6, C7, and C8, supplies the latissimus dorsi. The axillary sensation to the radial aspect of the forearm.
nerve (Fig. 5.12), branching from C5 and C6, innervates the
deltoid and teres minor. A lateral patch of skin
Posterior cord of
Lateral cord of brachial plexus
brachial plexus Medial cord of
Posterior cord of brachial plexus Lateral Chapter
brachial plexus
Medial cord of
5
cord of brachial plexus
brachial plexus
Axillary nerve
Teres minor m.
Deltoid m. Biceps Musculocutaneous

brachii m. nerve
Coracobrachialis m.
Brachialis m.
FIG. 5.12 • Muscular and cutaneous distribution of the axillary FIG. 5.13 • Muscular and cutaneous distribution of the
nerve. musculocutaneous nerve.

Deltoid muscle FIG. 5.14 Application, strengthening, and flexibility

(del-toyd´ ́) The deltoid muscle is used in any lifting movement. The
trapezius muscle stabilizes the scapula as the deltoid pulls on
Origin
the humerus. The anterior fibers of the deltoid muscle flex and
der Anterior fibers: anterior lateral third of the clavicle Middle fibers: internally rotate the humerus. The posterior fibers extend and
tion lateral aspect of the acromion Posterior fibers: inferior edge of the externally rotate the humerus. The anterior fibers also
spine of the scapula horizontally adduct the humerus, while the posterior fibers
horizontally abduct it. Any movement of the humerus on the
Insertion
scapula will involve part or all of the deltoid muscle.
Deltoid tuberosity on the lateral humerus
Action
Lifting the humerus from the side to the position of abduction
der Anterior fibers: abduction, flexion, horizontal adduction, and internal is a typical action of the deltoid. Sidearm dumbbell raises are
n rotation of the glenohumeral joint Middle fibers: abduction of the excellent for strengthening the deltoid, especially the middle
glenohumeral joint Posterior fibers: abduction, extension, horizontal fibers. By abducting the arm in a slightly horizontally adducted
pter
abduction, and external rotation of the glenohumeral joint (30 degrees) position, the anterior deltoid fibers can be
emphasized. The posterior fibers can be strengthened better by
5 Palpation
abducting the arm in a slightly horizontally abducted (30
degrees) position. See Appendix 3 for more commonly used
Anterior fibers: from the clavicle toward the anterior humerus exercises for the deltoid and other muscles in this chapter.
during resisted flexion or horizontal adduction
Middle fibers: from the lateral border of the acromion down

der
toward the deltoid tuberosity during resisted abduction Stretching the deltoid requires varying positions, depending
ntal
tion on the fibers to be stretched. The anterior deltoid is stretched by
Posterior fibers: from the lower lip of the spine of the scapula taking the humerus into extreme horizontal abduction or by
toward the posterior humerus during resisted extension or extreme extension and adduction. The middle deltoid is
horizontal abduction stretched by taking the humerus into extreme adduction behind
the back. Extreme horizontal adduction stretches the posterior
Innervation
deltoid.
der
Axillary nerve (C5, C6)
al
n
O, Anterior lateral third of clavicle, lateral aspect

of acromion, inferior edge of spine of scapula
Extension
der
ion
Horizontal
abduction
der
ntal
tion
Abduction
I, Deltoid tuberosity
Horizontal adduction on lateral humerus
der
Flexion
al
n
FIG. 5.14 • Deltoid muscle, superior view. O, Origin; I, Insertion.

Pectoralis major muscle FIG. 5.15 adduction (with the arm below 90 degrees of abduction) of
the glenohumeral joint
(pek-to-ra ́lis ma ́jor)
Lower fibers (sternal head): internal rotation, horizontal adduction,
Origin and adduction and extension of the glenohumeral joint from a Shoulder
Upper fibers (clavicular head): medial half of the anterior flexed position to the anatomical position internal
surface of the clavicle rotation
Lower fibers (sternal head): anterior surface of the costal

cartilages of the first six ribs, and adjacent portion of the Palpation
sternum Upper fibers: from the medial end of the clavicle to the
intertubercular groove of the humerus, during flexion and
Shoulder
Insertion adduction from the anatomical position Lower fibers: from the ribs horizontal
Flat tendon 2 or 3 inches wide to the lateral lip of the and sternum to the intertubercular groove of the humerus, during adduction
intertubercular groove of the humerus resisted extension from a flexed position and resisted adduction
from the anatomical position
Action
Upper fibers (clavicular head): internal rotation, horizontal Chapter
Innervation
5
adduction, flexion up to about 60 degrees, abduction (once the
arm is abducted 90 degrees, the upper fibers assist in further Upper fibers: lateral pectoral nerve (C5–C7) Lower
abduction), and fibers: medial pectoral nerve (C8, T1)
Shoulder
flexion
O, Medial half of anterior

Shoulder
surface of
abduction
clavicle, anterior
surface of costal
Horizontal adduction
cartilages of first
six ribs, adjoining
portion of sternum
Shoulder
adduction
I, Flat tendon
2 or 3 inches
Adduction wide to lateral
lip of intertubercular
groove of humerus
Shoulder
extension
Internal rotation
FIG. 5.15 • Pectoralis major muscle, anterior view. O, Origin; I, Insertion.

Application, strengthening, and flexibility used powerfully in push-ups, pull-ups, throwing, and tennis
The anterior axillary fold is formed primarily by the pectoralis serves. With a barbell, the subject takes a supine position on a
major (Fig. 5.16). It aids the serratus anterior muscle in drawing bench with the arms at the side and moves the arms to a
the scapula forward as it moves the humerus in flexion and horizontally adducted position. This exercise, known as bench
internal rotation. Even though the pectoralis major is not pressing, is widely used for pectoralis major development.
attached to the scapula, it is effective in this scapula protraction
because of its anterior pull on the humerus, which joins to the
scapula at the glenohumeral joint. Typical action is shown in Due to the popularity of bench pressing and other
throwing a baseball. As the glenohumeral joint is flexed, the weight-lifting exercises that emphasize the pectoralis major and
humerus is internally rotated and the scapula is drawn forward its use in most sporting activities, it is often overdeveloped in
with upward rotation. It also works as a helper of the latissimus comparison to its antagonists. As a result, stretching is often
dorsi muscle when extending and adducting the humerus from a needed and can be done by passive external rotation. It is also
raised position. stretched when the shoulder is horizontally abducted. Extending
the shoulder fully provides stretching to the upper pectoralis
major, while full abduction stretches the lower pectoralis major.
pter
The pectoralis major and the anterior deltoid work closely
5 together. The pectoralis major is
Pectoralis major
Serratus anterior
Coracobrachialis
Short head of biceps brachii Long
head of biceps brachii Deltoid
Teres major
Latissimus dorsi
Biceps brachii
Coracobrachialis
Triceps brachii
Humerus
FIG. 5.16 • Cross section of right arm and relationship of glenohumeral muscles in axilla.

Latissimus dorsi muscle FIG. 5.17 thoracic vertebrae (T6–T12); slips from the lower three ribs
(lat-is ́i-mus dor ́si)
Origin Insertion Shoulder

Posterior crest of the ilium, back of the sacrum and spinous Medial lip of the intertubercular groove of the humerus, just adduction
processes of the lumbar and lower six anterior to the insertion of the teres major
Shoulder
extension
Anterior view
Chapter
5
I, Medial lip of
intertubercular
groove of humerus
Shoulder
internal
rotation
Internal rotation
Extension
Shoulder
Adduction
horizontal
O, Posterior crest of ilium, back of abduction
sacrum and spinous
processes
of lumbar and lower six
thoracic vertebrae,
slips from lower
three ribs
FIG. 5.17 • Latissimus dorsi muscle, posterior view. O, Origin; I, Insertion.

Action downwardly rotates the scapula by way of its action in pulling

Adduction of the glenohumeral joint Extension of the the entire shoulder girdle downward in active glenohumeral
glenohumeral joint Internal rotation of the glenohumeral joint adduction. It is one of the most important extensor muscles of
Horizontal abduction of the glenohumeral joint the humerus and contracts powerfully in chinning. The
latissimus dorsi is assisted in all its actions by the teres major
and is sometimes referred to as the swimmer’s muscle because
Palpation of its function in pulling the body forward in the water during
internal rotation, adduction, and extension. Development of this
The tendon may be palpated as it passes under the teres major at
muscle contributes significantly to what is known as a
the posterior wall of the axilla, particularly during resisted
“swimmer’s build.”
extension and internal rotation. The muscle can be palpated in the
upper lumbar/lower thoracic area during extension from a flexed
position. The muscle may be palpated throughout most of its
Exercises in which the arms are pulled down bring the
length during resisted adduction from a slightly abducted position.
latissimus dorsi muscle into powerful contraction. Chinning,
rope climbing, and other uprise movements on the horizontal
pter
bar are good examples. In barbell exercises, the basic rowing
and pullover exercises are good for developing the “lats.”
5 Innervation
Thoracodorsal nerve (C6–C8)
Pulling the bar of an overhead pulley system down toward the
shoulders, known as “lat pulls,” is a common exercise for this
muscle.
Application, strengthening, and flexibility
Latissimus dorsi means broadest muscle of the back. This The latissimus dorsi is stretched with the teres major when
muscle, along with the teres major, forms the posterior axillary the shoulder is externally rotated while in a 90-degree abducted
fold (see Fig. 5.16). It has a strong action in adduction, position. This stretch may be accentuated further by abducting
extension, and internal rotation of the humerus. Due to the the shoulder fully while maintaining external rotation and then
upward rotation of the scapula that accompanies glenohumeral laterally flexing and rotating the trunk to the opposite side.
abduction, the latissimus effectively

Teres major muscle FIG. 5.18 diagonally upward and laterally from the inferior angle of the
scapula during resisted internal rotation
(te ́rez ma ́jor)
Origin Shoulder
extension
Posteriorly on the inferior third of the lateral border of the scapula Innervation
and just superior to the inferior angle Lower subscapular nerve (C5, C6)

Insertion The teres major muscle is effective only when the rhomboid muscles
Medial lip of the intertubercular groove of the humerus just stabilize the scapula or move Shoulder
posterior to the insertion of the latissimus dorsi the scapula in downward rotation. Otherwise, the internal
rotation
scapula would move forward to meet the arm.
This muscle works effectively with the latissimus dorsi. It assists the
Action latissimus dorsi, pectoralis major, and subscapularis in adducting, internally
Extension of the glenohumeral joint, particularly from the rotating, and extending the humerus. It is said Chapter
flexed position to the posteriorly extended position
to be the latissimus dorsi’s “little helper.” It may be strengthened by lat
Internal rotation of the glenohumeral joint Adduction of the pulls, rope climbing, and 5
glenohumeral joint, particularly from the abducted position down internal rotation exercises against resistance.
to the side and toward the midline of the body Externally rotating the shoulder in a 90-degree abducted
position stretches the teres major.
Palpation
Just above the latissimus dorsi and below the teres minor on the Shoulder
adduction
posterior scapula surface, moving
Anterior view with

teres major insertion
Extension
I, Medial lip of the
intertubercular groove
of the humerus
Internal
rotation
Adduction
O, Inferior third of lateral border

of scapula
FIG. 5.18 • Teres major muscle, posterior view. O, Origin; I, Insertion.

Coracobrachialis muscle FIG. 5.19 Innervation

(kor-a-ko-bra ́ki-a ́lis) Musculocutaneous nerve (C5–C7)
Origin Application, strengthening, and flexibility

Coracoid process of the scapula The coracobrachialis is not a powerful muscle, but it does assist
der
n
in flexion and adduction and is most functional in moving the
Insertion
arm horizontally toward and across the chest. It is best
Middle of the medial border of the humeral shaft strengthened by horizontally adducting the arm against
resistance, as in bench pressing. It may also be strengthened
Action by performing lat pulls (defined on
Flexion of the glenohumeral joint Adduction of
der
the glenohumeral joint p. 128).
tion
Horizontal adduction of the glenohumeral joint The coracobrachialis is best stretched in extreme horizontal
abduction, although extreme extension also stretches this
Palpation muscle.
pter The belly may be palpated high up on the medial arm just
5
posterior to the short head of the biceps brachii and toward the
coracoid process, particularly with resisted adduction.
der
Horizontal adduction
ntal
tion
Coracobrachialis
muscle
O, Coracoid process
Adduction of the scapula
I, Middle of the medial

border of
the humeral shaft
Flexion
FIG. 5.19 • Coracobrachialis muscle, anterior view. O, Origin; I, Insertion.

Rotator cuff muscles weakness, and loss of movement at the shoulder can result.
Loss of function of the rotator cuff muscles, due to injury or loss
Figs. 5.20 and 5.21 illustrate the rotator cuff muscle group, of strength and endur-
which, as previously mentioned, is most important in ance, may cause the humerus to move superiorly, Shoulder
maintaining the humeral head in its proper location within the resulting in this impingement. internal
glenoid cavity. The acronym SITS may be used in learning the rotation
names of the supraspinatus, infraspinatus, teres minor, and

subscapularis. These muscles, which are not very large in
Acromion process Clavicle
comparison with the deltoid and pectoralis major, must possess
Coracoid process
not only adequate strength but also a significant amount of
muscular endurance to ensure their proper functioning, Supraspinatus
Infraspinatus
particularly in repetitious overhead activities such as throwing, Lesser tubercle Shoulder
swimming, and pitching. Quite often when these types of Greater tubercle abduction
activities are conducted with poor technique, muscle fatigue, or Subscapularis
Teres minor
inadequate warm-up and conditioning, the rotator cuff muscle
group—particularly the supraspinatus—fails to dynamically
Chapter
stabilize the humeral head in the glenoid cavity, leading to
further rotator cuff problems such as tendinitis and rotator cuff
impingement within the subacromial space.
5
Humerus
Shoulder
Rotator cuff impingement syndrome occurs when the
external
tendons of these muscles, particularly the supraspinatus and
rotation
infraspinatus, become irritated and inflamed as they pass
FIG. 5.20 • Rotator cuff muscles, anterolateral view, right shoulder.

through the subacromial space between the acromion process
of the scapula and the head of the humerus. Pain,
Shoulder
extension
Supraspinatus Subscapularis
muscle
muscle
Infraspinatus muscle
Shoulder
adduction
External rotation
Teres minor
tendon
Shoulder
horizontal
abduction
External rotation
Infraspinatus Internal rotation
Subscapularis tendon
tendon Supraspinatus
tendon
Abduction
FIG. 5.21 • Rotator cuff muscles, superior view, right shoulder.

Subscapularis muscle FIG. 5.22 actively internally rotating by pressing the forearm against the
chest.
(sub-skap-u-la ́ris)
der Origin
Innervation
al Entire anterior surface of the subscapular fossa Upper and lower subscapular nerve (C5, C6)
n
Insertion Application, strengthening, and flexibility

Lesser tubercle of the humerus The subscapularis muscle, another rotator cuff muscle, holds
the head of the humerus in the glenoid fossa from in front and
Action below. It acts with the latissimus dorsi and teres major muscles
der Internal rotation of the glenohumeral joint Adduction of in its typical movement but is less powerful in its action because
tion the glenohumeral joint Extension of the glenohumeral of its proximity to the joint. The muscle also requires the help of
joint the rhomboid in stabilizing the scapula to make it effective in the
Stabilization of the humeral head in the glenoid fossa movements described. The subscapularis is relatively hidden
behind the rib cage in its location on the anterior aspect of the
pter Palpation scapula in the subscapular fossa. It may be strengthened with
exercises similar to those used for the latissimus dorsi and teres
5
The subscapularis, latissimus dorsi, and teres major, in
conjunction, form the posterior axillary fold. Most of the major, such as rope climbing and lat pulls. A specific exercise
subscapularis is inaccessible on the anterior scapula behind the for its development is done by internally rotating the arm against
rib cage. The lateral portion may be palpated with the subject resistance in the beside-the-body position at 0 degrees of
supine and arm in slight flexion and adduction so that the elbow glenohumeral abduction.
is lying across the abdomen. Use one hand posteriorly to grasp
der
the medial border and pull it laterally, while palpating between the
ion scapula and rib cage with the other hand with the subject
External rotation with the arm adducted by the side
stretches the subscapularis.
FIG. 5.22 • Subscapularis muscle, anterior view.

O, Origin; I, Insertion.
Stabilization of
humeral head
I, Lesser tubercle
of humerus
Adduction
Internal
rotation
O, Entire anterior
Extension
surface of sub-
scapular fossa

Supraspinatus muscle FIG. 5.23 the humeral head to subluxate anteriorly. In the follow-through
phase, the humeral head tends to move posteriorly.
(su ́pra-spi-na ́tus)
Origin The supraspinatus, along with the other rotator cuff muscles, must
Medial two-thirds of the supraspinous fossa have excellent strength and Shoulder
endurance to prevent abnormal and excessive abduction
Insertion movement of the humeral head in the fossa.
Superiorly on the greater tubercle of the humerus The supraspinatus is the most often injured rotator cuff
muscle. Acute severe injuries may occur with trauma to the
Action shoulder. However, mild to moderate strains or tears often occur
Abduction of the glenohumeral joint with athletic activity, particularly if the activity involves repetitious
Stabilization of the humeral head in the glenoid fossa overhead movements, such as throwing or swimming.
Palpation Injury or weakness in the supraspinatus may be detected

Anterior and superior to the spine of the scapula in the when the athlete attempts to sub-
supraspinous fossa during initial abduction in the scapula plane. stitute the scapula elevators and upward rota- Chapter
Also, the tendon may be palpated in a seated position just off the tors to obtain humeral abduction. An inability
acromion on the greater tubercle. to smoothly abduct the arm against resistance is 5
indicative of possible rotator cuff injury.
The supraspinatus muscle may be called into play whenever
Innervation the middle fibers of the deltoid muscle are used. A “full-can
Suprascapular nerve (C5) exercise” may be used to emphasize supraspinatus action. This
is performed by placing the arm in thumbs-up position, followed
Application, strengthening, and flexibility by abducting the arm to 90 degrees in a 30- to 45-degree
The supraspinatus muscle holds the head of the humerus in the horizontally adducted position (scaption), as if one were holding
glenoid fossa. In throwing movements, it provides important a full can.
dynamic stability by maintaining the proper relationship between
the humeral head and the glenoid fossa. In the cocking phase Adducting the arm behind the back with the shoulder
of throwing, there is a tendency for internally rotated and extended stretches the supraspinatus.
FIG. 5.23 • Supraspinatus muscle, posterior view.

Abduction
I, Superiorly on
greater tubercle
of humerus
Stabilization O, Medial two-thirds

of humeral of supraspinous fossa
head

Infraspinatus muscle FIG. 5.24 Application, strengthening, and flexibility

(in ́fra-spi-na ́tus) The infraspinatus and teres minor muscles are effective when
der Origin
the rhomboid muscles stabilize the scapula. When the humerus
al is rotated outward, the rhomboid muscles flatten the scapula to
n Posterior surface of scapula below spine the back and fixate it so that the humerus may be rotated.
Insertion An appropriate amount of strength and endurance is critical

Greater tubercle on posterior side of the humerus in both the infraspinatus and teres minor as they are called
upon eccentrically to slow down the arm from high velocity
Action internal rotation activities such as baseball pitching and serving
der External rotation of the glenohumeral joint Horizontal in tennis. The infraspinatus is vital to maintaining the posterior
ntal abduction of the glenohumeral joint Extension of the stability of the glenohumeral joint. It is the most powerful of the
tion glenohumeral joint external rotators and is the second most commonly injured
Stabilization of the humeral head in the glenoid fossa rotator cuff muscle.
pter
Both the infraspinatus and the teres minor can best be
5 Palpation
Just below the spine of the scapula passing upward strengthened by externally rotating the arm against resistance in
and laterally to the humerus during resisted external rotation the 15- to 20-degree abducted position and the 90-degree
abducted position.
Innervation Stretching of the infraspinatus is accomplished with internal

rotation and extreme horizontal adduction.
lder Suprascapular nerve (C5, C6)
ion
Horizontal
abduction
I, Greater tubercle
on posterior side
External
rotation
O, Posterior surface of
scapula below spine
FIG. 5.24 • Infraspinatus muscle, posterior view. O, Origin; I, Insertion.

Teres minor muscle FIG. 5.25 Palpation

(te ́rez mi ́nor) Just above the teres major on the posterior scapula surface,
moving diagonally upward and laterally from the inferior angle of Shoulder
Origin
the scapula during resisted external rotation external
Posteriorly on the upper and middle aspect of the lateral border rotation
of the scapula
Innervation
Insertion
Axillary nerve (C5, C6)
Posteriorly on the greater tubercle of the humerus
Action
The teres minor functions very similarly to the Shoulder
External rotation of the glenohumeral joint Horizontal infraspinatus in providing dynamic posterior sta- horizontal
abduction of the glenohumeral joint Extension of the bility to the glenohumeral joint. Both of these mus- abduction
glenohumeral joint cles perform the same actions together. The teres minor is
Stabilization of the humeral head in the glenoid fossa strengthened with the same exercises that are used in
strengthening the infraspinatus. Chapter
5
The teres minor is stretched similarly to the infraspinatus by internally
rotating the shoulder
while moving into extreme horizontal adduction.
Shoulder
extension
Horizontal
abduction
I, Greater tubercle
of humerus on
posterior side
External
rotation
O, Posterior scapula,
lateral border
FIG. 5.25 • Teres minor muscle, posterior view. O, Origin; I, Insertion.

REVIEW EXERCISES a. The rotator cuff muscles are not functioning properly
due to fatigue or lack of appropriate strength and
endurance.
1. List the planes in which each of the following glenohumeral
b. The scapula stabilizers are not functioning properly due
joint movements occurs. List the respective axis of rotation
to fatigue or lack of strength and endurance.
for each movement in each plane.
4. The movements of the scapula in relation to the humerus

a. Abduction
can be explained by discussing the movement of the
b. Adduction
shoulder complex in its entirety. How does the position of
c. Flexion
the scapula affect shoulder joint abduction? How does the
d. Extension
position of the scapula affect shoulder joint flexion?
e. Horizontal adduction
f. Horizontal abduction
g. External rotation
5. Describe the bony articulations and movements specific to
h. Internal rotation
shoulder joint rotation during the acceleration phase of the
2. Why is it essential that both anterior and posterior muscles
throwing motion and how an athlete can work toward
of the shoulder joint be properly developed? What are
pter increasing the velocity of the throw. What factors affect the
some activities or sports that would cause unequal
5
velocity of the throw?
development? equal development?
6. Using the information from this chapter and other

3. What practical application do the activities or sports in
resources, how would you strengthen the four rotator cuff
Question 2 support if each of the following is true?
muscles? Give several examples of how these muscles are
used in everyday activities.
7. Muscle analysis chart • Shoulder girdle and shoulder joint
Complete the chart by listing the muscles primarily involved in each movement.
Shoulder girdle Shoulder joint
Upward rotation Abduction
Downward rotation Adduction
Depression Extension
Elevation Flexion
Abduction Horizontal adduction
Internal rotation
Adduction Horizontal abduction
External rotation

8. Antagonistic muscle action chart • Shoulder joint
Complete the chart by listing the muscle(s) or parts of muscles that are antagonist in their actions to the muscles in the left column.
Agonist Antagonist
Deltoid (anterior fibers)
Deltoid (middle fibers)
Deltoid (posterior fibers)
Supraspinatus
Subscapularis
Teres major Chapter
Infraspinatus/Teres minor 5
Latissimus dorsi
Pectoralis major (upper fibers)
Pectoralis major (lower fibers)
Coracobrachialis

LABORATORY EXERCISES c. Flexion

d. Extension
e. Horizontal adduction
1. Locate the following parts of the humerus and scapula on a
f. Horizontal abduction
human skeleton and on a subject:
g. External rotation
a. Greater tubercle
h. Internal rotation
b. Lesser tubercle
4. Using an articulated skeleton, compare the relationship of
c. Neck
the greater tubercle to the undersurface of the acromion in
d. Shaft
each of the following situations:
e. Intertubercular groove
f. Medial epicondyle
a. Flexion with the humerus internally versus externally
g. Lateral epicondyle
rotated
h. Trochlea
b. Abduction with the humerus internally versus externally
i. Capitulum
rotated
j. Supraspinous fossa
c. Horizontal adduction with the humerus internally versus
k. Infraspinous fossa
externally rotated
l. Spine of the scapula
pter 5. Pair up with a partner with the back exposed. Use your
2. How and where can the following muscles be palpated on a
5
hand to grasp your partner’s right scapula along the lateral
human subject?
border to prevent scapula movement. Have your partner
a. Deltoid
slowly abduct the glenohumeral joint as much as possible.
b. Teres major
Note the difference in total abduction possible normally
c. Infraspinatus
versus when you restrict movement of the scapula. Repeat
d. Teres minor
the same exercise, except hold the inferior angle of the
e. Latissimus dorsi
scapula tightly against the chest wall while you have your
f. Pectoralis major (upper and lower)
partner internally rotate the humerus. Note the difference in
Note: Using the pectoralis major muscle, indicate how
total internal rotation possible normally versus when you
various actions allow muscle palpation. Demonstrate and
restrict movement of the scapula.
3. locate on a human subject the muscles that are primarily
used in the following shoulder joint movements:
a. Abduction
b. Adduction
6. Shoulder joint movement analysis chart
After analyzing each of the exercises in the chart, break each into two primary movement phases, such as a lifting phase and a lowering
phase. For each phase, determine the shoulder joint movements occurring, and then list the shoulder joint muscles primarily responsible
for causing/controlling those movements. Beside each muscle in each movement, indicate the type of contraction as follows: I—isometric;
C—concentric; E—eccentric.

Exercise
Push-up
Chin-up
Bench press
Dip
Lat pull
Overhead press
Prone row
Barbell shrugs

7. Shoulder joint sport skill analysis chart
Analyze each skill in the chart and list the movements of the right and left shoulder joint in each phase of the skill. You may prefer to list
the initial position the shoulder joint is in for the stance phase. After each movement, list the shoulder joint muscle(s) primarily
responsible for causing/controlling that movement. Beside each muscle in each movement, indicate the type of contraction as follows:
I—isometric; C—concentric; E—eccentric. It may be desirable to review the concepts for analysis in Chapter 8 for the various phases.
(R)
Baseball
pitch
(L)
(R)
Volleyball
serve Chapter
(L)
5
(R)
Tennis serve
(L)
(R)
Softball
pitch
(L)
(R)
Tennis
backhand
(L)
(R)
Batting
(L)
(R)
Bowling
(L)
(R)
Basketball
free throw
(L)

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Garth WP, et al: Occult anterior subluxations of the shoulder in Smith LK, Weiss EL, Lehmkuhl LD: Brunnstrom’s clinical kinesiology,
noncontact sports, American Journal of Sports Medicine 15:579, ed 5, Philadelphia, 1996, Davis.
November–December 1987.
Spigelman T: Identifying and assessing glenohumeral internal-
Hislop HJ, Montgomery J: Daniels and Worthingham’s muscle testing: rotation deficit, Athletic Therapy Today 6:29–31, 2006.
techniques of manual examination, ed 8, Philadelphia, 2007, Saunders.
pter Stacey E: Pitching injuries to the shoulder, Athletic Journal 65:44,
January 1984.
5 Loftice JW, Fleisig GS, Wilk KE, Reinold MM, Chmielewski T,

Escamilla RF, Andrews JR, eds: Conditioning program for baseball pitchers, Birmingham,
Wilk KE, Reinold MM, Andrews JR, eds: The athlete’s shoulder, ed 2,
2004, American Sports Medicine Institute.

Myers JB, et al: Glenohumeral range of motion deficits and posterior

shoulder tightness in throwers with pathologic internal impingement,
American Journal of Sports Medicine 34:385–391, 2006.
Neumann DA: Kinesiology of the musculoskeletal system: foundations

Oatis CA: Kinesiology: the mechanics and pathomechanics of human For additional resources and a list of related websites,
movement, ed 2, Philadelphia, 2008, Lippincott Williams & Wilkins. visit www.mhhe.com/floyd19e.

Worksheet Exercises
Worksheet 1
a. Deltoid f. Teres minor

b. Supraspinatus g. Latissimus dorsi
c. Subscapularis h. Pectoralis major
d. Teres major i. Coracobrachialis
e. Infraspinatus
Chapter

Worksheet Exercises
Worksheet 2
Label and indicate with arrows the following movements of the shoulder joint. For each motion, complete the sentence by supplying the plane
in which it occurs and the axis of rotation.
a. Abduction occurs in the plane about the axis.

b. Adduction occurs in the plane about the axis.
c. Flexion occurs in the plane about the axis.
d. Extension occurs in the plane about the axis.
e. Horizontal adduction occurs in the plane about the axis.
f. Horizontal abduction occurs in the plane about the axis.
pter

C HAPTER 6
T HE E LBOW AND
R ADIOULNAR J OINTS
Objectives
A will involve
lmost the elbowof
any movement andtheradioulnar joints.
upper extremity
Quite often, these joints are grouped together Chapter
6
j To identify on a human skeleton selected bony features of
the elbow and radioulnar joints because of their close anatomical relationship.
The elbow joint is intimately associated with the
j To label selected bony features on a skeletal chart radioulnar joint in that both bones of the radioulnar joint, the
radius and ulna, share an articulation with the humerus to form
the elbow joint. For this reason, some may confuse motions of
j To draw and label the muscles on a skeletal chart
the elbow with those of the radioulnar joint. In addition,
radioulnar joint motion may be incorrectly attributed to the wrist
j To palpate the muscles on a human subject and list their joint because it appears to occur there. However, with close
antagonists inspection, movements of the elbow joint can be clearly
distinguished from those of the radioulnar joints, just as the
j To list the planes of motion and their respective axes of
radioulnar movements can be distinguished from those of the
rotation
wrist. Even though the radius and ulna are both part of the
j To organize and list the muscles that produce the primary articulation with the wrist, the relationship between them is not
movements of the elbow joint and the radioulnar joint nearly as intimate as that of the elbow and radioulnar joints.
j To determine, through analysis, the elbow and radioulnar

joint movements and muscles involved in selected skills
and exercises
Bones
The ulna is much larger proximally than the radius (Fig. 6.1), but
distally the radius is much larger than the ulna (see Fig. 7.1 on
p. 170). The scapula and humerus serve as the proximal
attachments for the muscles that flex and extend the elbow. The
for additional information and study material for this chapter, including: ulna and radius serve as the distal attachments for the same
muscles. The scapula, humerus, and ulna serve as proximal
attachments for the muscles that pronate and supinate the
j Self-grading quizzes radioulnar joints. The distal attachments of the radioulnar joint
j Anatomy flashcards muscles are located on the radius.
j Animations
j Related websites

The medial condyloid ridge, olecranon process, coronoid Joints

process, and radial tuberosity are important bony landmarks for
these muscles. Additionally, the medial epicondyle, lateral The elbow joint is classified as a ginglymus or hinge-type joint
epicondyle, and lateral supracondylar ridge are key bony that allows only flexion and extension (Fig. 6.1). The elbow may
landmarks for the muscles of the wrist and hand, discussed in actually be thought of as two interrelated joints: the humeroulnar
Chapter 7. and the radiohumeral joints (Fig. 6.2). Elbow motions
Humerus
Lateral Lateral
ridge Coronoid fossa supracondylar
Capitulum
ridge
Radial head
Lateral Medial Olecranon
Radial tuberosity
epicondyle epicondyle fossa
pter Lateral Radius
Capitulum
Trochlea
6
epicondyle
Head of Coronoid Olecranon

radius process process
Ulna
Radial
tuberosity Radial notch
Ulnar
tuberosity
Radius Ulna B Lateral view
A Anterior view
Humerus
Coronoid fossa
Trochlea
Radial tuberosity
Radius
Medial
epicondyle
Olecranon
process
Ulna
Coronoid process Trochlear notch
Ulnar tuberosity
C Medial view
FIG. 6.1 • Right elbow joint. A, Anterior view; B, Lateral view; C, Medial view.

primarily involve movement between the articular surfaces of allowing for more side-to-side laxity. The stability of the elbow in
the humerus and ulna—specifically, the humeral trochlear fitting flexion is more dependent on the collateral ligaments, such as
into the trochlear notch of the ulna. The head of the radius has a the lateral or radial collateral ligament and especially the medial
relatively small amount of contact with the capitulum of the or ulnar collateral ligament (Fig. 6.3). The ulnar collateral
humerus at the radiocapitellar joint. As the elbow reaches full ligament is critical to providing medial support to prevent the
extension, the olecranon process of the ulna is received by the elbow from abducting (not a normal movement of the elbow)
olecranon fossa of the humerus. This arrangement provides when stressed in physical activity. Many contact sports,
increased joint stability when the elbow is fully extended. particularly sports with throwing activities, place stress on the
medial aspect of the joint, resulting in injury. Often this injury
involves either acute or chronic stress to the ulnar collateral
ligament, or UCL,
As the elbow flexes approximately 20 degrees or more, its
bony stability is somewhat unlocked,
Radial notch Olecranon

of ulna process
Chapter
Trochlear
6
Head of
(semilunar)
radius
notch
Coronoid process
Olecranon Olecranon C Proximal view
Trochlear notch
Radial notch
of ulna Head of
radius
Head of Coronoid process
radius
Neck of
Neck of radius
radius Tuberosity of ulna
Superior
Tuberosity Posterior Anterior
of radius
Inferior
Ulna
Radius
Olecranon
Interosseous
process
margins
Trochlear
notch
Interosseous Coronoid
membrane
process
Radial
notch
Ulnar notch Posterior Anterior
of radius
Head of ulna
Styloid process
Styloid Styloid
Articular facets
process process
D Lateral view of proximal
A Anterior view B Posterior view end of ulna
FIG. 6.2 • Right radioulnar joint in supination. A, Anterior view; B, Posterior view; C, Proximal view of radioulnar joint; D, Lateral view
of proximal end of ulna.

resulting in partial to complete tears to it. The UCL is particularly lateral stability and are rarely injured. Additionally, the annular
crucial to those high-velocity sporting activities, such as ligament is located laterally, providing a sling effect around the
baseball pitching, that require optimal stability of the medial radial head to secure its stability.
elbow. Even moderate injury to this structure can seriously
impact an athlete’s ability to throw at the highest levels. In the anatomical position, it is common for the forearm to
Compromise of this structure often requires surgery using a deviate laterally from the arm from 5 to 15 degrees. This is
tendon graft such as the palmaris longus tendon to reconstruct referred to as the carrying angle and permits the forearms to
this ligament. This surgery, often referred to as the “Tommy clear the hips in the swinging movements during walking and
John procedure,” is particularly common among high school, also is important when carrying objects. Typically, the angle is
collegiate, and professional pitchers. The radial collateral and slightly greater in the dominant limb than in the nondominant
lateral ulnar collateral ligaments on the opposite side provide limb. It is also common for females to have a slightly greater
carrying angle than men (Fig. 6.4).
Joint
capsule
pter Humerus
6
Articular capsule
Lateral epicondyle
of humerus Medial epicondyle Radial collateral ligament
of humerus
Annular ligament Lateral ulnar collateral ligament Annular
ligament
Insertion of Ulnar collateral
tendon of biceps ligament
brachii m. (cut)
Radius
Ulna
B Lateral view
A Anterior View
Medial Tendon of biceps

brachii m. (cut) Humerus
Joint epicondyle Joint
capsule of humerus capsule
Synovial
Annular ligament Trochlea
Tendon of biceps membrane
brachii m. (cut) Radius
Synovial
membrane
Olecranon
bursa
Ulna Olecranon
Coronoid process Ulnar collateral ligament
of ulna Coronoid process
C Medial view D Sagittal cut view
FIG. 6.3 • Right elbow with ligaments detailed. A, Anterior view; B, Lateral view; C, Medial view; D, Sagittal cut view.

The elbow is capable of moving from 0 degrees of extension

to approximately 145 to 150 degrees of flexion, as detailed in Neutral
Fig. 6.5. Some people, more commonly females, may 0°
Pr
on
hyperextend the elbow up to approximately 15 degrees. ati
o n
The radioulnar joint is classified as a trochoid or pivot-type

joint. The radial head rotates around in its location at the ion
at
pin
proximal ulna. This rotary movement is accompanied by rotation 90° Su 90°
of the distal radius around the distal ulna. The radial head is
maintained in its joint by the annular ligament. The radioulnar FIG. 6.6 • ROM of the forearm: pronation and supination. Pronation:
joint can supinate approximately 80 to 90 degrees from the zero to 80 or 90 degrees.
neutral position. Pronation varies from 70 to 90 degrees (Fig. Supination: zero to 80 or 90 degrees. Total forearm motion: 160 to
6.6). 180 degrees. Persons may vary in the range of supination and
pronation. Some may reach the 90-degree arc, and others may
Due to the radius and ulna being held tightly together have only 70 degrees plus.
between the proximal and distal articulations by an interosseus
membrane, the joint between the shafts of these bones is often
referred
to as a syndesmosis type of joint. This interos-

seus membrane is helpful in absorbing and trans- Chapter
mitting forces received by the hand, particularly
during upper-extremity weight bearing. There 6
is substantial rotary motion between the bones
despite this classification.
Even though the elbow and radioulnar joints can and do
function independently of each other, the muscles controlling
each work together in synergy to perform actions at both to
benefit the total function of the upper extremity. For this reason,
dysfunction at one joint may affect normal function at the other.
Synergy among the glenohumeral, elbow, and radioulnar

joint muscles
FIG. 6.4 • Carrying angle of elbow. Just as there is synergy between the shoulder girdle and the
shoulder joint in accomplishing upper-extremity activities, there
is also synergy between the glenohumeral joint and the elbow
joint as well as the radioulnar joints.
90°
Flexion
As the radioulnar joint goes through its ranges of motion, the
150°
glenohumeral and elbow muscles contract to stabilize or assist
in the effectiveness of movement at the radioulnar joints. For
0°
example, when attempting to fully tighten (with the right hand) a
180°
Neutral screw with a screwdriver that involves radioulnar supination, we
10° tend to externally rotate and flex the glenohumeral and elbow
Hyperextension
joints, respectively. Conversely, when attempting to loosen a
tight screw with pronation, we tend to internally rotate and
extend the elbow and glenohumeral joints, respectively. In
FIG. 6.5 • ROM of the elbow: flexion, extension, and
either case, we depend on both the agonists and the
hyperextension. Flexion: zero to 150 degrees.
antagonists in the surrounding joints to provide an appropriate
Extension: 150 degrees to zero. Hyperextension:
amount of stabilization and assistance with the required task.
measured in degrees beyond the zero starting point. This motion is
not present in all persons. When it is present, it may vary from 5 to
15 degrees.

Movements FIGS. 6.5, 6.6, 6.7, 6.8, 6.9 Radioulnar joint movements
Pronation: Internal rotary movement of the radius on the ulna that
Elbow movements results in the hand moving from the palm-up to the palm-down
Flexion: Movement of the forearm to the shoulder by bending the position
elbow to decrease its angle Supination: External rotary movement of the radius on the ulna that
Extension: Movement of the forearm away from the shoulder by results in the hand moving from the palm-down to the palm-up
straightening the elbow to increase its angle position
ion
pter
ulnar
ion
Flexion Extension
A B
ulnar
ation
Pronation Supination
C D
FIG. 6.7 • Movements of the elbow and radioulnar joint. A, Elbow flexion; B, Elbow extension;
C, Radioulnar pronation; D, Radioulnar supination.

Origins Origins
Humerus
Scapula
Bellies
Extensors: Flexors:
Triceps brachii Biceps brachii
Long head Brachialis
Lateral head
Insertion
Radius
Insertion
Ulna
FIG. 6.8 • Right elbow, lateral view of flexors and extensors.

Chapter
6
Lateral epicondyle
Medial epicondyle
Supinator
Pronator teres
Ulna
Radius
Pronator quadratus
Bic eps
brachii
Radius
Bursa
Supinator
Ulna
C Muscle actions
A Supination B Pronation
FIG. 6.9 • Actions of the rotator muscles of the forearm. A, Supination; B, Pronation, C, Cross section just distal to the elbow, showing
how the biceps brachii aids the supinator.

Muscles specific pathology this condition may be termed lateral

epicondylagia or lateral epicondylosis.
The muscles of the elbow and radioulnar joints may be more Medial epicondylitis , a somewhat less common problem
clearly understood when separated by function. The elbow frequently referred to as “golfer’s elbow,” is associated with the
flexors, located anteriorly, are the biceps brachii, the brachialis, wrist flexor and pronator group near their origin on the medial
and the brachioradialis, with some weak assistance from the epicondyle. Both of these conditions involve muscles that cross
pronator teres (Figs. 6.10, 6.11, and 6.14). the elbow but act primarily on the wrist and hand. These
muscles will be addressed in Chapter 7.
The triceps brachii, located posteriorly, is the primary elbow
extensor, with assistance provided by the anconeus (Figs. 6.12,
6.13, and 6.14). The pronator group, located anteriorly, consists
of the pronator teres, the pronator quadratus, and the Elbow and radioulnar joint muscles—location
brachioradialis. The brachioradialis also assists with supination, Anterior
which is controlled mainly by the supinator muscle and the Primarily flexion and pronation
biceps brachii. The supinator muscle is located posteriorly. See Biceps brachii
Table 6.1. Brachialis
Brachioradialis
Pronator teres
A common problem associated with the muscles of the Pronator quadratus
elbow is “tennis elbow,” which usually involves the extensor
pter Posterior
digitorum muscle near its origin on the lateral epicondyle. This
6
Primarily extension and supination
condition, known technically as lateral epicondylitis , is quite
Triceps brachii
frequently associated with gripping and lifting activities. More
Anconeus
recently, depending upon the
Supinator
Trapezius m.
Clavicle
Deltoid m.
Pectoralis major m.
Triceps brachii m.
Biceps brachii—short head
Biceps brachii—long head
Brachialis m.
Pronator teres m.
Brachioradialis m. Bicipital aponeurosis
Flexor carpi radialis m.
Palmaris longus m.
Flexor carpi ulnaris m.
Flexor digitorum
superficialis m.
Flexor retinaculum
Palmar aponeurosis
FIG. 6.10 • Anterior upper-extremity muscles. FIG. 6.11 • Anterior upper-extremity muscles.

Trapezius m. Acromion process

of scapula
Deltoid m.
Triceps brachii m.
Brachioradialis m.
Ulnar nerve
Extensor carpi
Anconeus radialis longus m.
Flexor carpi Extensor carpi

ulnaris m. radialis brevis m.
Extensor carpi Extensor digitorum m.
ulnaris m.
Extensor digiti
minimi m.
Extensor
retinaculum
Chapter
6
FIG. 6.12 • Posterior upper-extremity muscles. FIG. 6.13 • Posterior upper-extremity muscles.
Acromion process
Serratus anterior (cut)
Spine of Clavicle
Coracobrachialis
scapula
Short Teres major
Deltoid Biceps head
Tendon of latissimus
Long Pectoralis major brachii Long
dorsi (cut)
head head
Triceps
Biceps brachii Long head
brachii Triceps
Lateral (long head)
Medial head brachii
head
Brachialis Radius Medial epicondyle
of humerus
Brachioradialis Biceps brachii
Anconeus tendon Brachialis
Pronator teres Aponeurosis of biceps

brachii
Ulna
A B
FIG. 6.14 • Muscles of the arm. A, Lateral view of the right shoulder and arm; B, Anterior view of the right shoulder and arm (deep).
Deltoid, pectoralis major, and pectoralis minor muscles removed to reveal deeper
structures.

TABLE 6.1 • Agonist muscles of the elbow and radioulnar joints
Plane of
Supination of the
Transverse
forearm
Supraglenoid
Biceps Flexion of the elbow
tubercle above
brachii
the superior lip Weak flexion of the Sagittal
long Easily palpated on the anterior
of the glenoid shoulder joint
head humerus; the long head and short
fossa
head tendons may be palpated in
Tuberosity Weak abduction of
Frontal the intertubercular groove and
of the radius the shoulder joint
Musculocuta-
and bicipital
Supination of the just inferomedial to the cor- neous nerve
Coracoid process aponeurosis Transverse acoid process, respectively;
forearm (C5, C6)
of the scapula (lacertus
distally, the biceps tendon is
and upper lip fibrosis) Flexion of the
Biceps palpated just anteromedial
of the glenoid elbow to the elbow joint during
brachii
fossa in conjunc- Sagittal
short supination and flexion
Weak flexion of the
tion with the
head shoulder joint
proximal attach-
pter ment of the
Weak abduction of
coracobrachialis Frontal
6 the shoulder joint
Deep on either side of the

biceps tendon during
Anterior muscles (primarily flexors and pronators)
flexion/extension with
forearm in partial pronation; lateral
Distal half of the Coronoid margin may be Musculocuta-
Flexion of the
Brachialis anterior shaft of process of Sagittal palpated between biceps neous nerve
elbow
the humerus the ulna brachii and triceps brachii; belly (C5, C6)
may be palpated
through biceps brachii when
forearm is in pronation during light
flexion
Flexion of the
Sagittal
Lateral sur- elbow
Distal 2/3 of the Anterolaterally on the proximal
face of the
lateral condyloid Pronation from forearm during resisted elbow
Brachio- distal end of Radial nerve
(supracondylar) supination to flexion with the
radialis the radius at (C5, C6)
ridge of the neutral Transverse radioulnar joint positioned
the styloid
humerus in neutral
process Supination from
pronation to neutral
Distal part of Pronation of the

Transverse
the medial con- forearm
Middle 1/3 Anteromedial surface of
dyloid ridge of
Pronator of the lateral the proximal forearm during Median nerve
the humerus
teres surface of Weak flexion of the resisted mid- to full pronation (C6, C7)
and medial side Sagittal
the radius elbow
of the proximal
ulna
Very deep and difficult to palpate,

Distal 1/4 of but with the forearm in
Distal 1/4 of the
Pronator the anterior Pronation of the supination, palpate immediately Median nerve
anterior side of Transverse
quadratus side of the forearm on either side of the radial pulse (C6, C7)
the ulna
radius with resisted pronation

TABLE 6.1 (continued) • Agonist muscles of the elbow and radioulnar joints
Plane of
Extension of the
elbow joint
Sagittal Proximally as a tendon on the
Infraglenoid Extension of the
Triceps posteromedial arm to underneath
tubercle below shoulder joint
brachii the posterior
inferior lip of Adduction of the
long Frontal deltoid during resisted
glenoid fossa of shoulder joint
head shoulder extension/
the scapula
Horizontal abduc- adduction
Olecranon tion of the shoulder Transverse joint
Radial nerve
process of
(C7, C8)
the ulna
Triceps Easily palpated on the proximal 2/3
Upper half of the
brachii Extension of the of the posterior humerus during
posterior surface
lateral elbow joint resisted
Posterior muscles (primarily extensors and supinators)
of the humerus
head extension
Sagittal
Triceps Deep head: medially and
Distal 2/3 of the
brachii Extension of the laterally just proximal to the
posterior surface
medial elbow joint medial and lateral epicondyles
of the humerus
head Chapter
Position elbow and forearm in

relaxed flexion and pronation, 6
Lateral epi- Lateral sur- respectively; palpate
condyle of the face of the deep to the brachioradialis,
humerus and proximal Supination of the extensor carpi radialis longus, Radial nerve
Supinator Transverse
neighboring pos- radius just terior forearm extensor carpi radialis brevis on (C6)
part of the below the ulna the lateral aspect of the proximal
head radius with slight resistance to
supination
Posterior
surface of Posterolateral aspect of the
Posterior surface
the lateral proximal ulna to the olecranon
of the lateral Extension of the Radial nerve
Anconeus olecranon Sagittal process during resisted extension
condyle of the elbow (C7, C8)
process and of the elbow with the wrist in flexion
humerus
proximal 1/4
of the ulna
Note: The flexor carpi radialis, palmaris longus, flexor carpi ulnaris, and flexor digitorum superficialis assist in weak flexion of the elbow, while the extensor carpi ulnaris,
extensor carpi radialis brevis, extensor carpi radialis longus, and extensor digitorum assist in weak extension of the elbow. Because they are covered in Chapter 7, they are
not listed above.

Nerves FIGS. 5.13, 6.15, 6.16 hand. The median nerve, illustrated in Fig. 6.16, innervates the
pronator teres and further branches to become the anterior
The muscles of the elbow and radioulnar joints are all interosseus nerve, which supplies the pronator quadratus. The
innervated from the median, musculocutaneous, and radial median nerve’s most important related derivations are from C6
nerves of the brachial plexus. The radial nerve, originating from and C7. It provides sensation to the palmar aspect of the hand
C5, C6, C7, and C8, provides innervation for the triceps brachii, and first three phalanges. The palmar aspect of the radial side
brachioradialis, supinator, and anconeus (Fig. 6.15). More of the fourth finger is also provided sensation, along with the
specifically, the posterior interosseous nerve, derived from the dorsal aspect of the index and long fingers. The
radial nerve, supplies the supinator. The radial nerve also musculocutaneous nerve, shown in Fig. 5.13, branches from C5
provides sensation to the posterolateral arm, forearm, and and C6 and supplies the biceps brachii and brachialis. Because
there is no innervation to the muscles discussed in this chapter
from the ulnar nerve, it is not addressed here, but it is often
injured at the elbow in various ways. See Chapter 7 for some
Posterior cord of brachial plexus Lateral discussion related to this nerve and injuries to it.
Medial cord
cord of brachial plexus
of brachial
plexus
Posterior cord of
pter Radial nerve brachial plexus
6 Long head of
Lateral head of
triceps brachii m.
Lateral cord of
brachial plexus
Medial cord of
triceps brachii m.
brachial plexus
Medial head of
triceps brachii m.
Brachioradialis m.
Anconeus m.
Extensor carpi
Supinator m. radialis longus m.
Extensor carpi Extensor carpi Median nerve
ulnaris m. radialis brevis m.
Extensor digiti Abductor pollicis
minimi m. longus m.
Extensor pollicis
Pronator teres m.
longus and
Extensor brevis mm. Flexor carpi radialis m.
digitorum m.
Extensor indicis m. Palmaris longus m.
Extensor retinaculum Superficial

digital flexor m.
Deep digital
Flexor pollicis flexor m.
longus m.
Pronator
quadratus m. Flexor retinaculum
Thenar mm.
Lateral lumbricales mm.
FIG. 6.15 • Muscular and cutaneous distribution of the radial FIG. 6.16 • Muscular and cutaneous distribution of the median
nerve. nerve.

Biceps brachii muscle FIG. 6.17 However, technically it should be considered a three-joint
(multiarticular) muscle—shoulder, elbow, and radioulnar. It is
(bi´seps bra´ki-i)
weak in actions of the shoulder joint, although it does assist in
Origin providing dynamic anterior stability to maintain the humeral
Long head: supraglenoid tubercle above the superior lip head in the glenoid fossa. It is more powerful in flexing the
of the glenoid fossa elbow when the radioulnar joint is
Short head: coracoid process of the scapula and upper lip of the
glenoid fossa in conjunction with the proximal attachment of the supinated. It is also a strong supinator, particu- Elbow
coracobrachialis larly if the elbow is flexed. Palms away from the flexion
face (pronation) decrease the effectiveness of the biceps, partly
Insertion as a result of the disadvantageous pull of the muscle as the
Tuberosity of the radius and bicipital aponeurosis (lacertus radius rotates. The same muscles are used in elbow joint
fibrosis) flexion, regardless of forearm pronation or supination.
Radioulnar
Action
Flexion of the forearm with a barbell in the supination
Flexion of the elbow Supination hands, known as “curling,” is an excellent exercise to develop the biceps
of the forearm brachii. This movement can be performed one arm at a time with
Weak flexion of the shoulder joint dumbbells or both arms simultaneously with a barbell. Other activities in
Weak abduction of the shoulder joint when the shoulder joint which there is powerful flexion of the forearm are chinning and rope
is in external rotation climbing. See Chapter
Palpation
Easily palpated on the anterior humerus. The long head and short other muscles in this chapter. 6
Appendix 3 for more commonly used exercises for the biceps brachii and
head tendons may be palpated in the intertubercular groove and

Due to the multiarticular orientation of the biceps, all three
just inferior to the coracoid process, respectively. Distally, the
joints must be positioned appropriately to achieve optimal
biceps tendon is palpated just anteromedial to the elbow joint
stretching. The elbow must be extended maximally with the
during supination and flexion.
shoulder in full extension. The biceps may also be stretched by
beginning with full elbow extension and progressing into full
Innervation horizontal abduction at approxi-
Musculocutaneous nerve (C5, C6) Shoulder
mately 70 to 110 degrees of shoulder abduction. In flexion
Application, strengthening, and flexibility all cases, the forearm should be fully pronated to
The biceps is commonly known as a two-joint (shoulder and achieve maximal lengthening of the biceps brachii.
elbow), or biarticular, muscle.
Shoulder
abduction
O, Coracoid
process
O, Supraglenoid
tubercle
Long head
} Biceps brachii
Short head
Flexion
I, Bicipital
aponeurosis I, Radial
tuberosity
FIG. 6.17 • Biceps brachii muscle, anterior
view. O, Origin; I, Insertion.
Supination

Brachialis muscle FIG. 6.18 Application, strengthening, and flexibility

(bra´ki-a´lis) The brachialis muscle is used along with other flexor muscles,
regardless of pronation or supination. It pulls on the ulna, which
Origin does not rotate, thus making this muscle the only pure flexor of
Distal half of the anterior shaft of the humerus this joint.
Insertion The brachialis muscle is called into action whenever the

Coronoid process of the ulna elbow flexes. It is exercised along with elbow curling exercises,
n
as described for the biceps brachii, pronator teres, and
Action
brachioradialis muscles. Elbow flexion activities with the forearm
True flexion of the elbow pronated isolate the brachialis to some extent by reducing the
effectiveness of the biceps brachii. Since the brachialis is a pure
Palpation
flexor of the elbow, it can be stretched maximally only by
Deep on either side of the biceps tendon during flexion/extension
extending the elbow with the shoulder relaxed and flexed.
with forearm in partial pronation. The lateral margin may be
Forearm positioning should not affect the stretch on the
palpated between the biceps brachii and the triceps brachii, and
brachialis unless the forearm musculature itself limits elbow
the belly may be palpated through the biceps brachii when the
extension, in which case the forearm is probably best positioned
forearm is in pronation during light flexion.
in neutral.
pter Innervation
6 Musculocutaneous nerve
from radial and and nerves
median sometimes
(C5,branches
C6)
Brachialis muscle
O, Distal half of anterior portion

of humerus
Flexion
I, Coronoid process
of ulna
FIG. 6.18 • Brachialis muscle, anterior view. O, Origin; I, Insertion.

Brachioradialis muscle FIG. 6.19 extensor carpi radialis brevis and extensor carpi radialis longus,
to which it lies directly anterior. The brachioradialis muscle acts
(bra´ki-o-ra´di-a´lis)
as a flexor best in a midposition or neutral position between
Origin pronation and supination. In a supinated position of the forearm,
Distal two-thirds of the lateral condyloid (supracondylar) ridge of it tends to pronate as it flexes. In a pronated position, it tends to
the humerus supinate as it flexes.
Insertion This muscle is favored in its action of flexion Elbow

Lateral surface of the distal end of the radius at the styloid when the neutral position between pronation and flexion
process supination is assumed, as previously suggested. Its insertion at
the end of the radius makes it a strong elbow flexor. Its ability as
Action a supinator decreases as the radioulnar joint moves toward
Flexion of the elbow
Pronation of the forearm from supinated position to neutral neutral. Similarly, its ability to pronate decreases Radioulnar
as the forearm reaches neutral. Because of its pronation
Supination of the forearm from pronated position to neutral action of rotating the forearm to a neutral thumb-
up position, it is referred to as the hitchhiker muscle, although it has no
action at the thumb. As you will see in Chapter 7, nearly all the muscles
Palpation originating off the lateral epicondyle have some action as weak elbow
Anterolaterally on the proximal forearm during resisted elbow extensors. This is not the Chapter
flexion with the radioulnar joint positioned in neutral
6
case with the brachioradialis, due to its line of pull being anterior to the
elbow’s axis of rotation.
Innervation
The brachioradialis may be strengthened by performing elbow curls
Radial nerve (C5, C6) against resistance, particularly with the radioulnar joint in the neutral
position. In addition, the brachioradialis may be developed by performing
pronation and supination movements through the full range of motion Radioulnar
The brachioradialis is one of three muscles, sometimes known
as the mobile wad of three, on the lateral forearm. The other
two muscles are the supination
against resistance.
The brachioradialis is stretched by maximally extending the
elbow with the shoulder in flexion and the forearm in either
maximal pronation or maximal supination.
O, Distal two-thirds of lateral

condyloid
Brachioradialis m.
(supracondylar)
ridge of humerus
Supination Pronation
I, Lateral surface of distal

end of
radius at styloid
process
FIG. 6.19 • Brachioradialis muscle, lateral view.


Otot trisep brakii ARA. 6.20 Kepala lateral: mudah teraba pada dua pertiga proksimal
humerus posterior
(tri´seps bra´ki-i)
Medial head (kepala dalam): medial dan lateral hanya proksimal
Asal epikondilus medial dan lateral
Kepala panjang: tuberkulum infraglenoid di bawah bibir inferior
Persarafan
fossa glenoid skapula
Saraf radial (C7, C8)
njangan
Kepala lateral: separuh atas permukaan posterior humerus

Kepala medial: dua pertiga distal permukaan posterior
Tindakan khas dari trisep brachii ditunjukkan dalam push-up
humerus
ketika ada ekstensi siku yang kuat. Ini digunakan dalam
Insersi keseimbangan tangan dan dalam setiap gerakan mendorong
u yang melibatkan ekstremitas atas. Kepala panjang adalah
njangan
Proses olekranon pada ulna
ekstensor penting dari sendi bahu.
Tindakan
Semua kepala: ekstensi siku Dua otot memperpanjang siku — trisep brakii dan
Kepala panjang: ekstensi, adduksi, dan abduksi sendi bahu anconeus. Push-up menuntut kontraksi yang kuat dari otot-otot
secara horizontal ini. Penurunan pada palang paralel lebih sulit dilakukan. Bangku
menekan barbel atau halter adalah latihan yang sangat baik.
Rabaan
Overhead press dan triceps curl (ekstensi siku dari posisi
Lengan posterior selama ekstensi yang ditahan dari posisi fl overhead) menekankan trisep.
exed dan distal hanya proksimal ke penyisipannya pada
6 proses olekranon
Kepala panjang: secara proksimal sebagai tendon pada lengan Trisep brakii harus diregangkan dengan kedua bahu dan
posteromedial hingga di bawah deltoid posterior selama ekstensi / siku secara maksimal.
adduksi bahu yang ditolak
u
ksi
O, Infraglenoid
tuberkel
dari skapula
O, Setengah bagian atas
dari posterior
permukaan
u
humerus
ntal
ikan
Kepala panjang
Kepala lateral
O, Distal dua pertiga

dari posterior
Perpanjangan permukaan humerus
Kepala medial
Saya, Olecranon
proses
dari ulna
ARA. 6.20 • Otot trisep brakii, tampak posterior. O, Asal; I, Penyisipan.

Otot Anconeus ARA. 6.21 Persarafan

(an-końe-us) Saraf radial (C7, C8)

Permukaan posterior dari kondilus lateral humerus Fungsi utama dari otot anconeus adalah untuk menarik membran
sinovial dari sendi siku keluar dari jalannya proses olekranon. Siku
perpanjangan
Insersi selama perpanjangan siku. Ini berkontraksi bersama dengan
Permukaan posterior proses olekranon lateral dan seperempat trisep brachii. Ini diperkuat dengan latihan ekstensi siku
bagian proksimal ulna melawan resistensi. Kelenturan siku maksimal meregangkan
anconeus.
Tindakan
Perpanjangan siku
Rabaan
Aspek posterolateral dari ulna proksimal ke proses olekranon selama
ekstensi siku yang ditahan dengan pergelangan tangan yang
terbuka
Bab
Perpanjangan
O, permukaan Posterior
dari kondilus lateral
dari humerus
Anconeus m.
I, permukaan Posterior
ulna atas dan
olekranon
ARA. 6.21 • Otot Anconeus, tampak posterior. O, Asal; I, Penyisipan.

Otot pronator teres ARA. 6.22 Aplikasi, penguatan, dan fl eksibilitas

(pro-na´tor te´rez) Gerakan khas dari otot pronator teres adalah dengan lengan
bawah pronasi sebagai gerakan siku. Gerakan lebih lemah saat
oulnar Asal supinasi. Penggunaan pronator teres sendiri dalam gerakan
asi
Bagian distal punggungan kondiloid medial humerus dan sisi cenderung membawa punggung tangan ke wajah saat
medial ulna proksimal berkontraksi. Pronasi lengan bawah dengan halter di tangan
melokalisasi tindakan dan mengembangkan otot pronator teres.
Insersi Penguatan otot ini dimulai dengan memegang palu di tangan
Sepertiga tengah permukaan lateral jari-jari dengan kepala palu digantung dari sisi ulnar tangan sementara
lengan bawah ditopang di atas meja atau meja. Palu harus
Tindakan
digantung ke lantai, dengan lengan bawah diposisikan ke posisi
Pronasi lengan bawah Lemahnya telapak menghadap ke bawah.
siku
Rabaan
n
Permukaan anteromedial lengan bagian proksimal selama menahan
Siku harus sepenuhnya terentang saat lengan bawah berada
pronasi pertengahan hingga penuh
dalam posisi supinasi penuh untuk meregangkan pronator teres.
Persarafan
Saraf median (C6, C7)
O, bagian distal punggungan

condyloid medial
dari humerus,
Pronator teres m. sisi medial

ulna proksimal
I, Sepertiga tengah
permukaan lateral
radius
Pronasi
ARA. 6.22 • Otot pronator teres, pandangan anterior. O, Asal; I, Penyisipan.

Otot pronator quadratus ARA. 6.23 Persarafan

(pro-na´tor kwad-ra´tus) Saraf median (cabang interoseus palmar) (C6, C7)
Asal Aplikasi, penguatan, dan fl eksibilitas Radioulnar
Keempat bagian distal dari sisi anterior ulna Otot pronator quadratus bekerja pada pronat- pronasi
melatih lengan bawah dalam kombinasi dengan trisep dalam
Insersi memanjangkan siku. Ini biasanya digunakan untuk memutar obeng,
Keempat distal dari sisi anterior jari-jari seperti dalam mengeluarkan sekrup (dengan tangan kanan), saat
ekstensi dan pronasi diperlukan. Ini digunakan juga dalam melempar
Tindakan
bola obeng, ketika ekstensi dan pronasi dibutuhkan. Ini dapat
Pronasi lengan bawah dikembangkan dengan latihan pronasi serupa melawan resistansi,
seperti yang dijelaskan untuk pronator teres. Pronator quadratus paling
Rabaan
baik diregangkan dengan menggunakan pasangan untuk memegang
Pronator kuadratus, karena kedekatannya dan penampilannya pada pergelangan tangan dan secara pasif membawa lengan bawah ke posisi
beberapa gambar anatomi, terkadang disalahartikan sebagai supinasi ekstrim.
retinakulum fleksor. Lihat Gambar 6.16. Ini sangat dalam dan sulit
untuk dipalpasi, tetapi dengan lengan bawah dalam posisi supinasi
dapat teraba segera di kedua sisi denyut radial dengan pronasi
yang tertahan.
Bab
Pronasi
Pronator quadratus m.
I, Distal keempat sisi
O, Distal keempat sisi
anterior
radius anterior
tulang hasta
ARA. 6.23 • Otot pronator quadratus, pandangan anterior. O, Asal; I, Penyisipan.

Otot supinator ARA. 6.24 Aplikasi, penguatan, dan fl eksibilitas
(su´pi-na´tor) Otot supinator berperan saat gerakan ekstensi dan supinasi

diperlukan, seperti saat memutar obeng. Kurva dalam
oulnar Asal melempar bola bisbol memanggil otot ini untuk bermain karena
nasi Epikondilus lateral humerus dan sekitarnya siku diperpanjang sebelum bola dilepaskan. Hal ini paling
bagian posterior ulna terisolasi dalam aktivitas yang membutuhkan supinasi dengan
ekstensi siku, karena biseps brachii membantu supinasi paling
Insersi banyak saat siku keluar.
Permukaan lateral dari jari-jari proksimal tepat di bawah kepala
Tangan harus dipegang dan lengan bawah direntangkan,

Tindakan
sebagai upaya untuk menempatkan lengan bawah pada
Supinasi lengan bawah cengkeraman tangan. Ini melokalkan, sampai taraf tertentu,
tindakan supinator.
Rabaan
Latihan palu yang digunakan untuk otot pronator teres dapat
Posisikan siku dan lengan bawah dalam gerakan santai dan dimodifikasi untuk mengembangkan supinator. Pada awalnya,
pronasi, dan palpasi jauh ke brakioradialis, ekstensor karpi lengan bawah ditopang dan tangan bebas dari tepi meja. Palu
radialis longus, ekstensor karpi radialis brevis pada aspek lagi-lagi dipegang di sisi ulnar tangan yang menggantung ke
lateral jari-jari proksimal dengan sedikit resistensi terhadap arah lantai. Lengan bawah kemudian ditopang ke posisi telapak
tangan ke atas untuk memperkuat otot ini.
6 supinasi
Persarafan
Supinator diregangkan saat lengan bawah diposisikan secara
Saraf radial (C6)
maksimal.
O, Lateral I, permukaan lateral

epikondilus dari proksimal
dari humerus radius hanya
di bawah kepala
Belakang Depan
O, Tetangga
Supinator m. bagian posterior
dari ulna
Supinasi
ARA. 6.24 • Otot supinator, tampak posterior. O, Asal; I, Penyisipan.

TINJAU LATIHAN membuka, dan memutar kenop berlawanan arah jarum jam, dan menarik
pintu hingga terbuka.
4. Sendi siku adalah penyisipan distal yang mana otot-otot
1. Buat daftar bidang di mana setiap gerakan sendi siku dan
biartikular? Jelaskan setiap gerakan yang terlibat di siku
radioulnar berikut terjadi. Sebutkan sumbu rotasi
dan sendi superior yang berasal dari otot.
masing-masing untuk setiap gerakan di setiap bidang.
5. Mengangkat televisi saat Anda membantu teman sekamar Anda

Sebuah. Lengkungan c. Pronasi
bergerak membutuhkan teknik pengangkatan yang tepat dan
b. Perpanjangan d. Supinasi
sudut tarikan yang efektif. Jelaskan sudut tarikan yang dipilih
2. Diskusikan perbedaan antara dagu dengan telapak tangan
pada sendi siku dan mengapa dipilih daripada sudut lainnya.
menghadap wajah dan dagu dengan telapak tangan menjauhi
wajah. Pertimbangkan ini secara berotot dan anatomis.
6. Buat daftar otot yang terlibat dengan "tennis elbow" dan
jelaskan secara spesifik bagaimana Anda akan mendorong
3. Menganalisis dan membuat daftar perbedaan aktivitas otot
seseorang untuk melatih kekuatan dan fleksibilitas otot-otot ini.
sendi siku dan radioulnar antara memutar kenop pintu searah
jarum jam dan mendorong pintu
7. Bagan analisis otot • Sendi siku dan radioulnar
Isi tabel dengan mendaftar otot-otot utama yang terlibat dalam setiap gerakan.
Bab
Lengkungan Perpanjangan
6
Pronasi Supinasi
8. Grafik aksi otot antagonis • Sendi siku dan radioulnar
Isi tabel dengan mendaftar otot-otot atau bagian-bagian otot yang antagonis dalam tindakannya terhadap otot-otot di kolom kiri.
Agonis Antagonis
Bisep brachii
Brachioradialis
Brachialis
Pronator teres
Supinator
Trisep brachii
Anconeus

LATIHAN LABORATORIUM 4. Sendi radioulnar proksimal

5. Sendi radiocapitellar
6. Proses olekranon
1. Temukan bagian humerus, jari-jari, dan ulna berikut pada
7. Fossa olekranon
kerangka manusia dan pada subjek:
2. Bagaimana dan di mana otot-otot berikut dapat diraba pada
Sebuah. Kerangka
subjek manusia?
1. Epikondilus medial
Sebuah. Bisep brachii
2. Epikondilus lateral
b. Brachioradialis
3. Punggungan suprakondilaris lateral
c. Brachialis
4. Trochlea
d. Pronator teres
5. Kapitulum
e. Supinator
6. Fossa olekranon
f. Trisep brachii
7. Proses Olekranon
g. Anconeus
8. Proses koronoid
3. Palpasi dan buat daftar otot-otot yang terutama bertanggung jawab atas
9. Fosa koronoid
gerakan-gerakan berikut saat Anda memeragakan masing-masing:
10. Tuberositas jari-jari
11. Tuberositas ulnaris
Sebuah. Lengkungan
b. Subyek
b. Perpanjangan
1. Epikondilus medial
c. Pronasi
2. Epikondilus lateral
d. Supinasi
3. Punggungan suprakondilaris lateral
6
4. Grafik analisis gerakan sendi siku dan radioulnar
Setelah menganalisis setiap latihan di bagan, bagi masing-masing latihan menjadi dua fase gerakan utama, seperti fase mengangkat dan fase
menurunkan. Untuk setiap fase, tentukan gerakan sendi siku dan radioulnar yang terjadi, kemudian buat daftar otot sendi siku dan radioulnar yang
terutama bertanggung jawab untuk menyebabkan / mengendalikan gerakan tersebut. Di samping setiap otot di setiap gerakan, tunjukkan jenis
kontraksi sebagai berikut: I — isometrik; C — konsentris; E — eksentrik.
Gerakan fase awal (mengangkat) Fase Gerakan Sekunder (Menurunkan)
Olahraga Gerakan Agonis (s) - (tipe kontraksi) Agonis (s) - (tipe kontraksi)
Push-up
Dagu
Bench press
Menukik
Tarik lat
Tekan overhead
Baris rawan

5. Bagan analisis keterampilan olahraga sendi siku dan radioulnar
Analisis setiap keterampilan dalam bagan dan buat daftar gerakan siku kanan dan kiri serta sendi radioulnar di setiap fase keterampilan.
Anda mungkin lebih suka mencantumkan posisi awal sendi siku dan radioulnar untuk fase berdiri. Setelah setiap gerakan, buat daftar otot
sendi siku dan radioulnar yang terutama bertanggung jawab untuk menyebabkan / mengendalikan gerakan itu. Di samping setiap otot di
setiap gerakan, tunjukkan jenis kontraksi sebagai berikut: I — isometrik; C — konsentris; E — eksentrik. Mungkin diinginkan untuk meninjau
konsep analisis di Bab 8 untuk berbagai tahap.
Olahraga Fase berdiri Fase persiapan Fase gerakan Fase tindak lanjut
(R)
Baseball
nada
(L)
(R)
Bola voli
Menyajikan
(L)
Bab
(R)
6
Tenis
Menyajikan
(L)
(R)
Sofbol
nada
(L)
(R)
Tenis
backhand
(L)
(R)
Memukul
(L)
(R)
Bowling
(L)
(R)
Bola basket
lemparan bebas
(L)

Referensi Rasch PJ: Kinesiologi dan anatomi terapan, ed 7, Philadelphia, 1989,

Lea & Febiger.
Shier D, Butler J, Lewis R: Anatomi & fisiologi manusia Hole,

Andrews JR, Zarins B, Wilk KE: Cedera dalam bisbol, Philadelphia, ed 12, New York, 2010, McGraw-Hill.
Sieg KW, Adams SP: Esensi ilustrasi dari anatomi muskuloskeletal,
Kembali BR Jr, dkk: Triceps pecah: laporan kasus dan tinjauan pustaka, ed 4, Gainesville, FL, 2002, Megabooks.
Jurnal Kedokteran Olahraga Amerika 15: 285, Mei – Juni 1987.
Sisto DJ, dkk: Analisis elektromiografi siku masuk
Gabbard CP, dkk: Pengaruh posisi grip dan lengan bawah pada lengan ex anggukan, Jurnal Kedokteran Olahraga Amerika 15: 260, Mei – Juni
kinerja gantung, Riset Triwulanan untuk Latihan dan Olahraga, 1987.
Juli 1983.
Smith LK, Weiss EL, Lehmkuhl LD: Kinesiologi klinis Brunnstrom,
Penjamin Otak: Alat bantu untuk pemeriksaan perifer ed 5, Philadelphia, 1996, Davis.
sistem saraf, ed 4, London, 2000, Saunders.
Springer SI: cedera badminton dan siku, National Racquetball
Herrick RT, Herrick S: Trisep pecah dalam presentasi powerlifter 16: 7, Maret 1987.
sebagai sindrom terowongan kubital — laporan kasus, Jurnal Kedokteran Olahraga Amerika
Van De Graaff KM: Anatomi manusia, ed 6, Dubuque, IA, 2002,
15: 514, September – Oktober 1987.
McGraw-Hill.
Hislop HJ, Montgomery J: Tes otot Daniels dan Worthingham:
Van Roy P, Baeyens JP, Fauvart D, Lanssiers R, Clarijs JP:
teknik pemeriksaan manual, ed 8, Philadelphia, 2007, Saunders.
Arthrokinematics siku: studi tentang sudut membawa,
Ilmu Ergonomi 48 (11–14): 1645–1656, 2005.
Loftice JW, Fleisig GS, Wilk KE, Reinold MM, Chmielewski T,
Wilk KE, Reinold MM, Andrews JR (eds): Bahu atlet, ed 2,
Escamilla RF, Andrews JR (eds): Program pengkondisian untuk pelempar bisbol, Birmingham,
2004, Institut Kedokteran Olahraga Amerika.
Yilmaz E, Karakurt L, Belhan O, Bulut M, Serin E, Avci M: Variasi
dari sudut pembawa dengan usia, jenis kelamin, dan referensi khusus ke samping,
Magee DJ: Penilaian fisik ortopedi, ed 5, Philadelphia, 2008, Ortopedi 28 (11): 1360–1363, 2005.
Saunders.
6 Muscolino JE: Manual sistem otot: otot rangka dari

tubuh manusia, ed 3, St. Louis, 2010, Elsevier Mosby.
Oatis CA: Kinesiologi: mekanika dan patomekanika manusia Untuk sumber daya tambahan dan daftar situs web terkait,
gerakan, ed 2, Philadelphia, 2008, Lippincott Williams & Wilkins. kunjungi www.mhhe.com/floyd19e.

Latihan Lembar Kerja

Untuk tugas di dalam atau di luar kelas, atau untuk pengujian, gunakan lembar kerja sobek ini.
Lembar Kerja 1
Dengan menggunakan krayon atau spidol berwarna, gambar dan beri label pada lembar kerja otot-otot berikut. Tunjukkan asal dan penyisipan masing-masing otot
dengan "O" dan "I", masing-masing.
Sebuah. Bisep brachii e. Supinator

b. Brachioradialis f. Trisep brachii
c. Brachialis g. Pronator quadratus
d. Pronator teres h. Anconeus
Bab


Lembar Kerja 2
Beri label dan tunjukkan dengan panah gerakan berikut dari sendi siku dan radioulnar. Kemudian di bawah, untuk setiap gerakan, buat daftar
otot agonis, bidang tempat gerakan terjadi, dan sumbu rotasinya.
1. Sendi siku 2. Sendi radioulnar

Sebuah. Lengkungan Sebuah. Pronasi
b. Perpanjangan b. Supinasi
1. a. Penyebab ___________________________________ Otot _____________________ terjadi pada bidang _____________________ di
sekitar sumbu _____________________.
b. Penyebab ___________________________________ Otot _____________________ terjadi pada bidang _____________________ di
sekitar sumbu _____________________.
2. a. Penyebab ___________________________________ Otot _____________________ terjadi pada bidang _____________________ di
sekitar sumbu _____________________.
b. Penyebab ___________________________________ Otot _____________________ terjadi pada bidang _____________________ di
sekitar sumbu _____________________.

C HAPTER 7
T DIA W RIST AND H. DAN
J OINTS
Tujuan
T tangan,
dia dankita
penting bagi jari-jari
tentangsering diabaikan
persendian dalam
pergelangan tangan,
j Untuk mengidentifikasi pada kerangka manusia, pilih fitur tulang perbandingan dengan sendi yang lebih besar yang dibutuhkan untuk ambulasi.
pergelangan tangan, tangan, dan jari Seharusnya tidak demikian, karena meskipun karakteristik keterampilan motorik
halus bidang ini tidak penting dalam beberapa olahraga, banyak olahraga dengan
j Untuk memberi label fitur tulang yang dipilih pada bagan kerangka aktivitas terampil memerlukan fungsi yang tepat- Bab
7
pergelangan tangan dan tangan. Beberapa cabang olahraga, seperti panahan,
j Untuk menggambar dan memberi label otot pada bagan kerangka
bowling, golf, baseball, dan tenis,
membutuhkan penggunaan gabungan dari semua sambungan ini.

j Untuk meraba otot pada subjek manusia sambil Selain itu, fungsi yang tepat pada persendian dan otot tangan kita
mendemonstrasikan tindakan mereka sangat penting untuk aktivitas sehari-hari sepanjang hidup kita.
j Untuk membuat daftar bidang gerak dan sumbu rotasinya

Karena banyaknya otot, tulang, dan ligamen, bersama dengan
masing-masing
ukuran sendi yang relatif kecil, anatomi fungsional pergelangan
j Untuk mengatur dan membuat daftar otot yang menghasilkan tangan dan tangan menjadi rumit dan berlebihan bagi beberapa
gerakan utama pergelangan tangan, tangan, dan jari orang. Kompleksitas ini dapat disederhanakan dengan
menghubungkan anatomi fungsional dengan tindakan utama
sendi: fleksi, ekstensi, abduksi, dan adduksi pergelangan tangan
j Untuk menentukan, melalui analisis, gerakan dan otot pergelangan dan tangan.
tangan dan tangan yang terlibat dalam keterampilan dan latihan yang
dipilih
Sejumlah besar otot digunakan dalam gerakan ini. Secara
anatomis dan struktural, pergelangan tangan dan tangan
manusia telah berkembang pesat, mekanisme kompleks yang
mampu melakukan berbagai gerakan — hasil dari susunan 29
tulang, lebih dari 25 sendi, dan lebih dari 30 otot, 18 di
Sumber Daya Pusat Pembelajaran Online antaranya adalah otot intrinsik (keduanya asal dan penyisipan
ditemukan di tangan).
fl oyd19e untuk informasi tambahan dan bahan pelajaran untuk bab ini,
Bagi kebanyakan orang yang menggunakan teks ini,
termasuk:
pengetahuan luas tentang otot-otot intrinsik ini tidak diperlukan.
j Kuis penilaian mandiri Namun, pelatih atletik, ahli terapi fisik, ahli terapi okupasi, ahli
j Kartu anatomi tulang, ahli anatomi, dokter, dan perawat membutuhkan
j Animasi pengetahuan yang lebih luas. Otot intrinsik terdaftar,
Situs web terkait
diilustrasikan, dan dibahas sampai tingkat tertentu di
j

akhir bab ini. Referensi di akhir bab ini memberikan sumber Tulang
tambahan untuk memperoleh informasi lebih lanjut.
Pergelangan tangan dan tangan berisi 29 tulang, termasuk
Diskusi kita terbatas pada tinjauan tentang otot, persendian, jari-jari dan ulna (Gambar 7.1). Delapan tulang karpal dalam dua
dan gerakan yang terlibat dalam aktivitas motorik kasar. Otot baris empat tulang membentuk pergelangan tangan. Baris
yang dibahas adalah otot lengan bawah dan otot ekstrinsik proksimal terdiri dari sisi radial (jempol) ke sisi ulnaris (jari kecil),
pergelangan tangan, tangan, dan jari. Otot ekstrinsik yang lebih dari skafoid (berbentuk perahu) atau navicular seperti yang
besar dan lebih penting dari setiap sendi disertakan, biasa disebut, bulan sabit (berbentuk bulan), triquetrum (tiga-
memberikan pengetahuan dasar tentang area ini. Resep latihan terpojok), dan tulang pisiform (berbentuk kacang). Baris distal,
untuk memperkuat otot-otot ini akan menjadi mubazir, karena dari radial ke sisi ulnar, terdiri dari tulang trapezium (lebih
hanya ada empat gerakan yang dicapai dengan tindakan banyak multangular), trapezoid (lebih kecil multangular), capitate
gabungannya. Salah satu latihan yang akan memperkuat (headshaped), dan hamate (hooked) tulang. Tulang-tulang ini
banyak otot ini adalah push-up ujung jari. membentuk lengkungan tiga sisi yang cekung di sisi palmar.
Lengkungan tulang ini direntang oleh ligamen karpal transversal
dan karpal volar yang membentuk terowongan karpal , yang
sering menjadi sumber masalah yang dikenal sebagai carpal
tunnel syndrome (lihat Gambar 7.8). Dari tulang karpal ini,
7 Interphalangeal distal
sendi (DIP)
Interphalangeal proksimal Distal
sendi (PIP) ruas
Metacarpophalangeal Falang
Tengah
gabungan (MCP)
ruas
Interphalangeal Proksimal
sendi (IP) ruas
4 3 2
3 4 Metacarpals
2 5 5
(metacarpus)
1
1
Karpometacarpal
sendi (CMC)
Karper
Berbentuk kacang
Trapesium (tulang pergelangan tangan)
Trapesium Triquetrum
Trapesium
Bengkok
Styloid radial Trapesium
proses Styloid ulnaris
proses Proses styloid radial
Berbentuk kepala Berbentuk kepala
Berbentuk semi bulan
Skafoid Tulang hasta Skafoid
Tuberkel Lister SEBUAH Radius B
ARA. 7.1 • Tangan kanan. SEBUAH, Tampilan posterior (dorsal); B, Tampilan anterior (palmar).

skafoid adalah yang paling sering retak, biasanya oleh hiperekstensi banyak dari pergelangan tangan dan jari-jari fleksor, sedangkan
pergelangan tangan yang parah karena jatuh pada tangan yang epikondilus lateral dan punggung supracondylar lateral
terulur. Sayangnya, fraktur khusus ini sering dianggap sebagai berfungsi sebagai titik asal untuk banyak ekstensor pergelangan
keseleo setelah cedera awal, hanya menyebabkan masalah yang tangan dan jari (Gambar 6.1 dan 6.3). Secara distral, landmark
signifikan dalam jangka panjang jika tidak ditangani dengan benar. tulang kunci untuk otot-otot yang terlibat dalam gerakan
Perawatan sering membutuhkan imobilisasi yang tepat untuk waktu pergelangan tangan adalah dasar metakarpal kedua, ketiga,
yang lebih lama daripada banyak patah tulang dan / atau dan kelima serta pisiform dan hamate. Otot-otot jari, yang juga
pembedahan. Lima tulang metakarpal, nomor satu sampai lima dari terlibat dalam gerakan pergelangan tangan, menyisipkan di
ibu jari ke jari kecil, bergabung dengan tulang pergelangan tangan. dasar phalanx proksimal, tengah, dan distal (Gambar 7.1 dan
Ada 14 ruas (digit), tiga untuk setiap ruas kecuali ibu jari, yang 7.2). Dasar metakarpal pertama dan phalanx proksimal dan
hanya memiliki dua. Mereka diindikasikan sebagai proksimal, distal ibu jari berfungsi sebagai titik penyisipan utama untuk
tengah, dan distal dari metakarpal. Selain itu, ibu jari memiliki tulang otot-otot yang terlibat dalam gerakan ibu jari (Gbr. 7.1). Tangan
sesamoid di dalam tendon fleksornya, dan sesamoid lain dapat terdiri dari tiga bagian yang berbeda: pergelangan tangan,
muncul di jari. telapak tangan, dan jari telunjuk. Telapak tangan selanjutnya
dapat dipisahkan menjadi tenar, hipotenar,
Epikondilus medial, punggungan kondiloid medial, dan

proses koronoid berfungsi sebagai titik asal
Proksimal
sendi interphalangeal
Metacarpophalangeal
bersama
Distal Bab
7
interphalangeal
bersama
Tulang hasta
Karper
Karper Artikular
cakram
Radius Radioulnar
bersama
SEBUAH
Tulang hasta
Interosseous
selaput
Karpometacarpal
sendi ibu jari
Radiocarpal
B Radius bersama
ARA. 7.2 • Struktur pergelangan tangan kiri dan sendi tangan. SEBUAH, Tampilan medial; B, Tampak posterior dengan bagian depan melalui pergelangan tangan.

Sendi pergelangan tangan bisa abduksi 15 sampai 25 derajat dan adduksi 25 sampai 40
derajat (Gbr. 7.3).

Sendi pergelangan tangan diklasifikasikan sebagai sendi tipe Setiap jari memiliki tiga sendi. Sendi metacarpophalangeal (MCP)
condyloid, memungkinkan terjadinya fleksi, ekstensi, abduksi diklasifikasikan sebagai kondiloid. Pada sambungan-sambungan ini,
(deviasi radial), dan adduksi (deviasi ulnaris) (Gbr. 7.2). Gerakan ekstensi 0 sampai 40 derajat dan 85 sampai 100 derajat fleksi
pergelangan tangan terjadi terutama antara radius distal dan baris dimungkinkan. Sendi proksimal interphalangeal (PIP), diklasifikasikan
karpal proksimal, terdiri dari skafoid, sabit, dan triquetrum. sebagai ginglymus, dapat bergerak dari ekstensi penuh ke sekitar 90
Akibatnya, pergelangan tangan sering disebut sebagai sendi hingga 120 derajat fleksion. Sendi interphalangeal distal (DIP), juga
radiokarpal. Sambungan memungkinkan pengencangan 70 hingga diklasifikasikan sebagai ginglymus, dapat berubah 80 hingga 90 derajat
90 derajat dan ekstensi 65 hingga 85 derajat. Itu dari ekstensi penuh (Gbr. 7.4).
Netral
Radial 0° Ulnar
90 ° deviasi deviasi
Perpanjangan
(dorsi fl exion)
Netral 0 °
Lengkungan
(palmar fl exion) 90 ° 90 °
90 °
SEBUAH B
ARA. 7.3 • ROM pergelangan tangan. SEBUAH, Fleksi dan ekstensi. Fleksi ( palmar fl exion): nol sampai 6 80 derajat. 20 derajat. Deviasi ulnaris: nol
7 Ekstensi ( dorsi fl exion): nol sampai 6 70 derajat; B, Deviasi radial dan ulnaris. Deviasi radial nol sampai
hingga 30 derajat.
0° 0°
Interphalangeal distal Metacarpophalangeal
Netral Interphalangeal proksimal Netral
bersama bersama
SEBUAH bersama
90 °
100 ° Ujung jari ke Ujung jari ke
0° 90 °
lipatan palmar distal lipatan telapak tangan bagian proksimal
Netral
1 2
Penculikan Abduction Abduction Penculikan

Adduksi Adduksi Adduksi Adduksi
45 °
10 °
0°
B 0°
Netral
Netral
Ekstensi — sendi metacarpophalangeal Hiperekstensi — sendi interphalangeal distal Jari menyebar Jari lainnya
1 2
ARA. 7.4 • ROM jari-jari. SEBUAH, Lengkungan. 1, Gerakan dapat diperkirakan atau diukur dalam derajat. 2, Gerakan dapat diperkirakan dengan
penggaris sebagai jarak dari ujung jari ke lipatan palmar distal ( kiri) ( Pengukuran
fl eksresi sendi tengah dan distal) dan ke lipatan palmar proksimal ( Baik) ( mengukur sendi jari bagian distal, tengah, dan proksimal); B, Perpanjangan,
penculikan, dan aduksi. 1, Perpanjangan dan hiperekstensi.
2, Penculikan dan adduksi. Gerakan ini terjadi di bidang telapak tangan menjauhi dan ke ujung atau tengah jari tangan. Penculikan jari
tengah terjadi saat jari bergerak ke samping menuju ibu jari, dan adduksi terjadi saat jari bergerak medial menuju jari kecil. Sebaran jari
dapat diukur dari ujung jari telunjuk ke ujung jari kecil ( Baik). Jari-jari individu menyebar dari ujung ke ujung jari yang ditunjukkan ( kiri).

Jempol hanya memiliki dua sendi, keduanya diklasifikasikan Gerakan

sebagai ginglymus. Sambungan MCP bergerak dari ekstensi
penuh ke suhu 40 hingga 90 derajat. Sambungan interphalangeal Tindakan umum dari pergelangan tangan adalah fleksi, ekstensi, abduksi,
(IP) bisa fl ex 80 sampai 90 derajat. Sendi carpometacarpal dan adduksi (Gbr. 7.7, IKLAN). Jari-jari hanya bisa mengembang dan
(CMC) pada ibu jari adalah sendi tipe pelana yang unik dengan menjulur (Gbr. 7.7, E dan F),
derajat abduksi 50 hingga 70 derajat. Ini bisa naik kira-kira 15 kecuali pada sendi metacarpophalangeal, dimana abduksi dan
sampai 45 derajat dan meluas 0 sampai 20 derajat (Gbr. 7.5). adduksi (Gbr. 7.7, G dan H) dikendalikan oleh otot-otot tangan
intrinsik. Di tangan, ruas tengah dianggap sebagai titik referensi
untuk membedakan abduksi dan adduksi. Penculikan jari
Meskipun terdapat terlalu banyak ligamen di pergelangan tangan telunjuk dan jari tengah terjadi ketika mereka bergerak ke lateral
dan tangan untuk memungkinkan pembahasan yang mendetail, menuju sisi radial lengan bawah. Penculikan cincin dan jari
cedera pada ligamen kolateral dari sendi metacarpophalangeal dan kelingking terjadi saat mereka bergerak ke arah medial ke arah
proksimal interphalangeal sangat umum terjadi karena tekanan sisi ulnaris tangan. Gerakan di bagian tengah jari telunjuk dan
medial dan lateral yang sering mereka temui. Pergelangan tangan, jari tengah ke arah sisi ulnaris lengan bawah adalah adduksi.
tangan, dan jari sangat bergantung pada ligamen untuk memberikan Adduksi cincin dan jari kecil terjadi saat jari-jari ini bergerak ke
dukungan dan stabilitas statis. Beberapa ligamen jari diperinci pada lateral menuju sisi radial tangan. Ibu jari diculik saat bergerak
Gambar 7.6. menjauh dari telapak tangan dan mengalami adduksi saat
bergerak menuju aspek palmar dari metakarpal kedua. Ini
90 °
Bab
SEBUAH
0°
Netral
7
0°
Netral
1 2
Netral 0 °
Netral 0 °
Netral 0 ° 0°
15 °
B
80 ° 50 °
1 2 3 4
C atau
1 2 Fleksi ke ujung jari kecil 3 Fleksi ke pangkal jari kecil
ARA. 7.5 • ROM jempol. SEBUAH, Penculikan. 1, Posisi awal nol: jempol yang diperpanjang di samping jari telunjuk, yang sejajar dengan
jari-jari. Penculikan adalah sudut yang dibuat antara tulang metakarpal
ibu jari dan jari telunjuk. Gerakan ini dapat terjadi di dua bidang. 2, Penculikan radial atau perpanjangan
terjadi sejajar dengan bidang telapak tangan; B, Lengkungan. 1, Posisi awal nol: jempol yang diperpanjang. 2,
Fleksi sendi interphalangeal: nol hingga 6 80 derajat. 3, Fleksi sendi metacarpophalangeal: nol hingga 6 50 derajat. 4, Fleksi sendi
carpometacarpal: nol hingga 6 15 derajat; C, Berlawanan. Posisi awal nol ( paling kiri): ibu jari sejajar dengan jari telunjuk. Berlawanan adalah
gerakan komposit yang terdiri dari tiga elemen: ( 1) penculikan, ( 2) rotasi, dan ( 3) fl exion. Gerakan biasanya dianggap lengkap ketika
ujung ibu jari menyentuh ujung jari tangan kelima. Beberapa orang menganggap busur oposisi selesai ketika ujung ibu jari menyentuh
dasar jari kelima. Kedua metode tersebut diilustrasikan.

Phalanx distal Phalanx distal

Jaminan
Penyisipan
Kapsul sendi ligamen
fl eksor digitorum
Ligamen palmar profundus m.
Phalanx tengah Phalanx tengah
angan tangan
Jaminan
n
ligamen
Kapsul sendi
Penyisipan Ligamen agunan
Ligamen palmar fl eksor digitorum
Phalanx proksimal superfokus m.
Phalanx proksimal
angan tangan Jaminan

Kapsul sendi ligamen Ligamen palmar
njangan Ligamen agunan
Ligamen palmar
Melintang dalam
Metacarpal ketiga ligamen metacarpal

Metacarpal ketiga
tulang tulang
angan tangan
SEBUAH B C
ikan
ARA. 7.6 • Sendi metacarpophalangeal dan interphalangeal jari panjang kiri. SEBUAH, Tampilan lateral; B, Tampilan anterior (palmar); C, Tampilan
posterior.
7
gerakan, bersama dengan pronasi dan supinasi lengan bawah, aspek atau sisi radial lengan bawah; juga, pergerakan jari
memungkinkan terjadinya banyak gerakan halus dan terkoordinasi pada menjauh dari jari tengah
lengan bawah, pergelangan tangan, dan tangan. Adduksi (deviasi ulnaris, exion ulnaris): Gerakan sisi jari
Fleksi (palmar fl exion): Gerakan telapak tangan dan / atau falang kelingking tangan ke arah aspek medial atau sisi ulnaris lengan
menuju aspek anterior atau volar lengan bawah bawah; juga, gerakan jari-jari kembali bersama menuju jari
tengah
Perpanjangan (dorsi fl exion): Gerakan punggung tangan dan /

atau falang menuju aspek posterior atau dorsal lengan bawah; Berlawanan: Gerakan ibu jari melintasi aspek palmar untuk
kadang-kadang disebut sebagai hiperekstensi melawan salah satu atau semua falang
Reposisi: Movement of the thumb as it returns to the anatomical
Abduksi (deviasi radial, exion radial): Gerakan ibu jari tangan ke position from opposition with the hand and/or fingers
tion arah lateral
Wrist flexion Wrist extension

A B
FIG. 7.7 • Right wrist and hand movements. A, Wrist flexion; B, Wrist extension.

2nd–5th
MCP, PIP,
and DIP
flexion
Thumb
CMC flexion
Wrist abduction Wrist adduction

(radial deviation) (ulnar deviation)
C D
2nd–5th
MCP, PIP,
and DIP
extension
Chapter
7
Flexion of fingers and thumb, opposition Extension of fingers and thumb, reposition
E F
Thumb
CMC
extension
Adduction of metacarpophalangeal
Abduction of metacarpophalangeal
joints and the thumb
joints and the thumb
G H
FIG. 7.7 (continued) • Right wrist and hand movements. C, Wrist abduction; D, Right wrist adduction;
E, Flexion of the fingers and thumb, opposition; F, Extension of the fingers and thumb, reposition;
G, Adduction of metacarpophalangeal joints and the thumb; H, Abduction of metacarpophalangeal joints and the thumb.

Muscles TABLE 7.1 Another nine muscles function primarily to move the
phalanges but are also involved in wrist joint actions because
The extrinsic muscles of the wrist and hand can be grouped they originate on the forearm and cross the wrist. These
according to function and location (Table 7.1). There are six muscles generally are weaker in their actions on the wrist. The
muscles that move the wrist but do not cross the hand to move flexor digitorum superficialis and the flexor digitorum profundus
the fingers and thumb. The three wrist flexors in this group are are finger flexors; however, they also assist in wrist flexion
the flexor carpi radialis, flexor carpi ulnaris, and palmaris along with the flexor pollicis longus, which is a thumb flexor. The
longus—all of which have their origin on the medial epicondyle extensor digiorum, the extensor indicis, and the extensor digiti
of the humerus. The extensors of the wrist have their origins on minimi are finger extensors but also assist in wrist extension,
the lateral epicondyle and include the extensor carpi radialis along with the extensor pollicis longus and extensor pollicis
longus, extensor carpi radialis brevis, and extensor carpi ulnaris brevis, which extend the thumb. The abductor pollicis longus
(Figs. 6.11 and 6.13). abducts the thumb and assists in wrist abduction.
TABLE 7.1 • Agonist muscles of the wrist and hand joints
Plane of
Flexion of the
Sagittal
wrist
pter
Anterior distal
7 Base of 2nd
Abduction
of the wrist
Frontal
forearm and wrist
surface, slightly
Flexor Medial and 3rd Median
lateral, in line with the
carpi epicondyle metacarpals nerve
2nd and 3rd
radialis of humerus on palmar (C6, C7)
Weak flexion metacarpals with
surface Sagittal
of the elbow resisted flexion and
abduction
Weak pronation
Transverse
of the forearm
Anterior muscles (wrist flexors)
Anteromedial and
Palmar Flexion of the central aspect of the
aponeurosis wrist anterior forearm just
Medial Median
Palmaris of the 2nd, proximal to the wrist,
epicondyle Sagittal nerve
longus 3rd, 4th, particularly with slight
of humerus (C6, C7)
and 5th Weak flexion of wrist flexion and
metacarpals the elbow opposition of thumb
to the 5th finger
Flexion of the
Sagittal
wrist Anteromedial surface
Medial Base of 5th of the forearm, a few
epicondyle metacarpal inches below the
Flexor
of humerus (palmar Adduction medial epicondyle Ulnar nerve
carpi Frontal
and posterior surface), of the wrist of the humerus to just (C8, T1)
ulnaris
aspect of pisiform, proximal to the wrist,
proximal ulna and hamate with resisted
Weak flexion flexion/adduction
Sagittal
of the elbow

TABLE 7.1 (continued) • Agonist muscles of the wrist and hand joints
Plane of
Flexion of the In depressed

fingers at the area between
Medial epicondyle
metacarpo- palmaris longus
of humerus Each tendon
phalangeal and and flexor carpi
splits and
Ulnar head: proximal inter- ulnaris tendons,
attaches to
medial coronoid phalangeal joints particularly when
the sides
Flexor process making a fist but
of the mid- Median nerve
digitorum Sagittal keeping the distal
Radial head: dle phalanx (C7, C8, T1)
superficialis Flexion of the interphalangeals
upper 2/3 of of the four
wrist extended and with
anterior border fingers on
slightly resisted
of the radius just the palmar
wrist flexion; also
distal to the radial surface
on anterior mid-
tuberosity Weak flexion of
forearm during
the elbow
same activity
Flexion of the Deep to the

four fingers at flexor digitorum
the metacar- superficialis, but
pophalangeal, on anterior mid-
proximal inter- forearm while
Chapter
phalangeal, flexing the distal
7
Anterior muscles (wrist and phalangeal flexors)
and distal inter- interphalangeal

Median nerve
phalangeal joints joints and keeping
(C8, T1) to 2nd
Flexor Proximal 3/4 Base of distal the proximal
and 3rd fingers;
digitorum of anterior and phalanges of Sagittal interphalangeal
ulnar nerve (C8,
profundus medial ulna four fingers joints extended;
T1) to 4th and
over the palmar
5th fingers
surface of the
2nd, 3rd, 4th, and 5th
Flexion of the
metacarpo-
wrist
phalangeal joints
during finger
flexion against
resistance
Flexion of the
Middle anterior thumb carpo- Anterior surface of
surface of the metacarpal, the thumb on the
radius and ante- metacarpo- proximal phalanx,
rior medial bor- phalangeal, and and just lateral to the
der of the ulna interphalangeal Sagittal palmaris longus
Base of distal Median nerve
Flexor just distal to the joints and medial to the
phalanx of palmar interos-
pollicis coronoid pro- flexor carpi radi-
thumb on pal- seous branch
longus cess; occasionally alis on the anterior
mar surface Flexion of the (C8, T1)
a small head is distal forearm,
present attaching wrist especially during
on the medial active flexion of the
epicondyle of the thumb interphalan-
humerus Abduction of the geal joint
Frontal
wrist

Plane of
Extension of
Sagittal
the wrist
Lateral Just lateral to the ulnar

epicondyle of styloid process
Base of 5th
Extensor humerus and Adduction and crossing the
metacarpal Frontal Radial nerve
carpi middle 1/2 of of the wrist posteromedial wrist,
on dorsal (C6, C7, C8)
ulnaris the posterior particularly with
surface
border of the wrist extension/
ulna adduction
Weak
extension of Sagittal
the elbow
Extension of Just proximal to

Sagittal
the wrist the dorsal aspect
of the wrist and
approximately 1 cm
medial to the radial
pter styloid process, the
Extensor Base of 3rd Abduction
Frontal tendon may be felt during
7
Lateral
carpi metacarpal of the wrist Radial nerve
epicondyle of extension and
Posterior muscles (wrist extensors)
radialis on dorsal (C6, C7)

humerus traced to base of 3rd
brevis surface
metacarpal, particularly
when making a
Weak fist; proximally and
flexion of Sagittal posteriorly, just medial
the elbow to the bulk of the

brachioradialis
Extension of
Sagittal
the wrist Just proximal to
the dorsal aspect
of the wrist and
approximately 1 cm
Abduction
Distal third Frontal medial to the radial
of the wrist
of lateral styloid process, the
Extensor supracondylar Base of 2nd tendon may be felt
carpi ridge of metacarpal during extension Radial nerve
radialis humerus on dorsal Weak flex- and traced to base of (C6, C7)
longus and lateral surface
ion of the Sagittal
2nd metacarpal,
epicondyle of elbow particularly when
the humerus making a fist;
proximally and
posteriorly, just medial
to the bulk of the
Weak
Transverse brachioradialis
pronation

Plane of
Extension of
the 2nd, 3rd, With all four fingers
4th, and 5th extended, on the posterior
Four
phalanges at surface of the distal
tendons
the metacarpo- forearm immediately
to bases
phalangeal medial to extensor pollicis longus
of middle Radial
Lateral joints tendon and lateral to the extensor
Extensor and distal nerve
epicondyle Sagittal carpi
digitorum phalanxes (C6, C7,
of humerus ulnaris and extensor digiti
of four Extension of the C8)
minimi, then dividing into four
fingers wrist
separate tendons
on dorsal
that are over the dorsal aspect of
surface
the hand and
Weak extension
metacarpophalangeal joints
of the elbow
Extension of the
With forearm pronated on the
index finger at
Base of posterior aspect of the distal
the metacarpo-
the middle forearm and dorsal surface of the
phalangeal
Middle to and distal Sagittal hand just medial to the extensor Radial
joint
Extensor distal 1/3 phalanxes digitorum tendon of the index nerve
indicis of posterior of the 2nd Weak wrist finger with extension of the index (C6, C7, Chapter
ulna phalange fingers and flexion of the 3rd, 4th, C8)
Posterior muscles (wrist and phalangeal extensors)
extension
on dorsal
surface
and 5th fingers 7
Weak supination Transverse
Extension of the Passing over the dorsal

little finger at aspect of the distal
Base of the metacarpo- radioulnar joint, particularly
the middle phalangeal with relaxed flexion of other fingers
and distal joint Radial
Extensor Lateral and alternating 5th finger extension
phalanxes nerve
digiti epicondyle Sagittal and relaxation; dorsal surface of
of the 5th Weak wrist (C6, C7,
minimi of humerus forearm immediately medial
phalange extension C8)
on dorsal
to the extensor digitorum and
surface Weak elbow
lateral to the extensor carpi
extension
ulnaris
Extension of Dorsal aspect of the hand to its

the thumb at insertion on the base of the distal
the carpometa- phalanx; also on posterior surface
carpal, meta- of lower forearm between
Posterior Base of carpophalangeal,
Sagittal
lateral distal and interphalan- radius and ulnar just proximal to Radial
Extensor
surface of phalanx geal joints the extensor indicis and medial to nerve
pollicis
the lower of thumb the extensor pollicis brevis and (C6, C7,
longus Extension of the
middle on dorsal abductor pollicis longus C8)
wrist
ulna surface
Abduction of the with forearm pronated and fingers
Frontal
wrist in relaxed flexion while actively
extending
Weak supination Transverse the thumb

Plane of
Extension of the
thumb at the Just lateral to the
carpometacarpal extensor pollicis longus
and metacarpo- tendon on the dorsal side of

Base of
Posterior muscles (wrist and
Posterior phalangeal the hand to its insertion on

phalangeal extensors)
proximal Sagittal
Extensor surface joints the proximal phalanx with Radial
phalanx
pollicis of lower nerve
of thumb
brevis middle extension of the thumb (C6, C7)
on dorsal Weak wrist
radius carpometacarpal and
surface extension
metacarpophalangeal
and flexion of the
Abduction of the
Frontal interphalangeal joints
wrist
Abduction of
the thumb at the
carpometacarpal
joint Frontal
Abduction of the
Posterior Base of 1st
wrist
Posterior muscles
Abductor aspect of metacarpal Lateral aspect of the wrist joint Radial

pollicis radius and on dorsal Extension of just proximal to the 1st nerve
pter longus midshaft lateral the thumb at the metacarpal (C6, C7)
7
of the ulna surface carpometacarpal
joint Sagittal
Weak wrist
extension
Weak supination Transverse
All of the wrist flexors generally have their origins on the The wrist extensors generally have their origins on the
anteromedial aspect of the proximal forearm and the medial posterolateral aspect of the proximal forearm and the lateral
epicondyle of the humerus, whereas their insertions are on the humeral epicondyle, whereas their insertions are located on the
anterior aspect of the wrist and hand. All of the flexor tendons posterior aspect of the wrist and hand. The flexor and extensor
except for the flexor carpi ulnaris and palmaris longus pass tendons at the distal forearm immediately proximal to the wrist
through the carpal tunnel, along with the median nerve (Fig. are held in place on the palmar and dorsal aspects by
7.8). Conditions leading to swelling and inflammation in this transverse bands of tissue. These bands, known respectively as
area can result in increased pressure in the carpal tunnel, which the flexor and extensor retinaculum, prevent these tendons from
interferes with normal function of the median nerve, leading to bowstringing during flexion and extension.
reduced motor and sensory function of its distribution. Known as
carpal tunnel syndrome , this condition is particularly common
with repetitive use of the hand and wrist in manual labor and The wrist abductors are the flexor carpi radialis, extensor
clerical work such as typing and keyboarding. Often, slight carpi radialis longus, extensor carpi radialis brevis, abductor
modifications in work habits and the positions of the hand and pollicis longus, extensor pollicis longus, and extensor pollicis
wrist during these activities can be preventive. Additionally, brevis. These muscles generally cross the wrist joint
flexibility exercises for the wrist and finger flexors may be anterolaterally and posterolaterally to insert on the radial side of
helpful. the hand. The flexor carpi ulnaris and extensor carpi ulnaris
adduct the wrist and cross the wrist joint anteromedially and
posteromedially to insert on the ulnar side of the hand.

Thenar muscles Ulnar artery
Median nerve Ulnar nerve
Flexor carpi radialis Flexor retinaculum

tendon covering carpal tunnel
Carpal tunnel Ulnar bursa
Trapezium Hypothenar muscles
Flexor digitorum Flexor digitorum

profundus tendons superficialis tendons
Anterior
Radial artery Hamat e
Trapezoid Capitate
Lateral Medial
Scaphoid Extensor tendons
Posterior
FIG. 7.8 • Cross section of the right wrist, viewed as if from the distal end of a person’s right forearm extended toward you with the palm
up. Note how the flexor tendons and median nerve are confined in a
tight space between the carpal bones and the flexor retinaculum.
Chapter
The intrinsic muscles of the hand (see Table 7.2 and Fig.
7.26) have their origins and insertions on the bones of the hand.
Wrist and hand muscles—location 7
Anteromedial at the elbow and forearm and anterior at the
Grouping the intrinsic muscles into three groups according to hand (Fig. 7.9, A–C)
location is helpful in understanding and learning these muscles. Primarily wrist flexion
On the radial side are four muscles of the thumb—the opponens Flexor carpi radialis
pollicis, the abductor pollicis brevis, the flexor pollicis brevis, Flexor carpi ulnaris
and the adductor pollicis. On the ulnar side are three muscles of Palmaris longus
the little finger—the opponens digiti minimi, the abductor digiti Primarily wrist and phalangeal flexion
minimi, and the flexor digiti minimi brevis. In the remainder of Flexor digitorum superficialis
the hand are 11 muscles, which can be further grouped as the 4 Flexor digitorum profundus
lumbricals, the 3 palmar interossei, and the 4 dorsal interossei. Flexor pollicis longus
Posterolateral at the elbow and forearm and posterior at the
hand (Fig. 7.9, D)
Primarily wrist extension
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor carpi ulnaris
Primarily wrist and phalangeal extension
Extensor digitorum
Extensor indicis
Extensor digiti minimi
Extensor pollicis longus
Extensor pollicis brevis
Abductor pollicis longus

A B
Medial
epicondyle
of humerus
Pronator Flexor carpi
Brachioradialis
teres radialis
Palmaris
longus
Flexor carpi Flexor

ulnaris digitorum
superficialis
Radius
Ulna
Palmar
aponeurosis
Extensor
Lateral
Medial
Medial digitorum
epicondyle epicondyle
epicondyle (cut and
pter of humerus
of humerus of humerus reflected)
7 Radius
Supinator
Ulna
Anconeus Supinator (deep)
Extensor Extensor carpi

digiti radialis longus
Flexor
minimi (cut)
Flexor digitorum
Extensor carpi
pollicis profundus
Extensor radialis brevis
longus carpi
ulnaris (cut) Abductor
Pronator pollicis longus
quadratus Extensor
indicis Extensor
pollicis longus
Lumbricals
Cut tendons
of extensor Extensor
digitorum pollicis brevis
C D
FIG. 7.9 • Muscles of the forearm. A, Anterior view of the right forearm (superficial). Brachioradialis muscle is removed; B, Anterior view of
the right forearm (deeper than A). Pronator teres, flexor carpi radialis and
ulnaris, and palmaris longus muscles are removed; C, Anterior view of the right forearm (deeper than A or B).
Brachioradialis, pronator teres, flexor carpi radialis and ulnaris, palmaris longus, and flexor digitorum superficialis muscles are removed; D,
Deep muscles of the right posterior forearm, with extensor digitorum, extensor digiti minimi, and extensor carpi ulnaris muscles cut to
reveal deeper muscles.

Nerves Additionally, throwing athletes may experience a traction injury

to this nerve with the medial stress placed on the elbow during
The muscles of the wrist and hand are all innervated from the radial, median, and or in conjunction with an ulnar collateral ligament
pitching
ulnar nerves of the brachial plexus, as illustrated in Figs. 6.5, 6.6, and 7.10. The The ulnar nerve also may become inflamed from
sprain.
radial nerve, originating from C6, C7, and C8, provides innervation for thesubluxing
extensor or slipping out of its groove, especially in chronic
carpi radialis brevis and extensor carpi radialis longus. It then branches tocases.
become
the posterior interosseous nerve, which supplies the extensor carpi ulnaris, extensor
digitorum, extensor digiti minimi, abductor pollicis longus, extensor pollicis longus,
extensor pollicis brevis, and extensor indicis. The median nerve, arising from C6, C7,
C8, and T1, innervates the flexor carpi radialis, palmaris longus, and flexor digitorum
superficialis. It then branches to become the anterior interosseous nerve, which
innervates the flexor digitorum profundus for the index and long fingers as well as the
flexor pollicis longus. Regarding the intrinsic muscles of the hand, the median nerve
innervates the abductor pollicis brevis, flexor pollicis brevis (superficial head),
opponens pollicis, and first and second lumbrical. The ulnar nerve, branching from
Posterior cord of
C8 and T1, supplies the flexor digitorum profundus for the fourth and fifth fingers and brachial plexus
the flexor carpi ulnaris. Additionally, it innervates the remaining intrinsic muscles of Lateral cord of
the hand (the deep head of the flexor pollicis brevis, adductor pollicis, palmar brachial plexus
interossei, dorsal interossei, third and fourth lumbrical, opponens digiti minimi,
Medial cord of
abductor digiti minimi, and flexor digiti minimi brevis). Sensation to the ulnar side of brachial plexus
the hand, the ulnar half of the ring finger, and the entire little finger Deep head of flexor
Cr
ee
k
Ulnar nerve Chapter
Flexor carpi ulnaris m.
Flexor digitorum profundus m.
is provided by the ulnar nerve. Of all the nerves pollicis brevis m.

in the upper extremity, the ulnar nerve is trauma- Adductor pollicis m. Hypothenar mm.
tized the most. Most people have hit their “funny Medial lumbricals mm.
bone” and experienced a painful tingling sensation into the ulnar
side of their forearm and fourth and fifth fingers. This is actually
Palmar and dorsal
a contusion to the ulnar nerve at the medial elbow. Usually it
interossei mm.
subsides fairly quickly, but chronic contusions or pressure over
this area may lead to a hypersensitivity of this nerve, making it
FIG. 7.10 • Muscular and cutaneous distribution of the ulnar
more easily irritated.
nerve.

Flexor carpi radialis muscle FIG. 7.11 Application, strengthening, and flexibility
(fleksór kar´pi ra´di-a´lis) The flexor carpi radialis, flexor carpi ulnaris, and palmaris
longus are the most powerful of the wrist flexors. They are
Origin brought into play during any activity that requires wrist curling or
Medial epicondyle of the humerus stabilization of the wrist against resistance, particularly if the
n forearm is supinated.
Insertion
Base of the second and third metacarpals, anterior (palmar
The flexor carpi radialis may be developed by performing
surface)
wrist curls against a handheld resistance. This may be
accomplished when the supinated forearm is supported by a
Action
table, with the hand and wrist hanging over the edge to allow full
Flexion of the wrist Abduction of the range of motion. The extended wrist is then flexed or curled up
wrist Weak flexion of the elbow Weak to strengthen this muscle. See Appendix 3 for more commonly
tion
pronation of the forearm used exercises for the flexor carpi radialis and other muscles in
this chapter.
Palpation
Anterior surface of the wrist, slightly lateral, in line with the second
To stretch the flexor carpi radialis, the elbow must be fully
and third metacarpals with resisted flexion and abduction
extended with the forearm supinated while a partner passively
extends and adducts the wrist.
Innervation
Median nerve (C6, C7)
pter
7
O, Medial epicondyle
of humerus
Flexor carpi
radialis m.
Flexion
I, Base of second and third
metacarpals, anterior
Abduction
ulnar (palmar surface)
ion
FIG. 7.11 • Flexor carpi radialis muscle, anterior view. O, Origin; I, Insertion.

Palmaris longus muscle FIG. 7.12 Innervation

(pal-ma´ris lon´gus) Median nerve (C6, C7)

Medial epicondyle of the humerus
Unlike the flexor carpi radialis and flexor carpi Wrist
ulnaris, which are not only wrist flexors but also flexion
Insertion
abductors and adductors, respectively, the palmaris longus is involved
Palmar aponeurosis of the second, third, fourth, and fifth only in wrist flexion from the anatomical position because of its central
metacarpals location on the anterior forearm and wrist. It can, however, assist in
abducting the wrist from an extremely adducted position back to neutral
Action and assist in adducting the wrist from an extremely abducted position
Flexion of the wrist back to neutral. It may also assist slightly in forearm pronation because
Weak flexion of the elbow of its slightly lateral insertion in relation to its origin on the medial epi- Elbow
Palpation
The palmaris longus is absent in either one or both forearms in
some people. Anteromedial and central aspect of the anterior condyle. It may also be strengthened with any type flexion
forearm just proximal to the wrist, particularly with slight wrist of wrist-curling activity, such as those described for the flexor
flexion and opposition of thumb to the fifth finger carpi radialis muscle.
Maximal elbow and wrist extension stretches the palmaris
longus.
Chapter
of humerus
7
Palmaris
longus m.
Flexion
I, Palmaris aponeurosis of second,

third, fourth, and fifth
metacarpals
FIG. 7.12 • Palmaris longus muscle, anterior view. O, Origin; I, Insertion.

Flexor carpi ulnaris muscle FIG. 7.13 just proximal to the wrist, with resisted flexion/ adduction
(fleksór kar´pi ul-na´ris)
Origin Innervation
Medial epicondyle of the humerus Posterior Ulnar nerve (C8, T1)
n aspect of the proximal ulna
Insertion
The flexor carpi ulnaris is very important in wrist flexion or
Pisiform, hamate, and base of the fifth metacarpal (palmar
curling activities. In addition, it is one of only two muscles
surface)
involved in wrist adduction or ulnar flexion. It may be
strengthened with any type of wrist-curling activity against
Action
resistance, such as those described for the flexor carpi radialis
Flexion of the wrist muscle.
Adduction of the wrist, together with the extensor carpi ulnaris
muscle To stretch the flexor carpi ulnaris, the elbow must be fully
Weak flexion of the elbow extended with the forearm supinated while a partner passively
tion
extends and abducts the wrist.
Palpation
Anteromedial surface of the forearm, a few inches below the
medial epicondyle of the humerus to
pter
Flexor carpi
ulnaris m. O, Medial epicondyle
of humerus, posterior
aspect of proximal
ulna
Flexion
I, Pisiform, hamate, and base of fifth
metacarpal
(palmar surface)
Adduction
FIG. 7.13 • Flexor carpi ulnaris muscle, anterior view. O, Origin; I, Insertion.

Extensor carpi ulnaris muscle FIG. 7.14 Application, strengthening, and flexibility
(eks-ten´sor kar´pi ul-na´ris) Besides being a powerful wrist extensor, the extensor carpi ulnaris
muscle is the only muscle other than the flexor carpi ulnaris involved in
Origin wrist adduction or ulnar deviation. The extensor carpi Wrist
Lateral epicondyle of the humerus
Middle two-fourths of the posterior border of the ulna ulnaris, the extensor carpi radialis brevis, and the extension
extensor carpi radialis longus are the most powerful of the wrist
extensors. These muscles act as antagonists to wrist flexion to
Insertion allow the finger flexors to function more effectively in gripping.
Base of the fifth metacarpal (dorsal surface) Any activity requiring wrist extension or stabilization of the wrist
against resistance, particularly if the forearm is pronated,
Action depends greatly on the strength of these muscles. They are
Extension of the wrist often brought into play with the backhand in racquet sports.
Adduction of the wrist together with the flexor carpi ulnaris muscle
Wrist
Weak extension of the elbow The extensor carpi ulnaris may be developed adduction
by performing wrist extension against a handheld resistance.
Palpation This may be accomplished with the pronated forearm being
Just lateral to the ulnar styloid process and crossing the supported by a table with the hand hanging over the edge to
posteromedial wrist, particularly with wrist extension/adduction allow full range of motion. The wrist is then moved from the fully
flexed position to the fully extended position against the
resistance.
Innervation
Stretching the extensor carpi ulnaris requires the elbow to be extended
Radial nerve (C6–C8)
with the forearm pro- Chapter
nated while the wrist is passively flexed and slightly abducted.

7
O, Lateral epicondyle
of humerus
Elbow
Extensor
carpi extension
ulnaris m.
O, Middle two-fourths
of the posterior
border of the ulna
Extension
I, Base of fifth
metacarpal
(dorsal surface)
Adduction
FIG. 7.14 • Extensor carpi ulnaris muscle,

posterior view. O, Origin;
I, Insertion.

Extensor carpi radialis brevis Just proximal to the dorsal aspect of the wrist and approximately 1
cm medial to the radial styloid process, the tendon may be felt
muscle FIG. 7.15
during extension and traced to the base of the third metacarpal,
(eks-ten´sor kar´pi ra´di-a´lis bre´vis) particularly when making a fist; proximally and posteriorly, just
Origin medial to the bulk of the brachioradialis
ion
Lateral epicondyle of the humerus
Innervation
Insertion
Radial nerve (C6, C7)
Base of the third metacarpal (dorsal surface)

Action
The extensor carpi radialis brevis is important in any sports
tion
Extension of the wrist Abduction
activity that requires powerful wrist extension, such as golf or
of the wrist Weak flexion of the
tennis. Wrist extension exercises, such as those described for
elbow
the extensor carpi ulnaris, are appropriate for development of
Palpation the muscle.
Dorsal side of the forearm, and difficult to distinguish from the
extensor carpi radialis longus and the extensor digitorum Stretching the extensor carpi radialis brevis and longus
requires the elbow to be extended with the forearm pronated
while the wrist is passively flexed and slightly adducted.
pter
7 O, Lateral epicondyle
of humerus
Extensor carpi
radialis brevis m.
Abduction
I, Base of third
Extension metacarpal
(dorsal surface)
FIG. 7.15 • Extensor carpi radialis brevis muscle, posterior view. O, Origin; I, Insertion.

Extensor carpi radialis longus process, the tendon may be felt during extension and traced to
the base of the second metacarpal, particularly when making a
muscle FIG. 7.16
fist; proximally and posteriorly, just medial to the bulk of the
(eks-ten´sor kar´pi ra´di-a´lis lon´gus) brachioradialis
Wrist
Origin
extension
Distal third of lateral supracondylar ridge of the humerus and Innervation
lateral epicondyle of the humerus
Insertion
Base of the second metacarpal (dorsal surface)
The extensor carpi radialis longus, like the exten-
Action sor carpi radialis brevis, is important in any sports Wrist
activity that requires powerful wrist extension. In abduction
Extension of the wrist Abduction
addition, both muscles are involved in abduction of the wrist.
of the wrist Weak flexion of the
The extensor carpi radialis longus may be developed with the
elbow
same wrist extension exercises as described for the extensor
Weak pronation to neutral from a fully supinated position
carpi ulnaris muscle.
Palpation The extensor carpi radialis longus is stretched in the same

manner as the extensor carpi radialis brevis.
Just proximal to the dorsal aspect of the wrist and approximately
1 cm medial to the radial styloid
Chapter
7
O, Distal one-third of lateral
supracondylar ridge of
humerus and lateral
epicondyle of humerus
Extensor carpi radialis
longus m.
Elbow
flexion
Abduction
Extension
I, Base of second Radioulnar

metacarpal (dorsal surface)
pronation
FIG. 7.16 • Extensor carpi radialis longus muscle, posterior view. O, Origin; I, Insertion.

Flexor digitorum superficialis making a fist but keeping the distal interphalangeal extended and
slightly resisted wrist flexion; also on anterior mid-forearm during
muscle FIG. 7.17
the same activity
(fleksór dij-i-to´rum su´per-fish-e-alís)
Innervation
Origin
Median nerve (C7, C8, T1)
th Medial epicondyle of the humerus Ulnar head:
medial coronoid process Application, strengthening, and flexibility
n
Radial head: upper two-thirds of anterior border of the radius just The flexor digitorum superficialis muscle, also known as the
distal to the radial tuberosity flexor digitorum sublimis, divides into four tendons on the
palmar aspect of the wrist and hand to insert on each of the four
Insertion
fingers. The flexor digitorum superficialis and the flexor
Each tendon splits and attaches to the sides of the middle phalanx
digitorum profundus are the only muscles involved in flexion of
of the four fingers (palmar surface)
th all four fingers. Both of these muscles are vital in any type of
Action gripping activity.
n
Flexion of the fingers at the metacarpophalangeal and proximal
interphalangeal joints Squeezing a sponge rubber ball in the palm of the hand,
Flexion of the wrist along with other gripping and squeezing activities, can be used
Weak flexion of the elbow to develop these muscles.
The flexor digitorum superficialis is stretched by passively
Palpation extending the elbow, wrist, metacarpophalangeal, and proximal
In depressed area between palmaris longus and flexor carpi interphalangeal joints while maintaining the forearm in full
ulnaris tendons, particularly when supination.
pter
7 of humerus.
Ulnar head:
medial coronoid
process. Radial
head: upper
two-thirds of
anterior
border of
radius
Flexor digitorum
th superficialis m.
and
exion
Flexion of wrist
Flexion of fingers
I, Split tendons attach to sides of

middle phalanx of four fingers
(palmar surface)
FIG. 7.17 • Flexor digitorum superficialis muscle, anterior view. O, Origin; I, Insertion.
n

Flexor digitorum profundus Innervation
muscle FIG. 7.18 Median nerve (C8, T1) to the second and third fingers Ulnar nerve
(C8, T1) to the fourth and fifth fingers
(fleksór dij-i-to´rum pro-fun´dus)

Proximal three-fourths of the anterior and medial ulna Both the flexor digitorum profundus muscle and 2nd–5th
the flexor digitorum superficialis muscle assist in DIP
Insertion wrist flexion because of their palmar relationship flexion
Base of the distal phalanxes of the four fingers to the wrist. The flexor digitorum profundus is used in any type
of gripping, squeezing, or handclenching activity, such as
Action gripping a racket or climbing a rope.
Flexion of the four fingers at the metacarpophalangeal, proximal
interphalangeal, and distal interphalangeal joints The flexor digitorum profundus muscle may be developed through
these activities, in addition to the strengthening exercises described for
Flexion of the wrist the 2nd–5th
flexor digitorum superficialis muscle. PIP
Palpation The flexor digitorum profundus is stretched flexion

Difficult to distinguish, deep to the flexor digitorum superficialis, but similarly to the flexor digitorum superficialis, except that the
on anterior mid-forearm while flexing the distal interphalangeal distal interphalangeal joints must be passively extended in
joints and keeping the proximal interphalangeal joints in extension; addition to the wrist, metacarpophalangeal, and proximal
over the palmar surface of the second, third, fourth, and fifth interphalangeal joints while maintaining the forearm in full
metacarpophalangeal joints during finger flexion against supination.
resistance
Chapter
2nd–5th
MCP
flexion
O, Proximal
Flexor digitorum profundus m.
three-fourths of
anterior and
medial ulna
Flexion of wrist
2nd–5th
MCP and
PIP flexion
Flexion of fingers
Wrist
I, Base of distal phalanxes of the
four fingers flexion
FIG. 7.18 • Flexor digitorum profundus muscle, anterior view. O, Origin; I, Insertion.

Flexor pollicis longus muscle FIG. 7.19 medial to the flexor carpi radialis on the anterior distal forearm,
especially during active flexion of the thumb interphalangeal
(fleksór polí-sis lon´gus)
b joint
flexion Origin
Middle anterior surface of the radius and the anterior medial border Innervation
of the ulna just distal to the coronoid process; occasionally a small Median nerve, palmar interosseous branch (C8, T1)
head is present attaching on the medial epicondyle of the humerus
b
Insertion The primary function of the flexor pollicis longus muscle is
flexion flexion of the thumb, which is vital in gripping and grasping
Base of the distal phalanx of the thumb (palmar surface)
activities of the hand. Because of its palmar relationship to the
wrist, it provides some assistance in wrist flexion.
Action
It may be strengthened by pressing a sponge rubber ball
Flexion of the thumb carpometacarpal, metacarpophalangeal,
into the hand with the thumb and by many other gripping or
and interphalangeal joints
squeezing activities.
Flexion of the wrist
The flexor pollicis longus is stretched by passively extending
mb IP Abduction of the wrist
n
the entire thumb while simultaneously maintaining maximal wrist
Palpation extension.
Anterior surface of the thumb on the proximal phalanx, and just
lateral to the palmaris longus and
pter
Flexor pollicis longus m.

O, Middle anterior surface of radius
and from the anterior medial
border
Flexion of ulna just distal to
tion Flexion
coronoid process
I, Base of distal phalanx

of thumb
(palmar surface)
FIG. 7.19 • Flexor pollicis longus muscle, anterior view. O, Origin; I, Insertion.

Extensor digitorum muscle FIG. 7.20 that are over the dorsal aspect of the hand and
(eks-ten´sor dij-i-to´rum) 2nd–5th
Origin Innervation MCP

extension
Lateral epicondyle of the humerus Radial nerve (C6–C8)
Four tendons to bases of middle and distal phalanxes of the The extensor digitorum, also known as the extensor digitorum communis,
is the only muscle involved in extension of all four fingers. This muscle
four fingers (dorsal surface)
divides into four tendons on the dorsum of the 2nd–5th
Action
wrist to insert on each of the fingers. It also assists MCP, PIP,
Extension of the second, third, fourth, and fifth phalanges at
with wrist extension movements. It may be devel- and DIP
the metacarpophalangeal joints Extension of the wrist extension
oped by applying manual resistance to the dorsal aspect of the
flexed fingers and then extending the fingers fully. When
Weak extension of the elbow
performed with the wrist in flexion, this exercise increases the
Palpation workload on the extensor digitorum.
With all four fingers extended, on the posterior surface of the

To stretch the extensor digitorum, the fingers
distal forearm immediately medial to the extensor pollicis Wrist
must be maximally flexed at the metacarpopha- extension
longus tendon and lateral to the extensor carpi ulnaris and
langeal, proximal interphalangeal, and distal inter-
extensor digiti minimi, then dividing into four separate tendons
phalangeal joints while the wrist is fully flexed.
Chapter
of humerus
7
Extensor
digitorum m.
Elbow
extension
I, Four tendons to bases of

middle and distal phalanxes
Extension
of four
of wrist
fingers (dorsal surface)
Extension
of fingers
FIG. 7.20 • Extensor digitorum muscle, posterior view. O, Origin; I, Insertion.

Extensor indicis muscle FIG. 7.21 just medial to the extensor digitorum tendon of the index finger
with extension of the index fingers and flexion of the third, fourth,
CP (eks-ten´sor in´di-sis)
and fifth fingers
sion Origin
Between middle and distal one-third of the posterior ulna Innervation

Radial nerve (C6–C8)

Base of the middle and distal phalanxes of the second phalange The extensor indicis muscle is the pointing muscle. That is, it is
ion (dorsal surface) responsible for extending the index finger, particularly when the
other fingers are flexed. It also provides weak assistance to
Action wrist extension and may be developed through exercises similar
Extension of the index finger at the metacarpophalangeal joint to those described for the extensor digitorum.
Weak wrist extension

oulnar Weak supination of the forearm from a pronated
The extensor indicis is stretched by passively taking the
ation
position index finger into maximal flexion at its metacarpophalangeal,
proximal interphalangeal,
Palpation and distal interphalangeal joints while fully flexing the wrist.
With forearm pronated on the posterior aspect of the distal
forearm and dorsal surface of the hand
pter
O, Between middle and distal

one-third of
posterior ulna
Extensor indicis m.
Extension
I, Base of middle and distal

phalanxes of
second phalange
(dorsal surface)
FIG. 7.21 • Extensor indicis muscle, posterior view. O, Origin; I, Insertion.

Extensor digiti minimi muscle FIG. 7.22 fingers and alternating fifth finger extension and relaxation;
dorsal surface of forearm immediately medial to the extensor
(eks-ten´sor dijí-ti miním-i) 5th MCP
digitorum and lateral to the extensor carpi ulnaris
extension
Origin
Lateral epicondyle of the humerus Innervation
Insertion Radial nerve (C6–C8)
Base of the middle and distal phalanxes of the fifth phalange Application, strengthening, and flexibility
(dorsal surface)
The primary function of the extensor digiti minimi Wrist
Action muscle is to assist the extensor digitorum in extend- extension
ing the little finger. Because of its dorsal relationship to the
Extension of the little finger at the metacarpophalangeal joint
wrist, it also provides weak assistance in wrist extension. It is
strengthened with the same exercises described for the
extensor digitorum.
Weak elbow extension
The extensor digiti minimi is stretched by passively taking the little
Palpation finger into maximal flexion at its metacarpophalangeal, proximal
Passing over the dorsal aspect of the distal radioulnar joint, interphalangeal, and distal interphalangeal joints while fully Elbow
particularly with relaxed flexion of other

flexing the wrist. extension
of humerus
Chapter
Extensor digiti minimi m.
Extension
I, Base of middle and distal

phalanxes
FIG. 7.22 • Extensor of fifth phalange
digiti minimi muscle, (dorsal surface)
posterior view. O,
Origin; I, Insertion.

Extensor pollicis longus Innervation
muscle FIG. 7.23 Radial nerve (C6–C8)
(eks-ten´sor polí-sis lon´gus)

b Origin The primary function of the extensor pollicis longus muscle is
Posterior lateral surface of the lower middle ulna extension of the thumb, although it does provide weak
ion
assistance in wrist extension.
Insertion
It may be strengthened by extending the flexed thumb
Base of the distal phalanx of the thumb (dorsal surface)
against manual resistance. It is stretched by passively taking
Action the entire thumb into maximal flexion at its carpometacarpal,
metacarpophalangeal, and interphalangeal joints while fully
b Extension of the thumb at the carpometacarpal,
flexing the wrist with the forearm in pronation.
metacarpophalangeal, and interphalangeal joints Extension of
ion
the wrist
The tendons of the extensor pollicis longus and extensor
Abduction of the wrist
pollicis brevis, along with the tendon of the abductor pollicis
Weak supination of the forearm from a pronated position
longus, form the “anatomical snuffbox,” the small depression
that develops between these two tendons when they contract.
Palpation The name anatomical snuffbox originates from tobacco users
Dorsal aspect of the hand to its insertion on the base of the distal placing their snuff in this depression. Deep in the snuffbox the
b IP
phalanx; also on the posterior surface of the lower forearm scaphoid bone can be palpated and is often a site of point
ion
between radius and ulna just proximal to the extensor indicis and tenderness when it is fractured.
medial to the extensor pollicis brevis and abductor pollicis longus
with the forearm pronated and fingers in
pter
7 relaxed flexion while actively extending the thumb
ion
O, Posterior lateral
surface of lower
middle ulna
Extensor pollicis
longus m.
tion
Extension
Extension
ulnar
ation
of thumb
(dorsal surface)
FIG. 7.23 • Extensor
pollicis longus muscle,
posterior view. O, Origin;
I, Insertion.

Extensor pollicis brevis muscle FIG. 7.24 proximal phalanx with extension of the thumb carpometacarpal
and metacarpophalangeal joints and flexion of the
(eks-ten´sor polí-sis bre´vis)
interphalangeal joint
Origin
Innervation
Posterior surface of the lower middle radius Thumb
CMC
Insertion extension
Base of the proximal phalanx of the thumb (dorsal surface)
The extensor pollicis brevis assists the extensor pollicis longus
in extending the thumb. Because of its dorsal relationship to the
wrist, it, too, provides weak assistance in wrist extension.
Action
Thumb
Extension of the thumb at the carpometacarpal and
It may be strengthened through the same exer- MCP
cises described for the extensor pollicis longus extension
Wrist abduction
muscle. It is stretched by passively taking the first
carpometacarpal joint and the metacarpophalangeal joint of the
thumb into maximal flexion while fully flexing and adducting the
Palpation
wrist.
Just lateral to the extensor pollicis longus tendon on the dorsal side
of the hand to its insertion on the Wrist
abduction
Chapter
Wrist
extension
O, Posterior surface of lower

middle radius
Extensor pollicis
brevis m.
Extension
I, Base of proximal phalanx of

thumb (dorsal surface)
FIG. 7.24 • Extensor pollicis brevis muscle, posterior view. O, Origin; I, Insertion.

Abductor pollicis longus Palpation
muscle FIG. 7.25 With forearm in neutral pronation/supination on the lateral aspect
of the wrist joint just proximal to the first metacarpal during active
(ab-duk´tor polí-sis lon´gus)
b thumb and wrist abduction
Origin
tion
Posterior aspect of the radius and midshaft of the ulna
Innervation
Insertion
Base of the first metacarpal (dorsal lateral surface) Application, strengthening, and flexibility
The primary function of the abductor pollicis longus muscle is
Action abduction of the thumb, although it does provide some
tion
Abduction of the thumb at the carpometacarpal joint Abduction of assistance in abduction of the wrist. It may be developed by
the wrist abducting the thumb from the adducted position against a
Extension of the thumb at the carpometacarpal joint Weak manually applied resistance. Stretching of the abductor pollicis
supination of the forearm from a pronated position longus is accomplished by fully flexing and adducting the entire
thumb across the palm with the wrist fully adducted and in slight
Weak extension of the wrist joint flexion.
ion
pter
O, Posterior aspect of the radius

ulnar and midshaft
ation of ulna
Abductor pollicis
longus m.
ion Abduction
I, Base of first metacarpal (dorsal

lateral surface)
FIG. 7.25 • Abductor pollicis longus muscle, posterior view. O, Origin; I, Insertion.

Intrinsic muscles of the hand Four intrinsic muscles act on the carpometacarpal joint of
the thumb. The opponens pollicis is the muscle that causes
The intrinsic hand muscles may be grouped according to opposition in the thumb metacarpal. The abductor pollicis brevis
location as well as according to the parts of the hand they abducts the thumb metacarpal and is assisted in this action by
control (Fig. 7.26). The abductor pollicis brevis, opponens the flexor pollicis brevis, which also flexes the thumb
pollicis, flexor pollicis brevis, and adductor pollicis make up the metacarpal. The metacarpal of the thumb is adducted by the
thenar eminence—the muscular pad on the palmar surface of adductor pollicis. Both the flexor pollicis brevis and the adductor
the first metacarpal. The hypothenar eminence is the muscular pollicis flex the proximal phalanx of the thumb.
pad that forms the ulnar border on the palmar surface of the
hand and is made up of the abductor digiti minimi, flexor digiti
minimi brevis, palmaris brevis, and opponens digiti minimi. The The three palmar interossei are adductors of the second,
intermediate muscles of the hand consist of three palmar fourth, and fifth phalanges. The four dorsal interossei both flex
interossei, four dorsal interossei, and four lumbrical muscles. and abduct the index, middle, and ring proximal phalanxes, in
addition to assisting with extension of the middle and distal
phalanxes of these fingers. The third dorsal
Tendons of flexor
digitorum profundus
Chapter
Palmar plates Tendons of flexor digitorum

7
superficialis
Dorsal
interossei
Tendon of deep Tendon of flexor pollicis longus
digital flexor
Lumbricals Traverse head Adductor

Oblique head pollicis
Abductor digiti minimi
Hypothenar
Opponens digiti minimi
muscles Flexor pollicis brevis
Flexor digiti minimi brevis Thenar
Abductor pollicis brevis
Tendons of flexor digitorum muscles
Opponens pollicis
profundus
Tendons of flexor digitorum Tendon of extensor pollicis brevis Tendon of
superficialis
Position of pisiform bone abductor pollicis longus
Tendon of flexor carpi ulnaris

Flexor retinaculum
Tendons of flexor digitorum Radial artery
superficialis
Ulnar nerve Pronator quadratus
and artery
Tendon of palmaris longus Tendon of flexor carpi radialis
Median nerve Tendon of flexor pollicis longus
FIG. 7.26 • Intrinsic muscles of the right hand, anterior view.

interossei also adducts the middle finger. The four lumbricals little finger metacarpal. The abductor digiti minimi abducts the
flex the index, middle, ring, and little proximal phalanxes and little finger metacarpal, and the flexor digiti minimi brevis flexes
extend the middle and distal phalanxes of these fingers. this metacarpal.
Refer to Table 7.2 for further details regarding the intrinsic
b
Three muscles act on the little finger. The opponens digiti muscles of the hand.
tion minimi causes opposition of the
TABLE 7.2 • Intrinsic muscles of the hand
b Muscle Origin Insertion Action Palpation Innervation

flexion
Palmar aspect of
Anterior surface of Median
Opponens Lateral border of CMC opposition 1st metacarpal with
transverse carpal nerve
pollicis 1st metacarpal of thumb opposition of fingertips
ligament, trapezium (C6, C7)
to thumb
Anterior surface of Radial aspect of

b Abductor Base of 1st Median
transverse carpal CMC abduction palmar surface of
flexion pollicis proximal nerve
ligament, trapezium, of thumb 1st metacarpal with
brevis phalanx (C6, C7)
scaphoid 1st CMC abduction
Superficial head: Superficial

Thenar muscles
trapezium and Medial aspect of thenar head:

transverse carpal Base of proxi- CMC flexion and eminence just proximal median nerve
Flexor pol-
ligament mal phalanx of abduction; MCP to 1st MCP joint with 1st MCP (C6, C7)
licis brevis
Deep head: ulnar 1st metacarpal flexion of thumb flexion against resistance Deep head:
aspect of 1st ulnar nerve
pter
metacarpal (C8, T1)
7 Transverse head:
anterior shaft of
Ulnar aspect of Palmar surface
3rd metacarpal CMC adduction;
Adductor base of proxi- between 1st and Ulnar nerve
Oblique head: MCP flexion of
pollicis mal phalanx of 2nd metacarpal with (C8, T1)
base of 2nd and thumb
1st metacarpal 1st CMC adduction
3rd metacarpals,
capitate, trapezoid
th
flexion Bases of 2nd,
Shaft of 2nd, 4th, and 5th 4th, and 5th
MCP adduction
Palmar metacarpals proximal Ulnar nerve
of 2nd, 4th, and 5th Cannot be palpated
interossei and extensor phalanxes (C8, T1)
phalanges
expansions and extensor
expansions
Dorsal surface between

MCP flexion and
Bases of 2nd, 1st and 2nd metacarpals,
th abduction; PIP/
3rd, and 4th between shafts Ulnar nerve,
Intermediate muscles
PIP, Two heads on DIP extension of

Dorsal proximal of 2nd through 5th palmar
IP shafts on adjacent 2nd, 3rd, and 4th
interossei phalanxes metacarpals with active branch
ion metacarpals phalanges; MCP
and extensor abduction/adduction (C8, T1)
adduction of 3rd
expansions of 2nd, 3rd, and 4th MCP
phalange
joints
Extensor
MCP flexion 1st and 2nd:
expansions
and PIP/DIP median nerve
Flexor digitorum on radial
extension (C6, C7)
Lumbricals profundus tendon side of 2nd, Cannot be palpated
of 2nd, 3rd, 3rd and 4th:
in center of palm 3rd, 4th, and
4th, and 5th ulnar nerve
5th proximal
phalanges (C8, T1)
phalanxes

TABLE 7.2 (continued) • Intrinsic muscles of the hand
Muscle Origin Insertion Action Palpation Innervation
Hook of hamate On radial aspect of 2nd–5th

Medial MCP
Opponens and adjacent MCP opposition hypothenar eminence Ulnar nerve
border of flexion
digiti minimi transverse carpal of 5th phalange with opposition of 5th (C8, T1)
5th metacarpal
ligament phalange to thumb
Ulnar aspect Ulnar aspect of

Pisiform and
Abductor of base of MCP abduction hypothenar eminence Ulnar nerve
flexor carpi ulnaris
digiti minimi 5th proximal of 5th phalange with 5th MCP (C8, T1)
tendon
phalanx abduction
Hypothenar muscles
Palmar surface of 5th

Hook of hamate Ulnar aspect
Flexor digiti metacarpal, lateral to
and adjacent of base of MCP flexion Ulnar nerve
minimi opponens digiti minimi
transverse carpal 5th proximal of 5th phalange (C8, T1)
brevis with 5th MCP flexion
ligament phalanx
against resistance
Transverse carpal
ligament and
Palmaris Skin of ulnar Tenses the skin Ulnar border of the palm Ulnar nerve
medial margin
brevis border of palm on the ulnar side of the hand (C8, T1)
of palmar
aponeurosis
REVIEW EXERCISES c. Flexion

d. Extension Chapter
1. List the planes in which each of the following wrist, hand, and
2. Discuss why the thumb is the most important 7
part of the hand.
finger joint movements occurs. List the axis of rotation for
3. How should boys and girls be taught to do pushups? Justify
each movement in each plane.
your answer.
a. Hands flat on the floor
a. Abduction
b. Fingertips
b. Adduction
4. Muscle analysis chart • Wrist, hand, and fingers
Fill in the chart by listing the muscles primarily involved in each movement.
Wrist and hand
Flexion Extension
Adduction Abduction
Fingers, metacarpophalangeal joints
Flexion Extension
Abduction Adduction

Muscle analysis chart (continued)
Fingers, proximal interphalangeal joints
Flexion Extension
Fingers, distal interphalangeal joints
Flexion Extension
Thumb
Flexion Extension
Abduction Adduction
pter
5. List the muscles involved in the little finger as you type on a b. Subject
7 computer keyboard and reach for the left tab key with the
wrists properly stabilized in an ergonomic position.
1. Medial epicondyle
2. Lateral epicondyle
3. Lateral supracondylar ridge
6. Describe the importance of the intrinsic muscles in the 4. Pisiform
hand as you reach to turn a doorknob. Determine the kind 5. Scaphoid (navicular)
7. of flexibility exercises that would be indicated for a patient 2. How and where can the following muscles be palpated on a
with carpal tunnel syndrome, and explain in detail how they human subject?
should be performed. a. Flexor pollicis longus
b. Flexor carpi radialis
c. Flexor carpi ulnaris
d. Extensor digitorum communis
LABORATORY EXERCISES e. Extensor pollicis longus
f. Extensor carpi ulnaris
1. Locate the following parts of the humerus, radius, ulna, 3. Demonstrate the action and list the muscles primarily
carpals, and metacarpals on a human skeleton and on a responsible for the following movements at the wrist joint:
subject.
a. Skeleton a. Flexion
1. Medial epicondyle b. Extension
2. Lateral epicondyle c. Abduction
3. Lateral supracondylar ridge d. Adduction
4. Trochlea 4. With a laboratory partner, determine how and why
5. Capitulum maintaining full flexion of all the fingers is impossible when
6. Coronoid process passively moving the wrist into maximal flexion. Is it also
7. Tuberosity of the radius difficult to maintain maximal extension of all the finger joints
8. Styloid process—radius while passively taking the wrist into full extension?
9. Styloid process—ulna
10. First and third metacarpals
11. Wrist bones
12. First phalanx of third metacarpal

5. Wrist and hand joint exercise movement analysis chart
After analyzing each exercise in the chart, break each into two primary movement phases, such as a lifting phase and a lowering
phase. For each phase, determine the wrist and hand joint movements that occur, and then list the wrist and hand joint muscles
primarily responsible for causing/controlling those movements. Beside each muscle in each movement, indicate the type of
contraction as follows: I—isometric; C—concentric; E—eccentric.

Exercise
Push-up
Chin-up
Bench press
Dip
Lat pull
Chapter
Ball squeeze
7
Frisbee throw
6. Wrist and hand joint sport skill analysis chart
Analyze each skill in the chart and list the movements of the right and left wrist and hand joints in each phase of the skill. You may prefer
to list the initial positions that the wrist and hand joints are in for the stance phase. After each movement, list the wrist and hand joint
muscle(s) primarily responsible for causing/controlling the movement. Beside each muscle in each movement, indicate the type of
contraction as follows: I—isometric; C—concentric; E—eccentric. It may be desirable to study the concepts for analysis in Chapter 8 for
the various phases.
(R)
Baseball pitch
(L)
(R)
Volleyball serve
(L)
(R)
Tennis serve
(L)
(R)
Softball pitch
(L)

Wrist and hand joint sport skill analysis chart (continued)
(R)
Tennis backhand
(L)
(R)
Batting
(L)
(R)
Bowling
(L)
(R)
Basketball
free throw (L)
References Oatis CA: Kinesiology: the mechanics and pathomechanics of human

movement, ed 2, Philadelphia, 2008, Lippincott Williams & Wilkins.
Rasch PJ: Kinesiology and applied anatomy, ed 7, Philadelphia, 1989,

Gabbard CP, et al: Effects of grip and forearm position on flex arm Lea & Febiger.
hang performance, Research Quarterly for Exercise and Sport, July
1983.
York, 2008, McGraw-Hill.
Gench BE, Hinson MM, Harvey PT: Anatomical kinesiology,
Sieg KW, Adams SP: Illustrated essentials of musculoskeletal anatomy,
Dubuque, IA, 1995, Eddie Bowers.
pter ed 4, Gainesville, FL, 2002, Megabooks.
Guarantors of Brain: Aids to the examination of the peripheral
7
Sisto DJ, et al: An electromyographic analysis of the elbow in pitching,
nervous system, ed 4, London, 2000, Saunders.
American Journal of Sports Medicine 15:260, May–June 1987.
Hamilton N, Weimer W, Luttgens K: Kinesiology: scientific basis of
Smith LK, Weiss EL, Lehmkuhl LD: Brunnstrom’s clinical kinesiology,
ed 5, Philadelphia, 1996, Davis.
Hislop HJ, Montgomery J: Daniels and Worthingham’s muscle testing:
Springer SI: Racquetball and elbow injuries, National Racquetball
16:7, March 1987.
Stone RJ, Stone JA: Atlas of the skeletal muscles, ed 6, New York,
Lindsay DT: Functional human anatomy, St. Louis, 1996, Mosby.
2009, McGraw-Hill.
Magee DJ: Orthopedic physical assessment, ed 5, Philadelphia, 2008,
Saunders.
McGraw-Hill.
Norkin CC, Levangie PK: Joint structure and function—a

comprehensive analysis, ed 5, Philadelphia, 2011, Davis. For additional resources and a list of related websites,
Norkin CC, White DJ: Measurement of joint motion: a guide to visit www.mhhe.com/floyd19e.
goniometry, ed 4, Philadelphia, 2009, Davis.

Worksheet Exercises
Worksheet 1
Using crayons or colored markers, draw and label on the worksheet the following muscles. Indicate the origin and insertion of each muscle with
an “O” and an “I,” respectively.
a. Flexor pollicis longus f. Extensor carpi ulnaris k. Extensor digiti minimi

b. Flexor carpi radialis g. Extensor pollicis brevis l. Extensor indicis
c. Flexor carpi ulnaris h. Palmaris longus m. Flexor digitorum superficialis
d. Extensor digitorum i. Extensor carpi radialis longus n. Flexor digitorum profundus
e. Extensor pollicis longus j. Extensor carpi radialis brevis o. Abductor pollicis longus
Chapter

Worksheet Exercises
Worksheet 2
Label and indicate with arrows the following movements of the wrist and hands. For each motion, list the agonist muscle(s), the plane in which
the motion occurs, and its axis of rotation.
a. Flexion c. Abduction (ulnar flexion)

b. Extension d. Adduction (radial flexion)
pter
a. The muscle(s) cause to occur in the
plane about the axis.
b. The muscle(s) cause to occur in the
c. The muscle(s) cause to occur in the
d. The muscle(s) cause to occur in the

C HAPTER 8
M USCULAR A NALYSIS OF
U PPER E XTREMITY E XERCISES
Objectives
P critical for most sports
roper functioning of theactivities, as well asis
upper extremities
j To begin analyzing sport skills in terms of phases for many activities of daily living. Strength and endurance in this
and the various joint movements occurring in those part of the human body are essential for improved appearance
phases and posture, as well as for more efficient skill performance.
Unfortunately, it is often one of the body’s weaker areas,
j To understand various conditioning principles and how to
considering the number of muscles involved. Specific exercises
apply them to strengthening major muscle groups
and activities to condition this area should be intelligently
selected
j To analyze an exercise to determine the joint movements
and the types of contractions occurring in the specific by becoming thoroughly familiar with the mus- Chapter
muscles involved in those movements
cles involved.
Simple exercises may be used to begin teach- 8
j To learn and understand the concept of open versus ing individuals how to group muscles to produce joint
closed kinetic chain movement. Some of these simple introductory exercises are
j To learn to group individual muscles into units that included in this chapter.
produce certain joint movements The early analysis of exercise makes the study of structural
kinesiology more meaningful as students come to better
j To begin to think of exercises that increase the strength
understand the importance of individual muscles and groups of
and endurance of individual muscle groups
muscles in bringing about joint movements in various exercises.
Chapter 13 contains analysis of exercises for the entire body,
j To learn to analyze and prescribe exercises to strengthen with emphasis on the trunk and lower extremities. Contrary to
major muscle groups. what most beginning students in structural kinesiology believe,
muscular analysis of activities is not difficult once the basic
concepts are understood.

Upper-extremity activities
j Self-grading quizzes Children seem to have an innate desire to climb, swing, and
j Anatomy flashcards hang. Such movements use the muscles of the hands, wrists,
j Animations elbows, and shoulder joints. But the opportunity to perform
j Related websites these types of activities is limited in our modern culture.

Unless emphasis is placed on the development of this area of tension. If there is no tension, then the lengthening is passive,
our bodies by physical education teachers in elementary caused totally by the elbow flexors. If there is active tension,
schools, for both boys and girls, it will continue to be muscularly then the elbow extensors are contracting eccentrically to control
the weakest area of our bodies. Weakness in the upper the amount and speed of lengthening.
extremities can impair skill development and performance in
many common, enjoyable recreational activities, such as golf, An often confusing aspect is that, depending on the activity,
tennis, softball, and racquetball. People enjoy what they can do these muscle groups can function to control the exact opposite
well, and they can be taught to enjoy activities that will increase actions by contracting eccentrically. That is, through eccentric
the strength and endurance of this part of the body. These and contractions, the elbow flexors may control elbow extension, as
other such activities can be enjoyed throughout the entire adult in lowering the weight in a biceps curl, and the triceps brachii
life; therefore, adequate skill development built on an and anconeus may control elbow flexion, as in lowering the
appropriate base of muscular strength and endurance is weight in a triceps extension (see Tables 8.3 and 8.4). Exercise
essential for enjoyment and prevention of injury. professionals should be able to view an activity and not only
determine which muscles are performing the movement but also
know what type of contraction is occurring and what kinds of
exercises are appropriate for developing the muscles. Chapter 2
provides a review of how muscles contract to work in groups to
Often, we perform typical strengthening exercises in the function in joint movement.
weight room, such as the bench press, overhead press, and
biceps curl. These are good exercises, but they all concentrate
primarily on the muscles of the anterior upper extremity. This
can lead to an overdevelopment of these muscles with respect
to the posterior muscles. As a result, individuals may become
strong and tight anteriorly and weak and flexible posteriorly. It is Analysis of movement
for these reasons that one must be able to analyze specific In analyzing various exercises and sport skills, it is essential to
strengthening exercises and determine the muscles involved so break down all the movements into phases. The number of
that overall muscular balance is addressed through appropriate phases, usually three to five, will vary depending on the skill.
exercise prescription. Practically all sport skills will have at least a preparatory phase,
pter a movement phase, and a follow-through phase. Many will also
begin with a stance phase and end with a recovery phase. The
8 names of the phases will vary from skill to skill to fit in with the
terminology used in various sports, and they may also vary
Concepts for analysis depending on the body part involved. In some cases, these
major phases may be divided even further, as with baseball, in
In analyzing activities, it is important to understand that muscles which the preparatory phase for the pitching arm is broken into
are usually grouped according to their concentric function and early cocking and late cocking.
work in paired opposition to an antagonistic group. An example
of this aggregate muscle grouping to perform a given joint
action is seen with the elbow flexors all working together. In this
example, the elbow flexors (biceps, brachii, brachialis, and The stance phase allows the athlete to assume a
brachioradialis) are concentrically contracting as an agonist comfortable and appropriately balanced body position from
group to achieve flexion. As they flex the elbow, each muscle which to initiate the sport skill. The emphasis is on setting the
contributes significantly to the task. They are working in various joint angles in their correct positions with respect to one
opposition to their antagonists, the triceps brachii and another and to the sport surface. Generally, with respect to the
anconeus. The triceps brachii and anconeus work together as subsequent phases, the stance phase is a relatively static
an aggregate muscle group to cause elbow extension, but in phase involving fairly short ranges of motion. Due to the minimal
this example they are cooperating in their lengthening to allow amount of movement in this phase, the majority of the joint
the flexors to perform their task. In this cooperative lengthening, position maintenance throughout the body will be accomplished
the triceps and anconeus may or may not be under active through isometric contractions.
The preparatory phase , often referred to as the cocking or

wind-up phase, is used to lengthen

the appropriate muscles so that they will be in position to

generate more force and momentum as they concentrically
contract in the next phase. It is the most critical phase in
achieving the desired result of the activity and becomes more
dynamic as the need for explosiveness increases. Generally, to
lengthen the muscles needed in the next phase, concentric
contractions occur in their antagonist muscles in this phase.
Stance Preparatory
The movement phase , sometimes known as the

acceleration, action, motion, or contact phase, is the action part
of the skill. It is the phase in which the summation of force is
generated directly to the ball, sport object, or opponent and is
usually characterized by near-maximal concentric activity in the
involved muscles.
Movement
The follow-through phase begins immediately after the
climax of the movement phase, in order to bring about negative
acceleration of the involved limb or body segment. In this
phase, often referred to as the deceleration phase, the velocity
of the body segment progressively decreases, usually over a
wide range of motion. This velocity decrease is usually
attributable to high eccentric activity in the muscles that were
antagonist to the muscles used in the movement phase.
Generally, the greater the acceleration in the movement phase, Follow-through
the greater the length and importance of the follow-though

phase. Occasionally, some athletes may begin the FIG. 8.1 • Skill analysis phases—baseball pitch. The stance
phase is accomplished predominantly
follow-through phase too soon, thereby cutting short the
with isometric contractions. Movements in the preparatory phase
movement phase and achieving a less-than-desirable result in Chapter
are accomplished primarily through concentric contractions. The
the activity.
movement phase involves significant concentric activity. Eccentric
activity is high during the follow-through phase.
8
The recovery phase is used after followthrough to regain
balance and positioning to be ready for the next sport demand.
To a degree, the muscles used eccentrically in the
follow-through phase to decelerate the body or body segment
will be used concentrically in recovery to bring about the initial At ball release, the follow-through phase begins as the arm
return to a functional position. continues moving in the same direction established by the
movement phase until the velocity decreases to the point that
Skill analysis can be seen with the example of a baseball the arm can safely change movement direction. This
pitch in Fig. 8.1. The stance phase begins when the player deceleration of the body, and especially the arm, is
assumes a position with the ball in the glove before receiving accomplished by high amounts of eccentric activity. At this
the signal from the catcher. The pitcher begins the preparatory point, the recovery phase begins, enabling the player to
phase by extending the throwing arm posteriorly and rotating reposition to field the batted ball. In this example, reference has
the trunk to the right in conjunction with left hip flexion. The right been made primarily to the throwing arm, but there are many
shoulder girdle is fully retracted in combination with abduction similarities in other overhand sport skills, such as the tennis
and maximum external rotation of the glenohumeral joint to serve, javelin throw, and volleyball serve. In actual practice, the
complete this phase. Immediately following, the movement movements of each joint in the body should be analyzed with
phase begins with forward movement of the arm and continues respect to the various phases.
until ball release.

The kinetic chain concept in space through a single plane. These types of exercises are
known as joint-isolation exercises and are beneficial in isolating
As you have learned, our extremities consist of several bony a particular joint to concentrate on specific muscle groups.
segments linked by a series of joints. These bony segments and However, they are not very functional in that most physical
their linkage system of joints may be likened to a chain. Just as activity, particularly for the lower extremity, requires
with a chain, any one link in the extremity may be moved multiple-joint activity involving numerous muscle groups
individually without significantly affecting the other links if the simultaneously. Furthermore, since the joint is stable proximally
chain is open or not attached at one end. However, if the chain and loaded distally, shear forces are acting on the joint, with
is securely attached or closed, substantial movement of any one potential negative consequences.
link cannot occur without substantial and subsequent movement
of the other links.
If the distal end of the extremity is fixed, as in a pull-up,
push-up, dip, squat, or dead lift, the extremity represents a closed
In the body, an extremity may be seen as representing an open kinetic chain . See Fig. 8.2, B and D. In this closed system,
kinetic chain if the distal end of the extremity is not fixed to a movement of one joint cannot occur without causing predictable
relatively stable surface. This arrangement allows any one joint movements of the other joints in the extremity. Closed-chain
in the extremity to move or function separately without activities are very functional and involve the body moving in
necessitating movement of other joints in the extremity. This relation to the relatively fixed distal segment. The advantage of
does not mean that open kinetic chain activities have to involve multiplejoint exercises is that several joints are involved and
only one joint but rather that motion at one joint does not require numerous muscle groups must participate in causing and
motion at other joints in the chain. Examples in the upper controlling the multiple-plane movements, which strongly
extremity of these single joint exercises include the shoulder correlate to most physical activities. Additionally, the joint is
shrug, deltoid raise (shoulder abduction), and biceps curl (Fig. more stable due to the joint compressive forces from weight
8.2, A). bearing.
Lower-extremity examples include seated hip flexion, knee To state the differences another way, open-chain exercises
extension, and ankle dorsiflexion exercises (Fig. 8.2, C). In all involve the extremity being moved to or from the stabilized
these examples, the core of the body and the proximal segment body, whereas closed-chain exercises involve the body being
pter
are stabilized while the distal segment is free to move moved to or from the stabilized extremity. Table 8.1 provides a
8
A B
FIG. 8.2 • Open versus closed kinetic chain activities. A, Open-chain activity for the upper extremity;
B, Closed-chain activity for the upper extremity.

C D
FIG. 8.2 (continued) • Open versus closed kinetic chain activities. C, Open-chain activity for the lower extremity; D, Closed-chain
activity for the lower extremity.
TABLE 8.1 • Differences between open- and closed-chain exercises
Variable Open-chain exercise Closed-chain exercise
Distal end of extremity Free in space and not fixed Fixed to something Chapter
Movement pattern
Characterized by rotary stress in the joint (often
nonfunctional)
Characterized by linear stress in the joint
(functional)
8
Joint movements Occur in isolation Multiple occur simultaneously
Muscle recruitment Isolated (minimal muscular co-contraction) Stable Multiple (significant muscular co-contraction) Primarily
Joint axis during movement patterns transverse
Movement plane Usually single Multiple (triplanar)
Proximal segment of joint Distal Stable Mobile
segment of joint Motion occurs Mobile Mobile, except for most distal aspect
Distal to instantaneous axis of rotation Proximal and distal to instantaneous axis of rotation
Often nonfunctional, especially lower extremity

Functionality Functional
Joint forces Shear Compressive
Decreased due to shear and distractive forces

Joint stability Increased due to compressive forces
Stabilization Artificial Not artificial, rather realistic and functional
Physiological, provides for normal proprioceptive and

Loading Artificial
kinesthetic feedback
Adapted from Ellenbecker TS, Davies GJ: Closed kinetic chain exercise: a comprehensive guide to multiple-joint exercise, Champaign, IL, 2001, Human Kinetics.

comparison of variables that differ between openand this increased ability is due to a refinement of neuromuscular
closed-chain exercises, and Fig. 8.2 provides examples of each. function rather than to an actual increase in muscle tissue
strength. Similarly, a well-trained person will see relatively minor
Not every exercise or activity can be classified totally as improvements in the amount of weight that can be lifted over a
either an open- or closed-chain exercise. For example, walking much longer period of time. Therefore, the amount and rate of
and running are both open and closed due to their swing and progressive overload are extremely variable and must be
stance phases, respectively. Another case is bicycle riding, adjusted to match the specific needs of the individual’s exercise
which is mixed in that the pelvis on the seat is the stablest objectives.
segment, but the feet are attached to movable pedals.
Overload may be modified by changing any one or a
Consideration of the open versus closed kinetic chain is combination of three exercise variables—
important in determining both the muscles and their types of frequency, intensity, and duration . Frequency usually refers to
contractions when analyzing sports activities. Realizing the the number of times per week. Intensity is usually a certain
relative differences in demands on the musculoskeletal system percentage of the absolute maximum, and duration usually
through detailed analysis of skilled movements is critical for refers to the number of minutes per exercise bout. Increasing
determining the most appropriate conditioning exercises to the speed of doing the exercise, the number of repetitions, the
improve performance. Generally, closed kinetic chain exercises weight, and the bouts of exercise are all ways to modify these
are more functional and applicable to the demands of sports variables and apply the overload principle. All these factors are
and physical activity. Most sports involve closed-chain activities important in determining the total exercise volume.
in the lower extremities and open-chain activities in the upper
extremities. However, there are many exceptions, and
closed-chain conditioning exercises may be beneficial for Overload is not always progressively increased. In certain
extremities primarily involved in open-chain sporting activities. periods of conditioning, the overload should actually be
Open-chain exercises are useful in developing a specific muscle prescriptively reduced or increased to improve the total results
group at a single joint. of the entire program. This intentional variance in a training
program at regular intervals is known as periodization and is
done to bring about optimal gains in physical performance. Part
of the basis for periodization is so that the athlete will be at his
pter or her peak level during the most competitive part of the
season. To achieve this, a number of variables may be
8 Conditioning
It is not theconsiderations
intent of this book to thoroughly address
manipulated, including the number of sets per exercise or
repetitions per set, types of exercises, number of exercises per
conditioning principles, but a brief overview is provided to serve
training session, rest periods between sets and exercises,
as a general reference and reminder of the importance of
resistance used for a set, type of muscle contraction, and
applying these concepts correctly when developing major
number of training sessions per day and per week.
muscle groups.
Overload principle
A basic physiological principle of exercise is the overload
principle. It states that, within appropriate parameters, a muscle
or muscle group increases in strength in direct proportion to the SAID principle
overload placed on it. While it is beyond the scope of this text to The SAID (S pecific A daptations to I mposed
fully explain specific applications of the overload principle for D emands) principle should be considered in all aspects of
each component of physical fitness, some general concepts physiological conditioning and training. This principle, which
follow. To improve the strength and functioning of major states that the body will gradually, over time, adapt very
muscles, this principle should be applied to every large muscle specifically to the various stresses and overloads to which it is
group in the body, progressively throughout each year, at all subjected, is applicable in every form of muscle training, as well
age levels. In actual practice, the amount of overload applied as to the other systems of the body. For example, if an
varies significantly based on several factors. For example, an individual were to undergo several weeks of strength-training
untrained person beginning a strengthtraining program will exercises for a particular joint through a limited range of motion,
usually make significant gains in the amount of weight he or she the specific muscles involved in performing the strengthening
is able to lift in the first few weeks of the exercise program. Most exercises would improve primarily in the ability to move against
of increased resistance

through the specific range of motion used. There would be, in through participation in sports activities. Now it is believed that a
most cases, minimal strength gains significantly beyond the person needs to develop muscular strength, endurance, and
range of motion used in the training. Additionally, other flexibility in order to be able to participate safely and effectively
components of physical fitness—such as flexibility, in sports activities.
cardiorespiratory endurance, and muscular endurance—would
be enhanced minimally, if at all. In other words, to achieve Adequate muscular strength, endurance, and flexibility of
specific benefits, exercise programs must be specifically the entire body from head to toe should be developed through
designed for the adaptation desired. correct use of the appropriate exercise principles. Individuals
responsible for this development need to prescribe exercises
It should be recognized that this adaptation may be positive that will meet these objectives.
or negative, depending on whether the correct techniques are
used and stressed in the design and administration of the In schools this development should start at an early age and
conditioning program. Inappropriate or excessive demands continue throughout the school years. Results of fitness tests
placed on the body in too short a time span can result in injury. such as sit-ups, the standing long jump, and the mile run reveal
If the demands are too little or are administered too infrequently the need for considerable improvement in this area in children in
over too long a time period, less than desired improvement will the United States. Adequatemuscular strength and endurance
occur. Conditioning programs and the exercises included in are important in the adult years for the activities of daily living, as
them should be analyzed to determine whether they are using well as for job-related requirements and recreational needs.
the specific muscles for which they were intended in the correct Many back problems and other physical ailments could be
manner. avoided through proper maintenance of the musculoskeletal
system. Refer to Chapters 4 through 7 as needed.
Specificity
Specificity of exercise strongly relates to the discussion of the Analysis of upper-body exercises
SAID principle. The components of physical fitness—such as
muscular strength, muscular endurance, and flexibility—are not Presented over the next several pages are brief analyses of
general body characteristics but rather are specific to each body several common upper-body exercises.
area and muscle group. Therefore, the specific needs of the Following and perhaps expanding on the approach Chapter
individual must be addressed when designing an exercise used are encouraged in analyzing other upper-
program. Quite often, it will be necessary to analyze an body activities. All muscles listed in the analysis are 8
individual’s exercise and skill technique to design an exercise contracting concentrically unless specifically noted
program to meet his or her specific needs. Potential exercises to be contracting eccentrically or isometrically.
to be used in the conditioning program must be analyzed to
determine their appropriateness for the individual’s specific Valsalva maneuver
needs. The goals of the exercise program should be determined
regarding specific areas of the body, preferred time to physically Many people bear down by holding their breath without thinking
peak, and physical fitness needs such as strength, muscular when attempting to lift something heavy. This bearing down,
endurance, flexibility, cardiorespiratory endurance, and body known as the Valsalva maneuver, is accomplished by exhaling
composition. After establishing goals, a regimen incorporating against a closed epiglottis (the flap of cartilage behind the
the overload variables of frequency, intensity, and duration may tongue that shuts the air passage when swallowing) and is
be prescribed to include the entire body or specific areas in thought by many to enhance lifting ability. It is mentioned here
such a way as to address the improvement of the preferred to caution against its use, because it causes a dramatic
physical fitness components. Regular observation and follow-up increase in blood pressure followed by an equally dramatic drop
exercise analysis are necessary to ensure proper adherence to in blood pressure. Using the Valsalva maneuver can cause
correct technique. lightheadedness and fainting and can lead to complications in
people with heart disease. Instead of using the Valsalva
maneuver, people lifting should always be sure to use rhythmic
and consistent breathing. It is usually advisable to exhale during
the lifting or contracting phase and inhale during the lowering or
recovery phase.
Muscular development
For years it was thought that a person developed adequate
muscular strength, endurance, and flexibility

Shoulder pull
Description
In a standing or sitting position, the subject interlocks the fingers
in front of the chest and then attempts to pull them apart (Fig.
8.3). This contraction is maintained for 5 to 20 seconds.
Analysis
In this type of exercise, there is little or no movement of the
contracting muscles. In certain isometric exercises, contraction
of the antagonistic muscles is as strong as contraction of the
muscles attempting to produce the force for movement. The
muscle groups contracting to produce a movement are FIG. 8.3 • Shoulder pull.
designated the agonists . In the exercise just described, the
agonists in the right upper extremity are antagonistic to the
agonists in the left upper extremity, and vice versa (Table 8.2).
This exercise results in isometric contractions of the wrist and
hand, elbow, shoulder joint, and shoulder girdle muscles. The Isometric exercises vary in the number of muscles
strength of the contraction depends on the angle of pull and the contracting, depending on the type of exercise and the joints at
leverage of the joint involved. Thus, it is not the same at each which movement is attempted. The shoulder pull exercise
point. produces some contraction of agonist muscles at four sets of
joints. See Tables 4.1, 5.2, 6.1, and 7.1.
TABLE 8.2 • Shoulder pull
pter This entire exercise is designed so that all contractions presented are isometric
8 Joint Action Agonists Action Agonists
Flexion Resisted by flexors of wrists and Flexion Resisted by flexors of wrist and hand
Wrist hand Antagonists—wrist and MCP, PIP, PIP
and hand Agonists—wrist and MCP, PIP, PIP flexors
flexors
Extension Resisted by flexors of wrist, elbow, and Flexion Resisted by extensors of wrist, elbow, and hand
hand
Elbow
Agonists—triceps brachii, anconeus Agonists—biceps brachii, brachialis,
joint
Antagonists—biceps brachii, brachioradialis
brachialis, brachioradialis Antagonists—triceps brachii, anconeus
Horizontal Resisted by horizontal abductors of Horizontal Resisted by horizontal abductors of

abduction contralateral shoulder joint abduction contralateral shoulder joint
Agonists—deltoid, infraspinatus, teres Agonists—deltoid, infraspinatus, teres
Shoulder
minor, latissimus dorsi minor, latissimus dorsi
joint
Antagonists—contralateral deltoid, Antagonists—contralateral deltoid,
infraspinatus, teres minor, latissimus dorsi infraspinatus, teres minor, latissimus dorsi
Adduction Resisted by adductors of contralateral Adduction Resisted by adductors of contralateral shoulder

shoulder girdle girdle
Shoulder
Agonists—rhomboid and trapezius Agonists—rhomboid and trapezius
girdle
Antagonists—contralateral rhomboid Antagonists—contralateral rhomboid
and trapezius and trapezius

Arm curl
Description
With the subject in a standing position, the dumbbell is held in
the hand with the palm to the front. The dumbbell is lifted until
the elbow is completely flexed (Fig. 8.4). Then it is returned to
the starting position.
Analysis
This open kinetic chain exercise is divided into two phases for
analysis: (1) lifting phase to flexed position and (2) lowering
phase to extended position (Table 8.3). Note: An assumption is
made that no movement occurs in the shoulder joint and
shoulder girdle, although many of the muscles of both the
shoulder and the shoulder girdle are isometrically acting as
stabilizers. Review Tables 4.1,
5.2, 6.1, and 7.1.
A B
FIG. 8.4 • Arm curl. A, Beginning position in extension; B,

Flexed position.
Chapter
TABLE 8.3 • Arm curl
Lifting phase to flexed position Lowering phase to extended position
Joint Action Agonists Action Agonists
Flexion* Wrist and MCP, PIP, PIP flexors Flexion* Wrist and MCP, PIP, PIP flexors
(isometric contraction) (isometric contraction)
Flexor carpi radialis Flexor carpi radialis
Wrist
Flexor carpi ulnaris Flexor carpi ulnaris
and
Palmaris longus Palmaris longus
hand
Flexor digitorum profundus Flexor digitorum profundus
Flexor digitorum superficialis Flexor digitorum superficialis
Flexor pollicis longus Flexor pollicis longus
Flexion Elbow flexors Extension Elbow flexors (eccentric contraction)

Biceps brachii Biceps brachii
Elbow
Brachialis Brachialis
Brachioradialis Brachioradialis
* The wrist is in a position of slight extension to facilitate greater active finger flexion in gripping the dumbbell. (The flexors remain isometrically
contracted throughout the entire exercise, to hold the dumbbell.)

Triceps extension
Description
The subject may use the opposite hand to assist in maintaining
the arm in a shoulder-flexed position. Then, grasping the
dumbbell and beginning in full elbow flexion, the subject
extends the elbow until the arm and forearm are straight. The
shoulder joint and shoulder girdle are stabilized by the opposite
hand. Consequently, no movement is assumed to occur in
these areas (Fig. 8.5).
Analysis
This open kinetic chain exercise is divided into two phases for
analysis: (1) lifting phase to extended position and (2) lowering
phase to flexed position (Table 8.4). Note: An assumption is
made that no movement occurs in the shoulder joint and
shoulder girdle, although it is critical that many of the shoulder
and shoulder girdle muscles contract isometrically to stabilize
this area so that the exercise may be performed correctly.
Review Tables 4.1, 5.2, 6.1, and 7.1.
A B
FIG. 8.5 • Triceps extension. A, Beginning position in flexion; B, Extended

position.
pter
TABLE 8.4 • Triceps extension
Lifting phase to extended position Lowering phase to flexed position
Wrist
and
hand
Extension Elbow extensors Flexion Elbow extensors (eccentric contraction) Triceps

Elbow Triceps brachii brachii
Anconeus Anconeus
* The wrist is in a position of slight extension to facilitate greater active finger flexion in gripping the dumbbell. (The flexors remain isometrically
contracted throughout the entire exercise, to hold the dumbbell.)

Barbell press position, the barbell is pushed upward until fully overhead (Fig.
8.6, B), and then it is returned to the starting position. See
Description Tables 4.1, 5.2, 6.1, and 7.1.
This open kinetic chain exercise is sometimes referred to as the overhead
or military press. The barbell is held in a position high in front of Analysis
the chest, with palms facing forward, feet comfortably spread, This exercise is separated into two phases for analysis: (1)
and back and legs straight (Fig. 8.6, A). From this lifting phase to full overhead position and (2) lowering phase to
starting position (Table 8.5).
A B
FIG. 8.6 • Barbell press. A, Starting position; B, Full overhead position.
TABLE 8.5 • Barbell press
Lifting phase to full overhead position Action Lowering phase to starting position
Chapter
Joint Agonists Action Agonists
Flexion* Wrist and MCP, PIP, PIP flexors Flexion* Wrist and MCP, PIP, PIP flexors 8
Wrist
and
hand

Elbow
Triceps brachii brachii
joint
Anconeus Anconeus
Flexion Shoulder joint flexors Extension Shoulder joint flexors

Pectoralis major (clavicular (eccentric contraction)
head or upper fibers) Pectoralis major (clavicular head or upper
Shoulder Anterior deltoid fibers)
Coracobrachialis Anterior deltoid
Biceps brachii Coracobrachialis
Biceps brachii
Upward Shoulder girdle upward Downward Shoulder girdle upward rotators and elevators
rotation rotators and elevators rotation and (eccentric contraction)
Shoulder
and Trapezius depression Trapezius
girdle
elevation Levator scapulae Levator scapulae
Serratus anterior Serratus anterior
* The wrist is in a position of extension to facilitate greater active finger flexion in gripping the bar.

Chest press (bench press) weight is lowered to the starting position. Refer to Tables 4.1,
5.2, 6.1, and 7.1.
Description
Analysis
The subject lies on the exercise bench in the supine position,
This open kinetic chain exercise can be divided into two phases
grasps the barbell, and presses the weight upward through the
for analysis: (1) lifting phase to up position and (2) lowering
full range of arm and shoulder movement (Fig. 8.7). Then the
phase to starting position (Table 8.6).
A B
FIG. 8.7 • Chest press (bench press). A, Starting position; B, Up position.
TABLE 8.6 • Chest press (bench press)

pter
8
Lifting phase to up position Lowering phase to starting position
Wrist
and
hand

Elbow Triceps brachii brachii
Anconeus Anconeus
Flexion and Shoulder flexors and horizontal Extension Shoulder joint flexors and horizontal
horizontal adductors and adductors (eccentric contraction)
adduction Pectoralis major horizontal Pectoralis major
Shoulder
Anterior deltoid abduction Anterior deltoid
Coracobrachialis Coracobrachialis
Abduction Shoulder girdle abductors Adduction Shoulder girdle abductors

Shoulder Serratus anterior (eccentric contraction)
girdle Pectoralis minor Serratus anterior
Pectoralis minor
* The wrist is in a position of slight extension to facilitate greater active finger flexion in gripping the bar.

Chin-up (pull-up) and flexion, whereas a wider grip, as shown in Fig. 8.8, requires
more adduction and abduction, respectively. For a full review of
Description the muscles involved in the chin-up, see Tables 4.1, 5.2, 6.1,
The subject grasps a horizontal bar or ladder with the palms and 7.1.
away from the face (Fig. 8.8, A). From a hanging position on the
bar, the subject pulls up until the chin is over the bar (Fig. 8.8, B)
and then returns to the starting position (Fig. 8.8, C). Analysis
This closed kinetic chain exercise is separated into two phases
The width of the grip on the chin-up bar affects the shoulder for analysis: (1) pulling-up phase to chinning position and (2)
actions to a degree. A narrow grip will allow for more lowering phase to starting position (Table 8.7).
glenohumeral extension
FIG. 8.8 • Pull-up.

A, Straight-arm hang;
B, Chin over bar;
C, Bent-arm hang on way up or
down.
A B C
TABLE 8.7 • Chin-up (pull-up)

Chapter
8
Pulling-up phase to chinning position Lowering phase to starting position
Flexion Wrist and MCP, PIP, PIP flexors (isometric Flexion Wrist and MCP, PIP, PIP flexors (isometric
contraction) contraction)
Wrist
and
hand
Flexion Elbow flexors Extension Elbow flexors (eccentric contraction) Biceps

Biceps brachii brachii
Elbow
Adduction Shoulder joint adductors Abduction Shoulder joint adductors (eccentric contraction) Pectoralis
Pectoralis major major
Posterior deltoid Posterior deltoid
Shoulder
Latissimus dorsi Latissimus dorsi
Teres major Teres major
Subscapularis Subscapularis
Adduction, Shoulder girdle adductors, depressors, and Elevation, Shoulder girdle adductors, depressors, and downward
depression, downward rotators abduction, rotators (eccentric contraction) Trapezius (lower and
Shoulder
and Trapezius (lower and middle) and middle)
girdle
downward Pectoralis minor upward Pectoralis minor
rotation Rhomboids rotation Rhomboids

Latissimus pull (lat pull)

Description
From a sitting position, the subject reaches up and grasps a
horizontal bar (Fig. 8.9, A). The bar is pulled down to a position
below the chin (Fig. 8.9, B). Then it is returned slowly to the
starting position. The width of the grip on the horizontal bar
affects the shoulder actions to a degree. A narrow grip will allow
for more glenohumeral extension and flexion, whereas the more
common wider grip, as shown in Fig. 8.9, requires more
adduction and abduction, respectively. Tables 4.1, 5.2, 6.1, and
7.1 provide a thorough listing of the muscles utilized in this
exercise.
Analysis
This open kinetic chain exercise is separated into two phases
for analysis: (1) pull-down phase to below the chin position and
(2) return phase to starting position (Table 8.8).
FIG. 8.9 • Latissimus pull

(lat pull).
A, Starting position;
B, Downward position.
TABLE 8.8 • Latissimus pull (lat pull) B
Pull-down phase to below the chin position Action Return phase to starting position
pter
8 Flexion Wrist and MCP, PIP, PIP flexors Flexion Wrist and MCP, PIP, PIP flexors
Wrist
and
hand
Flexion Elbow flexors Extension Elbow flexors (eccentric contraction)

Elbow
Adduction Shoulder joint adductors Abduction Shoulder joint adductors

Pectoralis major (eccentric contraction)
Latissimus dorsi Pectoralis major
Shoulder
Teres major Latissimus dorsi
Subscapularis Teres major
Subscapularis
Adduction, Shoulder girdle adductors, depressors, and Abduction, Shoulder girdle adductors, depressors, and
depression, downward rotators Trapezius (lower and elevation, downward rotators (eccentric contraction)
Shoulder and middle) Pectoralis minor and
girdle downward upward Trapezius (lower and middle)
rotation Rhomboids rotation Pectoralis minor
Rhomboids

Push-up additional coverage of the muscles involved in the

upper-extremity portion of the push-up.
Description
The subject lies on the floor in a prone position with the legs Analysis
together, the palms touching the floor, and the hands pointed This closed kinetic chain exercise is separated into two phases
forward and approximately under the shoulders (Fig. 8.10, A). Keeping for analysis: (1) pushing phase to up position and (2) lowering
the back and legs straight, the subject pushes up to the up phase to starting position (Table 8.9).
position and then returns to the starting position (Fig. 8.10, B).
Chin-ups and push-ups are excellent exercises for the
shoulder area, shoulder girdle, shoulder joint, elbow joint, and
The push-up is a total body exercise in that the muscles of wrist and hand (see Figs. 8.8 and 8.10). The use of free
the cervical and lumbar spine, hips, knees, ankles, and feet are weights, machines, and other conditioning exercises helps
active isometrically to stabilize the respective areas. Table 8.9 develop strength and endurance for this part of the body.
includes only the muscles of the upper extremity in the analysis.
Tables 4.1, 5.2, 6.1, and 7.1 provide
A B
FIG. 8.10 • Push-up. A, Starting position; B, Up position.

Chapter
TABLE 8.9 • Push-up

8
Pushing phase to up position Lowering phase to starting position
Flexion Wrist and MCP, PIP, PIP flexors Flexion Wrist and MCP, PIP, PIP flexors
Wrist
and
hand
Extension Elbow extensors Flexion Elbow extensors (eccentric contraction)

Elbow Triceps brachii Triceps brachii
Anconeus Anconeus
Horizontal Shoulder joint horizontal adductors Horizontal Shoulder joint horizontal adductors
adduction Pectoralis major abduction (eccentric contraction)
Anterior deltoid Pectoralis major
Shoulder
Biceps brachii Anterior deltoid
Coracobrachialis Biceps brachii
Coracobrachialis
Abduction Shoulder girdle abductors Adduction Shoulder girdle abductors

Shoulder Serratus anterior (eccentric contraction)
girdle Pectoralis minor Serratus anterior
Pectoralis minor

Dumbbell bent-over row From this position, the subject adducts the shoulder girdle and
horizontally abducts the shoulder joint (Fig. 8.11, B). Then the
Description dumbbell is lowered slowly to the starting position. Tables 4.1,
This open kinetic chain exercise may also be performed in the 5.2, 6.1, and 7.1 provide more details on the muscles used in
prone position and is therefore sometimes referred to as a this exercise.
prone row. The subject is kneeling on a bench or lying prone on
a table so that the involved arm is free from contact with the
floor (Fig. 8.11, A). When kneeling, the subject uses the Analysis
contralateral arm to support the body. The dumbbell is held in This exercise is separated into two phases for analysis: (1)
the hand with the arm and shoulder hanging straight to the floor. pull-up phase to horizontal abducted position and (2) lowering
phase to starting position (Table 8.10).
pter FIG. 8.11 • Dumbbell

8 bent-over
position; B, Up position.
row. A, Starting
A B
TABLE 8.10 • Dumbbell bent-over row
Pull-up phase to horizontal abducted position Action Lowering phase to starting position
Flexion MCP, PIP, PIP flexors Flexion MCP, PIP, PIP flexors
Hand Flexor digitorum profundus Flexor digitorum profundus
Flexion Passive flexion as the arm becomes parallel Extension Passive extension as the arm becomes
Elbow to the floor due to gravity perpendicular to the floor due to gravity
Horizontal Shoulder joint horizontal abductors Posterior Horizontal Shoulder joint horizontal abductors
abduction deltoid adduction (eccentric contraction)
Infraspinatus Posterior deltoid
Shoulder
Teres minor Infraspinatus
Latissimus dorsi Teres minor
Latissimus dorsi
Adduction Shoulder girdle adductors Abduction Shoulder girdle adductors

Shoulder Trapezius (lower and middle) (eccentric contraction)
girdle Rhomboids Trapezius (lower and middle)
Rhomboids

REVIEW EXERCISES each of the following movements fully before proceeding to

the next. When finished, you should be reaching with the
palm of your hand straight in front of your shoulder to
1. Analyze other conditioning exercises that involve the
attempt contact with the wall. Your elbow should be fully
shoulder area, such as dips, upright rows, shrugs, dumbbell
extended with your glenohumeral joint flexed 90 degrees.
flys, and inclined presses. Discuss how you would teach
2. and train boys and girls who cannot perform one chin-up to
learn to do chin-ups. Additionally, discuss how you would
• Glenohumeral flexion to 90 degrees
teach and train subjects who cannot perform one push-up
• Full elbow extension
to do push-ups.
• Wrist extension to 70 degrees
• Full shoulder girdle protraction
3. Should boys and girls attempt to do chin-ups and push-ups
Analyze the movements and muscles responsible for each
to see whether they have adequate strength in the shoulder
movement at the shoulder girdle, glenohumeral joint,
area?
elbow, and wrist. Include the type of contraction for each
4. What, if any, benefit would result from doing fingertip
muscle for each movement.
push-ups as opposed to push-ups with the hands flat on
the floor?
4. Face a wall and stand about 6 inches from it. Place both
5. Develop a list of exercises not found in this chapter to
hands on the wall at shoulder level and put your nose and
develop the upper-extremity muscles. Separate the list into
chest against the wall. Keeping your palms in place on the
open- and closed-chain exercises.
wall, slowly push your body from the wall as in a push-up
until your chest is as far away from the wall as possible
without removing your palms from the wall surface. Analyze
LABORATORY EXERCISES the movements and muscles responsible for each
movement at the shoulder girdle, glenohumeral joint,
elbow, and wrist. Include the type of contraction for each
1. Observe and analyze shoulder muscular activities of
muscle for each movement.
children on playground equipment.
2. Test yourself doing chin-ups and push-ups to determine
your strength and muscular endurance in the shoulder
5. What is the difference between the two exercises in
area.
Questions 3 and 4? Can you perform the
3. Stand slightly farther than arm’s length from a wall with
your arms by your side and hands facing forward at
movements in Question 4 one step at a time, as 8 Chapter
you did in Question 3?

shoulder-level height. Perform
6. Exercise analysis chart
Analyze each exercise in the chart. Use one row for each joint involved that actively moves during the exercise. Do not include joints for
which there is no active movement or joints that are maintained in one position isometrically.
Force causing Force resisting Functional muscle

Joint, movement movement (muscle movement (muscle group, type of
Exercise Phase occurring or gravity) or gravity) contraction
Lifting
phase
Barbell
press
(overhead or
military press)
Lowering
phase

Exercise analysis chart (continued)

Lifting
phase
Chest press
(bench
press)
Lowering
phase
Pulling-up
phase
Chin-up
(pull-up)
pter Lowering
8 phase
Pull-down
phase
Latissimus
pull
(lat pull)
Return
phase


Pushing
phase
Push-up
Lowering
phase
Pull-up
phase
Dumbbell
bent-over
row (prone
row)
Lowering Chapter
phase

References National Strength and Conditioning Association; Baechle TR, Earle

RW: Essentials of strength training and conditioning, ed 2, Champaign, IL,
Adrian M: Isokinetic exercise, Training and Conditioning 1:1, June Northrip JW, Logan GA, McKinney WC: Analysis of sport motion:
1991. anatomic and biomechanic perspectives, ed 3, New York, 1983, McGraw-Hill.
Andrews JR, Zarins B, Wilk KE: Injuries in baseball, Philadelphia,
1998, Lippincott-Raven. Powers SK, Howley ET: Exercise physiology: theory and application
Booher JM, Thibodeau GA: Athletic injury assessment, ed 4, of fitness and performance, ed 8, New York, 2012, McGraw-Hill.
Dubuque, IA, 2000, McGraw-Hill. Smith LK, Weiss EL, Lehmkuhl LD: Brunnstrom’s clinical kinesiology,
Ellenbecker TS, Davies GJ: Closed kinetic chain exercise: a ed 5, Philadelphia, 1996, Davis.
comprehensive guide to multiple-joint exercise, Champaign, IL, Steindler A: Kinesiology of the human body, Springfield, IL, 1970,
2001, Human Kinetics. Charles C Thomas.
Fleck SJ: Periodized strength training: a critical review, Journal of Wilk KE, Reinold MM, Andrews JR, eds: The athlete’s shoulder, ed 2,
Strength and Conditioning Research, 13(1):82–89, 1999.
Geisler P: Kinesiology of the full golf swing—implications for
intervention and rehabilitation, Sports Medicine Update 11(2):9,
1996.

human motion, ed 12, New York, 2012, McGraw-Hill. For additional resources and a list of related websites,
Matheson O, et al: Stress fractures in athletes, American Journal of visit www.mhhe.com/floyd19e.
Sports Medicine 15:46, January–February 1987.
pter

Worksheet Exercises
Upright row exercise worksheet

List the movements that occur in each joint as the subject lifts the weight in performing upright rows and then lowers the weight. For each joint
movement, list the muscles primarily responsible, and indicate whether they are contracting concentrically or eccentrically with “C” or “E.”
Lifting phase
Joint Movement Muscles
Wrists
Elbows
Shoulder joints
Shoulder girdles
Lowering phase
Wrists
Elbows
Shoulder joints
Shoulder girdles
Chapter
Dip exercise worksheet 8

List the movements that occur in each joint as the subject moves the body up and down in performing dips. For each joint movement, list the
muscles primarily responsible, and indicate whether they are contracting concentrically or eccentrically with “C” or “E.”
Lifting body up phase
Joint Movement Muscles
Wrists
Elbows
Shoulder joints
Shoulder girdles
Lowering body down phase
Wrists
Elbows
Shoulder joints
Shoulder girdles

Worksheet Exercises
Upper-extremity sport skill analysis worksheet

Choose one skill in the left column to analyze and circle it. In your analysis, list the movements of each joint in each phase of the skill. You
may prefer to list the initial positions that the joints are in for the stance phase. After each movement, list the muscle(s) primarily responsible
for causing/controlling the movement. Beside each muscle in each movement, indicate the type of contraction as follows: I—isometric;
C—concentric; E—eccentric. You might want to review Chapters 4–7.
Skill Joint Stance phase Preparatory phase Movement phase Follow-through phase
Shoulder
girdle
Shoulder
joint
Baseball Elbow
pitch
(R)
Radio-
Volleyball ulnar
serve
pter
Wrist
8
Tennis
serve
Fingers
Softball
pitch
Shoulder
girdle
Tennis
backhand
Shoulder
joint
Batting
Bowling Elbow
(L)
Basketball Radio-
free throw ulnar
Wrist
Fingers

C HAPTER 9
T HE H IP J OINT
AND P ELVIC G IRDLE
Objectives
T tively
he hip,stable joint duefemoral
or acetabular to its bony architecture,
joint, is a rela-
j To identify on a human skeleton or subject selected strong ligaments, and large, supportive muscles. It functions in
bony features of the hip joint and pelvic girdle weight bearing and locomotion, which is enhanced significantly
by the hip’s wide range of motion, which provides the ability to
run, cross-over cut, side-step cut, jump, and make many other
j To label on a skeletal chart selected bony features
directional changes.
of the hip joint and pelvic girdle
j To draw on a skeletal chart the individual muscles

of the hip joint
Bones FIGS. 9.1 TO 9.3
j To demonstrate, using a human subject, all the movements
of the hip joint and pelvic girdle and list their respective The hip joint is a ball-and-socket joint that consists of the head
planes of movement and axes of motion of the femur connecting with the acetabulum of the pelvic girdle.
The femur projects out laterally from its head toward the greater
trochanter and then angles back toward the mid-
j To palpate on a human subject the muscles of the hip Chapter
j
joint and pelvic girdle
To list and organize the primary muscles that produce

line as it runs inferiorly to form the proximal bone 9
of the knee. It is the longest bone in the body.
movement of the hip joint and pelvic girdle and list their
The pelvic girdle consists of a right and left pelvic bone joined
antagonists
together posteriorly by the sacrum. The sacrum can be
j To determine, through analysis, the hip movements and considered an extension of the spinal column with five fused
muscles involved in selected skills and exercises vertebrae. Extending inferior from the sacrum is the coccyx. The
pelvic bones are made up of three bones: the ilium, the ischium,
and the pubis. At birth and during growth and development, they
are three distinct bones. At maturity, they are fused to form one
pelvic bone known as the os coxae.
The pelvic bone can be divided roughly into three areas,

for additional information and study material for this chapter, including: starting from the acetabulum:
Upper two-fifths 5 ilium Posterior and lower

j Self-grading quizzes two-fifths 5 ischium Anterior and lower one-fifth 5 pubis
j Animations
j Related websites In studying the muscles of the hip and thigh, it is helpful to
focus on the important bony

landmarks, keeping in mind their purpose as key attachment sacrum and coccyx. Posteroinferiorly, the ischial tuberosity
points for the muscles. The anterior pelvis serves to provide serves as the point of origin for the hamstrings, which extend
points of origin for muscles generally involved in flexing the hip. the hip. Medially, the pubis and its inferior ramus serve as the
Specifically, the tensor fasciae latae arises from the anterior point of origin for the hip adductors, which include the adductor
iliac crest, the sartorius originates on the anterior superior iliac magnus, adductor longus, adductor brevis, pectineus, and
spine, and the rectus femoris originates on the anterior inferior gracilis.
iliac spine. Laterally, the gluteus medius and minimus, which
abduct the hip, originate just below the iliac crest. Posteriorly, The proximal thigh generally serves as a point of insertion
the gluteus maximus originates on the posterior iliac crest as for some of the short muscles of the hip and as the origin for
well as the posterior three of the knee extensors. Most notably, the greater
trochanter is the point of insertion for all of the gluteal
Iliac crest Base of sacrum
Sacroiliac joints Sacrum

Ilium
Iliac fossa
Pectineal line Anterior superior

iliac spine
Anterior inferior
Femoral head iliac spine
Acetabulum
Greater trochanter
Femoral neck Coccyx
Pectineal line Obturator foramen

Intertrochanteric
line
Lesser trochanter Pubis
Ischial tuberosity
Inferior pubic ramus
pter Femur Ischium Symphysis pubis
9 Pubic crest
Superior pubic ramus
Adductor tubercle
Lateral epicondyle
Medial epicondyle
Lateral femoral condyle
Patella
Medial femoral condyle
Lateral tibial condyle

Medial tibial condyle
Gerdy’s tubercle
Fibular head
Fibula Tibial tuberosity
Tibia
FIG. 9.1 • Right pelvis and femur, anterior view.

Ilium Ischium Pubis Iliac crest Iliac crest
Anterior
Iliac fossa
gluteal line
Inferior
gluteal line
Anterior superior
Posterior Posterior
iliac spine
gluteal line superior
Arcuate line
Posterior iliac spine
superior iliac spine
Auricular
Anterior inferior surface
Posterior inferior iliac spine
iliac spine Posterior inferior
Body of ilium iliac spine
Greater sciatic notch
Greater sciatic notch
Acetabulum Superior ramus Pectineal line
of pubis Ischial spine
Ischial spine
Lesser sciatic notch Body of pubis

Inferior ramus Location of
Body of ischium pubic symphysis Obturator foramen
of pubis
Ischial tuberosity Obturator foramen
Ramus of ischium
Ramus of ischium
A B
FIG. 9.2 • Right pelvic bone. A, Lateral view; B, Medial view.
muscles and five of the six deep external rotators. Although not and for the most part are covered by thick, heavy muscles. Very
palpable, the lesser trochanter serves as the bony landmark minimal oscillating-type movements can occur in these joints, as
upon which the iliopsoas inserts. Anteriorly, the three vasti in walking or in hip flexion when lying on one’s back. However,
muscles of the quadriceps originate proximally. Posteriorly, the movements usually involve the entire pelvic girdle and hip joints.
linea aspera serves as the insertion for the hip adductors. In walking, there is hip flexion and extension with rotation of the
pelvic girdle, forward in hip flexion and backward in hip
extension. Jogging and running result in faster movements and
Distally, the patella serves as a major bony landmark to a greater range of movement.
which all four quadriceps muscles insert. The remainder of the
Chapter
hip muscles insert on the proximal tibia or fibula. The sartorius,
gracilis, and semitendinosus insert on the upper anteromedial Sport skills such as kicking a football or soccer 9
surface of the tibia just below the medial condyle, after crossing ball are other good examples of hip and pelvic
the knee posteromedially. The semimembranosus inserts movements. Pelvic rotation helps increase the length of the
posteromedially on the medial tibial condyle. Laterally, the stride in running; in kicking, it can result in a greater range of
biceps femoris inserts primarily on the head of the fibula, with motion, which translates into a greater distance or more speed
some fibers attaching on the lateral tibial condyle. to the kick.
Anterolaterally, Gerdy’s tubercle provides the insertion point for
the iliotibial tract of the tensor fasciae latae. Except for the glenohumeral joint, the hip is one of the most
mobile joints of the body, largely because of its multiaxial
arrangement. Unlike the glenohumeral, the hip joint’s bony
architecture provides a great deal of stability, resulting in
relatively few hip joint subluxations and dislocations.
Joints FIGS. 9.1 TO 9.7
Anteriorly, the pelvic bones are joined to form the symphysis The hip joint is classified as an enarthrodialtype joint and is
pubis, an amphiarthrodial joint. Posteriorly, the sacrum is formed by the femoral head inserting into the socket provided
located between the two pelvic bones and forms the sacroiliac by the acetabulum of the pelvis. An extremely strong and dense
joints. Strong ligaments unite these bones to form rigid, slightly ligamentous capsule, illustrated in Figs. 9.4 and 9.5, reinforces
movable joints. The bones are large and heavy the joint, especially anteriorly.

Posterior superior iliac spine

Iliac crest
Posterior
inferior
gluteal line
Sacrum Greater sciatic
Posterior inferior notch
iliac spine Lesser sciatic

Spine of ischium notch
Greater
Coccyx
trochanter
Intertrochanteric
Ischium
crest
Ischial tuberosity
Lesser
Pectineal line
trochanter
Gluteal
Linea aspera [Medial lip
Lateral lip tuberosity
Femur
Adductor
tubercle
Medial condyle
of femur
Lateral condyle
of femur
Lateral tibial
condyle
pter
Medial tibial
9 FIG. 9.3 • Right pelvis and femur, posterior

condyle
Tibia
view.
Fibula
Anteriorly, the iliofemoral, or Y, ligament prevents hip remaining surface of the acetabulum, as well as the femoral
hyperextension. The teres ligament attaches from deep in the head, is articular cartilage that may gradually degenerate with
acetabulum to a depression in the head of the femur and slightly age and/or injury, leading to osteoarthritis characterized by pain,
limits adduction. The pubofemoral ligament is located stiffness, and limited range of motion.
anteromedially and inferiorly and limits excessive extension and
abduction. Posteriorly, the triangular ischiofemoral ligament Because of individual differences, there is some
extends from the ischium below to the trochanteric fossa of the disagreement about the exact possible range of each
femur and limits internal rotation. movement in the hip joint, but the ranges are generally 0 to 130
degrees of flexion, 0 to 30 degrees of extension, 0 to 35
degrees of abduction, 0 to 30 degrees of adduction, 0 to 45
Similar to the glenoid fossa of the shoulder joint, the degrees of internal rotation, and 0 to 50 degrees of external
acetabulum is lined around most of its periphery with a labrum rotation (Fig. 9.8). Although rarely referred to as distinct
to enhance stability and provide some shock absorption. motions, the hip, when flexed to
Covering the

Iliofemoral
Ilium ligament
Ischiofemoral
ligament
Pubofemoral
ligament
Iliofemoral Greater
Pubis trochanter
ligament
Greater
trochanter Ischial
tuberosity
Femur
Femur
Lesser
trochanter
FIG. 9.5 • Right hip joint, posterior ligaments.

FIG. 9.4 • Right hip joint, anterior ligaments.
Anterior inferior
iliac spine
Round
ligament (cut)
Greater
sciatic notch Fovea
capitis
Acetabulum
Head of
femur
Labrum Greater
trochanter
Ischial
spine Superior Chapter
ramus
Ischial
tuberosity
of pubis
9
Obturator Femur
membrane
Transverse
Lesser
acetabular
trochanter
ligament
FIG. 9.6 • Right hip joint, lateral view, femur retracted.
90 degrees, can adduct and abduct in the transverse plane, exact location of the movement. All pelvic girdle rotation actually
similar to the glenohumeral joint. These motions include results from motion at one or more of the following locations: the
approximately 40 degrees of horizontal adduction and 60 right hip, the left hip, the lumbar spine. Although it is not
degrees of horizontal abduction. essential for movement to occur in all three of these areas, it
must occur in at least one for the pelvis to rotate in any
The pelvic girdle moves back and forth within three planes direction. Table 9.1 lists the motions at the hips and lumbar
for a total of six different movements. To avoid confusion, it is spine that can often accompany rotation of the pelvic girdle.
important to analyze the pelvic girdle activity to determine the

FIG. 9.7 • Right hip joint, coronal section.
Acetabular labrum
Acetabulum
Articular capsule
Greater trochanter Ligament of

of femur head of femur
Retinacular
fibers
Ischium
120°
30 8 or less
0° Neutral 0 8 Neutral
FLEXION
A B
30 8 or less
90 8 90 8 90 8 90 8
FIG. 9.8 • Active motion of the hip. A, Flexion 0 8 Neutral
is measured in 45 8
20 8
degrees from a supine position; the knee 08 08
can be extended or flexed; B, Extension Neutral Neutral
or hyperextension is normally C ABDUCTION ADDUCTION EXTENSION
Supine
measured with the knee extended; Prone
Neutral Neutral
pter C, Abduction can be measured
08 08
9
in a supine or side-lying position; adduction 90 8 90 8
External Internal External Internal
is best measured with the subject lying 35 8 45 8 rotation rotation rotation rotation
supine;
D, Internal and external rotation can be (medial) (lateral)
evaluated in either a supine or a prone 08 90 8 90 8 90 8 90 8
Neutral
position.
D ROTATION
TABLE 9.1 • Motions accompanying pelvic rotation
Pelvic rotation Lumbar spine motion Right hip motion Left hip motion
Anterior rotation Extension Flexion Flexion
Posterior rotation Flexion Extension Extension
Right lateral rotation Left lateral flexion Abduction Adduction
Left lateral rotation Right lateral flexion Adduction Abduction
Right transverse rotation Left lateral rotation Internal rotation External rotation
Left transverse rotation Right lateral rotation External rotation Internal rotation

Movements FIGS. 9.9, 9.10 Hip flexion: movement of the anterior femur from any point toward
the anterior pelvis in the sagittal plane
Anterior and posterior pelvic rotation occur in the sagittal or
Hip extension: movement of the posterior femur from any point
anteroposterior plane, whereas right and left lateral rotation
toward the posterior pelvis in the sagittal plane
occur in the lateral or frontal plane. Right transverse (clockwise)
rotation and left transverse (counterclockwise) rotation occur in Hip flexion
Hip abduction: movement of the femur in the frontal plane laterally
the horizontal or transverse plane of motion.
to the side away from the midline
Hip adduction: movement of the femur in the frontal plane medially
toward the midline Hip
extension
Hip
abduction
Hip
adduction
Hip
external
Flexion Extension Abduction Adduction
rotation
A B C D
Chapter
Hip
internal
rotation
External rotation Internal rotation Diagonal abduction Diagonal adduction

E F G H
FIG. 9.9 • Movements of the hip.

Anterior pelvic Posterior pelvic Left lateral pelvic Right transverse pelvic
rotation rotation rotation rotation
A B C D
FIG. 9.10 • Pelvic girdle motions.
Hip external rotation: lateral rotary movement of the femur in the tilt; accomplished by left hip abduction, right hip adduction, and/or
transverse plane around its longitudinal axis away from the right lumbar lateral flexion
midline; lateral rotation Right lateral pelvic rotation: in the frontal plane, the right pelvis
Hip internal rotation: medial rotary movement of the femur in the moves inferiorly in relation to the left pelvis; either the right pelvis
transverse plane around its longitudinal axis toward the midline; rotates downward or the left pelvis rotates upward; right lateral tilt;
medial rotation accomplished by right hip abduction, left hip adduction, and/or left
Hip diagonal abduction: movement of the femur in a diagonal lumbar lateral flexion
plane away from the midline of the body
pter
Left transverse pelvic rotation: in a horizontal plane of motion,
9 Hip diagonal
a diagonal plane toward the midline of the body
adduction: movement of the femur in
rotation of the pelvis to the body’s left; the right iliac crest moves
anteriorly in relation to the left iliac crest, which moves posteriorly;
Hip horizontal adduction: movement of the femur
accomplished by right hip external rotation, left hip internal
in a horizontal or transverse plane toward the pelvis
rotation, and/or right lumbar rotation
Hip horizontal abduction: movement of the femur in a horizontal

or transverse plane away from the pelvis
Right transverse pelvic rotation: in a horizontal plane of motion,
rotation of the pelvis to the body’s right; the left iliac crest moves
Anterior pelvic rotation: anterior movement of the upper pelvis;
anteriorly in relation to the right iliac crest, which moves
the iliac crest tilts forward in a sagittal plane; anterior tilt;
posteriorly; accomplished by left hip external rotation, right hip
downward rotation; accomplished by hip flexion and/or lumbar
internal rotation, and/or left lumbar rotation
extension
Posterior pelvic rotation: posterior movement of the upper pelvis;
the iliac crest tilts backward in a sagittal plane; posterior tilt; Some confusion in understanding and learning the pelvic
upward rotation; accomplished by hip extension and/or lumbar girdle motions can be avoided by always thinking about these
flexion movements from the perspective of the person’s pelvis that is
Left lateral pelvic rotation: in the frontal plane, the left pelvis actually moving. Further understanding may be gained by
moves inferiorly in relation to the right pelvis; either the left pelvis thinking of the person as moving his or her pelvis as if steering
rotates downward or the right pelvis rotates upward; left lateral a vehicle, as shown in Fig. 9.11.

Right lateral pelvic rotation Left lateral pelvic rotation
Left Right
Left lateral pelvic rotation Right lateral pelvic rotation
Pelvis from posterior vantage point
Posterior Anterior
pelvic rotation pelvic rotation
Posterior Anterior
superior superior
iliac spine iliac spine
Anterior
Chapter
9
Lateral view of pelvis from Left transverse Right transverse
right vantage point pelvic rotation pelvic rotation
A
Left Right
Posterior
Pelvis from superior vantage point
FIG. 9.11 • A, Anterior and posterior pelvic rotation; B, Right and left lateral pelvic rotation; C, Right and left transverse pelvic rotation.

Muscles FIGS. 9.12 TO 9.14 supine and contracting the hip flexors, the thighs will move
forward into flexion on the stable pelvis.
At the hip joint, there are seven two-joint muscles that have one
action at the hip and another at the knee. The muscles actually For another example, the hip flexor muscles are used in
involved in hip and pelvic girdle motions depend largely on the moving the thighs toward the trunk, but the extensor muscles
direction of the movement and the position of the body in are used eccentrically when the pelvis and the trunk move
relation to the earth and its gravitational forces. In addition, it downward slowly on the femur and concentrically when the
should be noted that the body part that moves the most will be trunk is raised on the femur—this, of course, occurs in rising to
the part least stabilized. For example, when one is standing on the standing position.
both feet and contracting the hip flexors, the trunk and pelvis will
rotate anteriorly, but when one is lying In the downward phase of the knee-bend exercise, the
movement at the hips and knees is flexion. The muscles
primarily involved are the hip and knee extensors in eccentric
contraction.
Iliopsoas
Gluteus minimus Gluteus medius
(deep)
Piriformis
Tensor
fasciae latae Gluteus maximus
Pectineus
Sartorius Adductor longus /
Adductor longus brevis
Rectus femoris Vastus lateralis
Gracilis
Vastus lateralis Vastus intermedius
Vastus intermedius Semitendinosus
Gracilis
(deep) Iliotibial band
Vastus medialis Adductor magnus
Biceps femoris
Semimembranosus
pter
9
Gastrocnemius
A B
FIG. 9.12 • Superficial and deep muscles of the lower extremity. A, Anterior view; B, Posterior view.

Additionally, it is important to understand that the action a through its rather large ranges of motion, the lines of pull of
particular muscle has on the hip may vary depending on the specific muscles may change significantly. This is best seen
position of the femur in relation to the pelvis at the time. As the with the adductors. If the hip is in flexion, the adductors, upon
hip moves concentric contraction, tend to cause extension, and if the hip is
in extension they tend to cause flexion.
Anterior Quadriceps Hip joint and pelvic girdle muscles—location

Muscle location largely determines the muscle action.
Rectus femoris Vastus medialis Medial
Seventeen or more muscles are found in the area (the six
Sartorius
Vastus lateralis
external rotators are counted as one muscle). Most hip joint and
Intermuscular
Vastus intermedius septum pelvic girdle muscles are large and strong.
Femur
Adductor longus
Adductor brevis
Gracilis Anterior
Biceps femoris Adductor magnus Primarily hip flexion
short head
Semimembranosus
Iliopsoas (iliacus and psoas)
Biceps femoris Semitendinosus
long head Pectineus
Lateral Rectus femoris* †
Sartorius †
Lateral
Primarily hip abduction
Gluteus medius
Posterior
Gluteus minimus
External rotators
Tensor fasciae latae †
FIG. 9.13 • Cross section of the left thigh at the midsection.

* Two-joint muscles; knee actions are discussed in Chapter 10.
† Two-joint muscles.
Anterior compartment
Chapter
Rectus femoris Vastus intermedius
Anterior
Vastus lateralis Vastus medialis
Sartorius
9
Nerve to vastus medialis
Saphenous nerve
Lateral Medial
Femoral artery
Femoral vein
Posterior Greater saphenous vein
Adductor longus
Deep femoral vein
Deep femoral artery
Gracilis
Biceps femoris
Adductor brevis
(short head)
Adductor magnus
Posterior Biceps femoris
compartment (long head)
Sciatic nerve
Semitendinosus
Medial compartment
Semimembranosus Intermuscular septa
FIG. 9.14 • Transverse section of the left midthigh, detailing the anterior, posterior, and medial compartments.

Posterior Muscle identification

Primarily hip extension
Gluteus maximus In developing a thorough and practical knowledge of the
Biceps femoris* † muscular system, it is essential that individual muscles be
Semitendinosus* † understood. Figs. 9.13, 9.15,
Semimembranosus* † 9.16, 9.17, and 9.18 illustrate groups of muscles that work
External rotators (six deep) together to produce joint movement. While viewing the muscles
in these figures, correlate them with Table 9.2.
Medial
Primarily hip adduction
The muscles of the pelvis that act on the hip joint may be
Adductor brevis
divided into two regions—the iliac and gluteal regions. The iliac
Adductor longus
region contains the iliopsoas muscle, which flexes the hip. The
Adductor magnus
iliopsoas actually is two different muscles: the iliacus and the
Gracilis †
psoas major, although some include the psoas minor in
discussion of the iliopsoas. The 10 muscles of the gluteal region
* Two-joint muscles; knee actions are discussed in Chapter 10. function primarily to
† Two-joint muscles.
Psoas minor
5th lumbar
vertebra
Psoas major Psoas minor
Piriformis
Iliac crest Psoas major
Iliacus
Sacro-
Iliacus Obturator spinous lig.
internus
Pubic bone Coccygeus

Sartorius
(cut) Levator
ani (cut) Gluteus
Iliopsoas
Rectus maximus
femoris (cut) Pectineus
Tensor fasciae
Adductor
latae Pectineus
pter magnus
Vastus Adductor
9 intermedius Adductor
brevis
longus
Rectus
Vastus Adductor femoris
lateralis Gracilis
magnus
Adductor Adductor
longus (cut) magnus Semimembranosus
Vastus Gracilis
Sartorius
medialis Semitendinosus
Femoral artery
and vein
Biceps femoris
Vastus
medialis
Sartorius
Patellar (cut)
tendon
Patella
Creek
Patella
Medial head
Creek
of gastrocnemius
FIG. 9.15 • Muscles of the right anterior pelvic and thigh regions.
FIG. 9.16 • Muscles of the right medial thigh.

memperpanjang dan memutar pinggul. Terletak di daerah Femoris, Vastus medialis, Vastus intermedius, Vastus lateralis,
gluteal adalah gluteus maximus, gluteus medius, gluteus dan sartorius. Kelompok otot hamstring yang terdiri dari biseps
minimi, dan tensor fasciae latae dan enam rotator eksternal femoris, semitendinosus, dan semimembranosus, terletak di
dalam — piriformis, obturator externus, obturator internus, kompartemen posterior. Kompartemen medial berisi otot paha
gemellus superior, gemellus inferior, dan quadratus femoris. yang terutama bertanggung jawab untuk adduksi pinggul, yaitu
adduktor brevis, adduktor longus, adduktor magnus, pektineus,
Paha dibagi menjadi tiga kompartemen oleh septa dan gracilis.
intermuskular (Gambar 9.14). Kompartemen anterior berisi
rektus
Puncak iliac
Gluteus medius
Tensor
fasciae latae
Sartorius
Gluteus maximus
Rektus femoris
Vastus lateralis
Saluran iliotibial
Bab
Bisep femoris, kepala panjang
Semimembranosus
9
Bisep femoris, kepala pendek
Tempurung lutut
Gastrocnemius
ARA. 9.18 • Otot paha kanan lateral.
ARA. 9.17 • Otot paha posterior kanan.

TABEL 9.2 • Otot agonis pada sendi pinggul
Pesawat dari
Fleksi pinggul
Sagittal
Panggul anterior
Tro- lebih kecil

rotasi
pelantun Rotasi eksternal Sulit dipalpasi;

Permukaan dalam
Iliacus tulang paha jauh di belakang posterior
dari ilium tersebut pinggul
dan poros adil dinding perut; dengan
di bawah Panggul transversal Melintang subjek duduk dan
rotasi secara kontralateral agak condong ke depan
saat ipsilateral untuk merilekskan perut
tulang paha distabilkan otot, palpasi psoas
sangat besar di antara
Fleksi pinggul
puncak iliaka dan tulang rusuk ke-12
Menurunkan Pinggang
Lebih kecil Panggul anterior di tengah-tengahnya
perbatasan saraf dan
trochanter rotasi Sagittal ASIS dan umbilikus dengan
melintang femoralis
dari tulang paha pinggul aktif; palpasi iliopsoas
proses Fleksi lumbar saraf
dan poros tendon distal
(L1 – L5), tulang belakang (L2 – L4)
dibawah pada aspek anterior pinggul
sisi psoas minor; kira-kira 1½ inci
Rotasi eksternal
Psoas tubuh dari garis pektineal di bawah pusat ligamentum
pinggul
utama toraks terakhir (dari pubis) dan inguinalis dengan aktif
dan tulang belakang (T12),
iliopectineal Panggul transversal Melintang pinggul fl exion / ekstensi
minor pinggang keunggulan rotasi contralater- subjek terlentang,
tulang belakang sekutu saat ipsilateral segera ke samping
(L1 – L5), (Psoas minor
Anterior
tulang paha distabilkan pektineus dan medial ke

intervertebralis terlibat
sartorius
hanya di lum- Ekspresi lateral dari
fibrokartilase,
bar tulang belakang tulang belakang lumbal
dan dasar dari
gerakan.) Frontal
tulang kelangkang
Rotasi panggul lateral
ke sisi kontralateral
Superior inferior anterior Fleksi pinggul

Lurus ke bawah anterior
tulang belakang iliaka dari aspek dari
9 Perpanjangan lutut paha dari anterior Femoralis

Rektus ilium dan patella dan
Sagittal tulang belakang iliaka inferior ke saraf
femoris alur (poste- tendon patela
Panggul anterior patela dengan ekstensi lutut / pinggul (L2 – L4)
rior) di atas ke tibial
rotasi yang tertahan
acetabulum tuberositas
Fleksi pinggul Fleksi Terletak di proksimal

hanya medial ke tensor
lutut
Sagittal fascia latae dan lateral
Panggul anterior iliopsoas; meraba
Depan
Depan rotasi superfisial dari
medial
iliaka superior anterior superior Femoralis
permukaan Rotasi eksternal
Tulang punggung dan takik sartorius iliac spine ke medial tibial saraf
tibia saja paha saat mengembang dari
tepat di bawah condyle selama (L2, L3)
dibawah pinggul dan lutut
tulang belakang Melintang resistensi gabungan
kondilus
dari pinggul / eksternal
Putaran internal yang lemah
rotasi / penculikan dan
tion lutut
kelenturan lutut dalam posisi
Penculikan pinggul Frontal terlentang

TABEL 9.2 (lanjutan) • Otot agonis pada sendi pinggul
Pesawat dari
Sulit dibedakan
Fleksi dari
Sagittal dari adduktor lain;
panggul
aspek anterior pinggul kira-kira
Garis kasar
1½ inci
Spasi 1 inci memimpin dari
di bawah pusat ligamen inguinalis; Femoralis
lebar di depan lebih rendah dari Penambahan
Pektineus Frontal hanya menyamping saraf
pubis saja trochanter panggul
dan sedikit proksimal (L2 – L4)
di atas puncak turun ke
untuk adduktor longus dan medial
linea aspera
ke iliopsoas selama fleksi dan
Rotasi eksternal
Melintang adduksi subjek terlentang
dari pinggul
Penambahan Jauh ke adduktor

Turunkan 2/3 dari Frontal
panggul longus dan superfisial
pektineal
Depan untuk adduktor magnus;
baris dari Rotasi eksternal
kemaluan inferior sangat sulit untuk dipalpasi Sumbat
Adduktor tulang paha dan karena menambah pinggul Melintang
ramus tepat di bawah dan membedakan dari saraf
brevis setengah bagian atas
asal dari adduktor adduktor longus, yang (L3, L4)
bibir medial
longus segera lebih rendah;
dari linea Membantu peredaran
Sagittal bagian proksimal hanya lateral
aspera dari pinggul
adduktor longus
Penambahan Paling menonjol

Frontal
Pubis anterior panggul otot proksimal Sumbat
Adduktor 1/3 tengah
tepat di bawahnya paha anteromedial saja saraf
Medial
longus linea aspera

puncak Membantu peredaran inferior ke tulang kemaluan (L3, L4) dengan
Sagittal
dari pinggul adduksi yang melawan
Penambahan Depan:
Panjang keseluruhan
Frontal Aspek medial paha antara
panggul sumbat
Tepi dari linea gracilis dan saraf
seluruh kemaluan aspera, batin Rotasi eksternal paha belakang medial dari (L2 – L4)
Adduktor
ramus dan kondiloid sebagai pinggul Tuberositas iskia melintang ke
magnus Bab
iskium dan punggungan, dan produk tambahan adduktor tubercle dengan Belakang:
adduktor tuberositas iskia

tuberkel
Perpanjangan
Sagittal
menolak adduksi dari
posisi penculikan
saraf skiatik
(L4, L5,
9
panggul S1 – S3)
Penambahan
Frontal
panggul
Kelemahan dari
Tendon superfisial tipis di
lutut
Anteromedial Sagittal paha anteromedial
Medial anterior
tepi Membantu dengan fl ex- dengan exion lutut dan adduksi Sumbat
permukaan
Gracilis menurun ion pinggul yang ditolak; hanya saraf
tibia di bawah
ramus dari posterior ke adduktor (L2 – L4)
kondilus Rotasi internal
pubis longus dan medial ke
dari pinggul
semitendinosus
Internal lemah
Melintang
rotasi
lutut

Pesawat dari
Fleksi lutut
Aspek posteromedial
Perpanjangan paha bagian distal dengan
Atas
panggul Sagittal kombinasi lutut fl exion
depan
dan rotasi internal Sciatic
medial Panggul posterior
Semiten- Ischial melawan perlawanan; hanya saraf — tibialis
permukaan rotasi
dinosaurus tuberositas distal ke tuberositas iskia dalam posisi divisi
tibia saja
Rotasi internal tengkurap dengan pinggul diputar (L5, S1, S2)
dibawah
pinggul secara internal
kondilus
Melintang selama lutut aktif
Rotasi internal fl exion
lutut yang terbuka
Fleksi lutut
Perpanjangan Sebagian besar tertutup oleh otot

panggul Sagittal lain, tendon dapat dirasakan di
Posteromedial posteromedial Sciatic
Panggul posterior
Semimem- Ischial permukaan aspek lutut saja saraf — tibialis
rotasi
tuberositas branosus tibialis medial jauh ke semitendinosus divisi
kondilus Rotasi internal tendon dengan kombinasi (L5, S1, S2)
pinggul lutut dan internal
Rotasi melintang melawan hambatan
Rotasi internal
lutut
Posterior
Fleksi lutut Kepala panjang:

Kepala panjang: Aspek posterolateral sciatic
ischial Perpanjangan paha bagian distal dengan saraf — tibialis
tuberositas. panggul Sagittal kombinasi lutut fl exion
Kepala divisi
Kepala pendek: dan rotasi eksternal (S1 – S3)
yang fibula Panggul posterior
Bisep setengah bagian bawah melawan perlawanan; hanya
dan lateral rotasi
Kepala pendek:
femoris dari linea distal ke tuberositas iskia
kondilus dari
aspera, Rotasi eksternal dalam posisi tengkurap sciatic
tibia saraf-
dan lateral pinggul dengan pinggul
9 kondiloid
punggung bukit
Rotasi eksternal
Melintang diputar secara internal selama
lutut aktif
peroneal
divisi
lutut (L5, S1, S2)
Perpanjangan
Posterior 1/4 Miring panggul
Sagittal Berlari ke bawah
dari puncak punggung bukit
Panggul posterior dan secara lateral antara
ilium, lateral
rotasi krista iliaka posterior
belakang permukaan
superior, celah anal Inferior
Gluteus permukaan semakin besar Rotasi eksternal
Melintang medially, dan gluteal fold di saraf gluteal
maximus sakrum dan trochanter pinggul
inferior, ditekankan (L5, S1, S2)
tulang ekor dekat dan
dengan ekstensi pinggul,
ilium, dan Pita iliotibial Serat atas: bantuan fasia
rotasi eksternal, dan
fascia dari pada lata penculikan pinggul
Frontal penculikan
daerah pinggang Serat bawah: membantu
di adduksi pinggul

Pesawat dari
Penculikan
panggul
Frontal
Panggul lateral
rotasi ke
sisi ipsilateral
Serat anterior:
rotasi internal
dari pinggul
Melintang Sedikit di depan dan
Serat posterior:
beberapa inci di atas
Posterior dan rotasi eksternal
trokanter mayor
Permukaan lateral permukaan tengah dari pinggul Unggul
Gluteus dengan elevasi aktif panggul
dari ilium tepat di dari yang lebih besar saraf gluteal
medius berlawanan dari posisi berdiri atau
bawah puncak trochanter dari Serat anterior: (L4, L5, S1)
abduksi aktif saat berbaring miring
tulang paha fl exion dari pinggul
Serat anterior: di panggul kontralateral

panggul anterior
rotasi
Sagittal
Serat posterior:
ekstensi dari
panggul
Serat posterior:
panggul posterior
rotasi
Lateral
Penculikan
panggul
Frontal
Panggul lateral
Jauh ke dalam gluteus
rotasi ke
Permukaan lateral
sisi ipsilateral medius; ditutupi oleh tensor
Permukaan anterior
dari ilium tepat di fasciae latae antara Unggul Bab
Gluteus dari yang lebih besar
9
bawah asalnya Pinggul internal krista iliaka anterior dan saraf gluteal
paling bungsu trokanter dari rotasi sebagai femur femur
dari gluteus Melintang trokanter mayor selama (L4, L5, S1)
medius diculik rotasi internal dan
penculikan
Fleksi pinggul
Sagittal
Panggul anterior
rotasi
Penculikan
panggul
Satu perempat
Frontal
dari jalan Panggul lateral
menuruni rotasi ke
paha ke dalam sisi ipsilateral Secara anterior, antara
Krista iliaka anterior
Tensor yang iliotibial krista iliaka anterior dan Unggul
dan permukaan ilium Fleksi pinggul
fasciae saluran, yang trokanter mayor selama saraf gluteal
tepat di bawah
latae pada gilirannya sisipan Sagittal fl exion, rotasi internal, (L4, L5, S1)
puncak Panggul anterior
ke Gerdy's rotasi dan penculikan
tuberkel dari
anterolateral Rotasi internal
kondilus tibialis pinggul saat Melintang
memanjang

Pesawat dari
Depan
Dengan subjek rawan dan gluteus maximus rileks,
tulang kelangkang,
Superior dan lakukan palpasi dalam-dalam Pertama dan
belakang
aspek posterior Pinggul eksternal antara trokanter kedua posterior superior lebih besar dan
Piriformis bagian dari Melintang
dari yang lebih besar rotasi sakrum sementara saraf sakral
iskium,
trochanter secara pasif secara internal / eksternal (S1, S2)
dan obturator
femur berputar
foramen

Aspek posterior
lakukan palpasi dalam-dalam
dari yang lebih besar
Gemellus Pinggul eksternal antara trokanter saraf sakralis superior posterior dan tulang
Tulang belakang iskiadika trochanter Melintang
unggul rotasi belakang iskiadika sementara (L5, S1, S2)
tepat di bawah
secara pasif secara internal / eksternal
piriformis.dll
femur berputar
Dengan subjek rawan dan gluteus maximus

Aspek posterior rileks, lakukan palpasi dalam antara posterior Ranting
Gemellus Ischial dari yang lebih besar Pinggul eksternal lebih besar dari sakral
Melintang
inferior tuberositas trochanter dengan rotasi trokanter dan tuberositas iskia sementara secara pleksus (L4,
Deep posterior
obturator internus pasif secara internal / L5, S1, S2)

femur yang berputar secara eksternal
Aspek posterior lakukan palpasi dalam-dalam Ranting

Margin dari
Sumbat dari yang lebih besar Pinggul eksternal antara posterior superior lebih besar dari trokanter sakralis
sumbat Melintang
internus trochanter dengan rotasi dan foramen obturatori pleksus (L4,
foramen
gamellus superior sementara secara pasif secara internal / L5, S1, S2)

Aspek posterior
Inferior lakukan palpasi secara mendalam antara trokanter
dari yang lebih besar Sumbat
Margin obturator sebesar Pinggul eksternal mayor posterior inferior dan foramen obturatori
trochanter Melintang saraf
externus sumbat rotasi sementara secara pasif secara internal /
tepat di bawah (L3, L4)
foramen
obturator internus
9 Dengan subjek rawan dan gluteus maximus

rileks, lakukan palpasi dalam antara trokanter Ranting
Quadratus Ischial Intertrochanteric Pinggul eksternal mayor posterior inferior dan tuberositas iskia dari sakral
Melintang
femoris tuberositas punggung tulang paha rotasi sementara secara pasif secara internal / kekusutan
(L4, L5, S1)


Saraf ARA. 9.19 dan bagian medial ekstremitas bawah dipersarafi oleh saraf
yang timbul dari pleksus lumbal. Pleksus sakralis dibentuk oleh
Otot-otot pinggul dan panggul semuanya dipersarafi dari ramus anterior L4, L5, dan S1 hingga S4. Punggung bawah,
pleksus lumbal dan sakralis, yang secara kolektif dikenal panggul, perineum, permukaan posterior paha dan tungkai,
sebagai pleksus lumbosakral. Pleksus lumbal dibentuk oleh serta permukaan dorsal dan plantar kaki dipersarafi oleh saraf
rami anterior saraf tulang belakang L1 sampai L4 dan beberapa yang timbul dari pleksus sakralis.
serat dari T12. Perut bagian bawah dan anterior
Ventral
rami
Depan
divisi
Belakang
divisi Unggul
gluteal
L1
saraf
Inferior Pudendal
L2 saraf
gluteal
Sumbat
saraf
saraf
L3 Pinggang
Lateral Sakral
kekusutan Femoralis
femoralis kekusutan
saraf
Yg berhubung dgn kulit Belakang
L4 Sciatic
saraf Yg berhubung dgn kulit
saraf
saraf
L5
Saraf femoralis Saphenous
saraf
Saraf obturator
Unggul S1
saraf gluteal
S2
Inferior Sakral Tibial
S3 saraf
gluteal kekusutan Umum Bab
saraf S4 fibular
Sciatic
Umum
fibular S5
(peroneal)
saraf
9
(peroneal)
saraf
saraf
Saraf tibialis
Saraf pudendal
SEBUAH B C
ARA. 9.19 • Saraf pada pleksus lumbosakral. SEBUAH, Merapatkan; B, Tampilan anterior; C, Tampilan posterior.

Saraf utama yang penting yang timbul dari pleksus lumbal serta obturator externus. Saraf obturator memberikan sensasi
hingga mempersarafi otot-otot pinggul adalah saraf femoralis pada paha medial.
dan obturator. Saraf femoralis (Gbr. 9.20) muncul dari divisi Saraf yang timbul dari pleksus sakralis yang menginervasi
posterior pleksus lumbal dan menginervasi otot anterior paha, otot pinggul adalah gluteal superior, gluteal inferior, siatika, dan
termasuk iliopsoas, rektus femoris, vastus medialis, vastus cabang dari pleksus sakralis. Saraf gluteus superior muncul dari
intermedius, vastus lateralis, pectineus, dan sartorius. Ini juga L4, L5, dan S1 untuk menginervasi gluteus medius, gluteus
memberikan sensasi pada paha anterior dan medial serta minimus, dan tensor fasciae latae. Saraf gluteus inferior muncul
tungkai dan kaki medial. Saraf obturator (Gambar 9.21) muncul dari L5, S1, dan S2 untuk mensuplai gluteus maximus. Cabang
dari divisi anterior pleksus lumbal dan memberikan persarafan dari pleksus sakralis menginervasi piriformis (S1, S2), gemellus
pada adduktor pinggul, seperti adduktor brevis, adduktor superior (L5, S1, S2), gemellus inferior dan obturator internus
longus, adduktor magnus, dan gracilis, (L4, L5, S1, S2), dan quadratus femoris (L4, L5, S1).
L2
L3
Iliacus m.
L4
Saraf femoralis
Bagian bawah
dari psoas mayor m.
Sartorius m.
Rektus femoris m. Pectineus m.
Vastus intermedius m.
Vastus medialis m.
Vastus lateralis m.
Sartorius m.
ARA. 9.20 • Distribusi otot dan kulit dari saraf femoralis.

Saraf skiatik terdiri dari saraf tibialis dan saraf peroneal kaki serta sebagian besar aspek punggung dan plantar kaki.
(fibula) umum, yang dibungkus bersama dalam selubung Divisi tibialis memberikan sensasi ke posterolateral tungkai
jaringan ikat sampai mencapai kira-kira di tengah-tengah paha bawah dan aspek plantar kaki, sedangkan divisi peroneal
posterior. Pembelahan saraf skiatik tibialis (Gambar 9.22) memberikan sensasi ke tungkai bawah anterolateral dan
menginervasi semitendinosus, semimembranosus, bisep dorsum kaki. Kedua saraf ini berlanjut ke ekstremitas bawah
femoris (kepala panjang), dan adduktor magnus. Saraf skiatik untuk memberikan fungsi motorik dan sensorik ke otot-otot kaki
memberikan sensasi ke bagian bawah anterolateral dan bagian bawah; ini akan dibahas di Bab 10 dan 11.
posterolateral
L2
L3 L4
L5
L4
S1
S2
S3
Saraf obturator
Obturator externus m. Saraf tibialis

Adduktor
Adduktor magnus m.
longus m.
Adduktor brevis m. Adduktor magnus m.
Kepala panjang biseps

Adduktor longus m. femoris m.
Gracilis m.
Semitendinosus m.
Adduktor magnus m.
Semimembranosus m.
Bab
Plantaris m.
Gastrocnemius m.
9
Popliteus m.
Soleus m.
Flexor digitorum
longus m.
Tibialis posterior m.
Flexor hallucis longus m.
Saraf plantar medial

ke otot plantar
Saraf plantar lateral
ke otot plantar
ARA. 9.21 • Distribusi otot dan kulit dari saraf obturator. ARA. 9.22 • Distribusi otot dan kulit dari saraf tibialis.

Otot Iliopsoas ARA. 9.23 vertebra toraks terakhir (T12), vertebra lumbal (L1 – L5),
fibrokartilago intervertebralis, dan dasar sakrum
(iléo-soás)
Asal
Insersi
Iliacus: permukaan bagian dalam ilium
a pinggul Psoas mayor dan minor: batas bawah file
Iliacus dan psoas mayor: trokanter kecil dari femur dan
proses melintang (L1 – L5), sisi badan batang tepat di bawah
ul
Otot minor psoas

Otot utama psoas
ang
n
Otot Iliacus
ang
Lengkungan
Rotasi eksternal
9
O, Sisi tubuh toraks terakhir
O, Batas bawah dari proses

(T12) dan semua vertebra
transversal
lumbal (L1 – L5),
dari vertebra lumbal
intervertebralis
1–5 (psoas mayor
fibrocartilages,
dan minor)
dan dasar sakrum
(psoas mayor dan
O, permukaan bagian dalam ilium minor)
(iIiacus)
I, garis pektineal (dari pubis) dan

iliopektineal
keunggulan
Aku, Trochanter kecil (psoas minor)
tulang paha dan poros
dibawah
(iliacus dan psoas mayor)
ARA. 9.23 • Otot Iliopsoas, tampak anterior. O, Asal; I, Penyisipan.

Psoas minor: garis pektineal (dari pubis) dan iliopectineal eminence saat dalam posisi terlentang. Asal psoas mayor di punggung bawah
cenderung menggerakkan punggung bawah ke anterior atau, dalam
posisi terlentang, menarik punggung bawah saat mengangkat paha.
Tindakan Karena alasan ini, masalah punggung bawah sering kali diperburuk
Fleksi pinggul oleh aktivitas ini, dan biasanya tidak disarankan untuk mengangkat
Rotasi panggul anterior kaki setinggi 6 inci. Otot perut adalah otot yang dapat digunakan
Rotasi eksternal pinggul untuk mencegah ketegangan pada punggung bagian bawah ini
Rotasi panggul transversal kontralateral ketika femur ipsilateral dengan menarik bagian depan panggul, sehingga melemaskan
distabilkan bagian belakang. Mengangkat kaki terutama melakukan gerakan
Fleksi tulang belakang lumbal (psoas mayor dan minor) Lateral fleksi pinggul dan bukan tindakan perut. Punggung mungkin terluka oleh
tulang belakang lumbal (psoas mayor dan minor) latihan legraising yang berat dan berkepanjangan karena iliopsoas
menarik tulang belakang lumbal menjadi hiperekstensi dan
Rotasi panggul lateral ke sisi kontralateral (psoas mayor dan meningkatkan kurva lordotik, terutama dengan tidak adanya
minor) stabilisasi yang memadai oleh bagian perut. Iiopsoas berkontraksi
dengan kuat, baik secara konsentris maupun eksentrik, dalam sit-up,
Rabaan terutama jika pinggul tidak terbuka. Semakin longgar dan / atau
Sulit dipalpasi; jauh di dinding perut posterior; dengan subjek duduk abduksi pinggul, semakin sedikit iliopsoas yang akan diaktifkan
dan sedikit condong ke depan untuk mengendurkan otot perut, dengan latihan penguatan perut.
palpasi psoas mayor dalam-dalam antara krista iliaka dan kosta
ke-12 sekitar pertengahan antara ASIS dan umbilikus dengan
gerakan pinggul aktif; palpasi iliopsoas tendon distal pada aspek
anterior pinggul kira-kira 1½ inci di bawah pusat ligamentum Iliopsoas dapat dilakukan dengan menopang lengan pada
inguinalis dengan gerakan pinggul aktif / ekstensi subjek batang celup atau palang sejajar dan kemudian mengangkat
terlentang, segera ke lateral pektineus dan medial ke sartorius pinggul untuk mengangkat kaki. Ini dapat dilakukan pada
awalnya dengan lutut keluar dalam posisi terselip untuk
mengurangi resistensi. Saat otot menjadi lebih berkembang, lutut
dapat diluruskan, yang meningkatkan panjang lengan tahanan
Persarafan untuk menambah tahanan. Konsep meningkatkan atau
Saraf lumbal dan saraf femoralis (L2-L4) menurunkan resistensi dengan memodifikasi lengan resistensi
dijelaskan lebih lanjut dalam Bab 3. Lihat Lampiran 3 untuk
Aplikasi, penguatan, dan fl eksibilitas latihan yang lebih umum digunakan untuk iliopsoas dan otot lain
Iliopsoas biasanya disebut seolah-olah itu adalah satu otot, tetapi dalam bab ini.
sebenarnya terdiri dari iliacus dan psoas mayor. Beberapa teks
anatomi membuat perbedaan ini dan mendaftar setiap otot satu Untuk meregangkan iliopsoas, yang sering menjadi Bab
per satu. Psoas minor menempel pada pubis di atas sendi ketat dengan sit-up dan kontra kaki lurus yang berlebihan 9
pinggul dan oleh karena itu tidak bekerja pada sendi pinggul. upeti ke anterior panggul miring, pinggul harus
Kebanyakan otoritas tidak memasukkannya dalam diskusi diperpanjang sehingga tulang paha berada di belakang bidang
tentang iliopsoas. tubuh. Untuk mengisolasi iliopsoas, lutut bengkak penuh harus
dihindari. Sedikit peregangan tambahan dapat diterapkan
Otot iliopsoas kuat dalam tindakan seperti mengangkat dengan memutar pinggul secara internal saat diperpanjang.
ekstremitas bawah dari lantai

Otot rektus femoris ARA. 9.24 depan dan di belakang). Hanya otot perut yang dapat mencegah
hal ini terjadi. Berbicara tentang kelompok hipfleksor secara
(rek´tus femór-is)
umum, dapat dikatakan bahwa banyak orang yang membiarkan
Asal panggul dimiringkan ke depan secara permanen seiring
Tulang belakang iliaka inferior anterior dari ilium dan alur bertambahnya usia. Dinding perut yang rileks tidak menahan
fl exion ( posterior) di atas acetabulum panggul; oleh karena itu, hasil kurva lumbal meningkat.
Insersi Umumnya, kemampuan otot untuk mengerahkan kekuatan

Aspek superior dari patela dan tendon patela ke tuberositas tibialis berkurang saat memendek. Hal ini menjelaskan mengapa otot
rektus femoris merupakan ekstensor lutut yang kuat saat
pinggul diperpanjang tetapi lebih lemah saat pinggul dibuka.
njangan Tindakan Otot ini dilatih, bersama dengan kelompok Vastus, dalam
Fleksi pinggul Perpanjangan berlari, melompat, melompat, dan melompat. Dalam gerakan
lutut Rotasi panggul anterior ini, pinggul diperpanjang dengan kuat oleh gluteus maximus
dan otot hamstring, yang menangkal kecenderungan otot rektus
femoris untuk membengkokkan pinggul saat lutut memanjang.
Rabaan
Itu dapat diingat sebagai salah satu kelompok otot paha depan.
Paha anterior lurus ke bawah dari tulang belakang iliaka anterior inferior ke Rektus femoris dikembangkan dengan melakukan latihan
patela dengan ekstensi lutut yang tertahan dan flekspinggul pinggul atau latihan ekstensi lutut melawan tahanan manual.
Persarafan
Saraf femoralis (L2 – L4)
Rektus femoris paling baik diregangkan dalam posisi
Aplikasi, penguatan, dan fl eksibilitas menyamping dengan meminta pasangan mengangkat lutut
sepenuhnya dan sekaligus mengangkat pinggul ke dalam ekstensi.
Menarik dari tulang belakang iliaka anterior inferior ilium, otot rektus
femoris memiliki kecenderungan yang sama untuk memutar panggul
ke arah anterior (ke bawah
Gaya pinggul
O, Anterior inferior
tulang belakang iliaka
9
O, Groove (posterior)
di atas
acetabulum
Rektus femoris m.
I, aspek Unggul dari patela dan

Ekstensi lutut
patela
tendon ke tuberositas
tibialis
ARA. 9.24 • Otot rektus femoris, pandangan anterior. O, Asal; I, Penyisipan.

Otot sartorius ARA. 9.25 Aplikasi, penguatan, dan fl eksibilitas

(sar-to´ri-us) Menarik dari tulang belakang iliaka anterior superior dan takik tepat
di bawahnya, kecenderungannya lagi adalah memiringkan panggul
Asal ke anterior (di depan) saat otot ini berkontraksi. Otot-otot perut
Tulang belakang iliaka anterior superior dan lekukan tepat di bawah tulang belakang harus mencegah kecenderungan ini dengan memutar panggul ke
Gaya pinggul
arah posterior (menarik ke depan), sehingga punggung bawah
terlipat.
Insersi
Permukaan medial anterior tibia tepat di bawah kondilus Sartorius, otot dua persendian, efektif sebagai eksor pinggul atau
sebagai eksor lutut. Terkadang Lutut
disebut sebagai otot penjahit, itu aktif di semua fl exion

Tindakan
gerakan pinggul dan lutut yang digunakan untuk mengambil posisi
Fleksi pinggul Fleksi lutut duduk sebagai penjahit. Itu lemah jika kedua ekspresi terjadi pada
saat yang bersamaan. Perhatikan bahwa, dalam upaya
Rotasi luar paha saat pinggul dan lutut keluar menyilangkan lutut dalam posisi duduk, seseorang biasanya
bersandar dengan baik,
Penculikan pinggul Rotasi sehingga meningkatkan asal untuk memperpanjang otot ini, Panggul
panggul anterior sehingga lebih efektif saat terbang dan menyeberang luar
Rotasi internal lutut yang lemah lutut. Dengan lutut terentang, sar- rotasi
torius menjadi gerakan pinggul yang lebih efektif. Ini adalah otot
Rabaan
terpanjang di tubuh dan diperkuat saat aktivitas pinggul
Terletak di proksimal hanya medial ke tensor fasciae latae dan
dilakukan seperti yang dijelaskan untuk mengembangkan
lateral iliopsoas; palpasi superfisial dari anterior superior iliac
iliopsoas. Meregang-
spine ke medial tibialis condyle selama resistensi gabungan dari
Proses dapat dilakukan oleh mitra secara pasif Panggul
hipfleksi / rotasi eksternal / abduksi dan lututfleksi dalam posisi
mengambil pinggul ke dalam ekstensi ekstrim, adduksi, penculikan
terlentang
dan rotasi internal dengan lutut terulur.
Persarafan
Saraf femoralis (L2, L3)
O, tulang belakang iliaka anterior

Bab
Gaya pinggul superior dan takik saja
di bawah tulang belakang ilium
9
Luar
rotasi
Sartorius m.
Lutut
intern
rotasi
Kelelahan lutut
I, medial anterior
permukaan
tibia tepat di bawah
kondilus
ARA. 9.25 • Otot sartorius, tampak anterior. O, Asal; I, Penyisipan.

Otot pektineus ARA. 9.26 pusat ligamen inguinalis; hanya lateral dan sedikit proksimal ke
adduktor longus dan medial ke iliopsoas selama fleksi dan
(pek-tiné-us)
adduksi subjek terlentang
Asal
Jarak selebar 1 inchi di bagian depan pubis tepat di atas
pinggul Persarafan
puncak (garis pektineal)
Saraf femoralis (L2 – L4)
Insersi
Garis kasar yang mengarah dari trokanter kecil sampai ke linea
Saat berkontraksi, pektineus juga cenderung memutar panggul
ul aspera (garis pektineal femur)
ksi ke arah anterior. Otot perut yang menarik panggul di depan
Tindakan mencegah tindakan miring ini.
Fleksi pinggul Adduksi
pinggul Otot pektineus dilatih bersama dengan otot iliopsoas dalam
Rotasi eksternal pinggul Rotasi mengangkat dan menurunkan kaki. Latihan pinggul dan latihan
panggul anterior adduksi pinggul melawan resistensi dapat digunakan untuk
memperkuat otot ini.
ul Rabaan
Sulit dibedakan dari adduktor lain; aspek anterior pinggul kira-kira Pektineus diregangkan dengan menculik sepenuhnya pinggul yang
i
1½ inci di bawah diperpanjang dan diputar secara internal.
Pectineus m.
9 O, Spasi selebar 1 inchi di

Luar depan pubis
rotasi di atas puncak (garis pektineal)
Adduksi
I, Garis kasar yang mengarah dari

trokanter kecil
turun ke linea aspera (garis
Lengkungan
pektineal femur)
ARA. 9.26 • Otot pektineus, pandangan anterior. O, Asal; I, Penyisipan.

Otot adduktor brevis ARA. 9.27 Rabaan

(ad-duk´tor bre´vis) Jauh ke dalam adduktor longus dan superfisial ke adduktor
magnus; sangat sulit untuk dipalpasi dan dibedakan dari adduktor Panggul
Asal longus, yang segera inferior; bagian proksimal hanya lateral adduksi
Bagian depan ramus pubis inferior tepat di bawah asal adduktor longus
adduktor longus
Insersi Persarafan
Dua pertiga bagian bawah garis pektineal femur dan separuh atas Saraf obturator (L3, L4)
bibir medial linea aspera
Aplikasi, penguatan, dan fl eksibilitas Panggul
luar
Tindakan Otot adduktor brevis, bersama dengan yang lainnya rotasi
Penambahan pinggul otot adduktor, memberikan gerakan yang kuat
Rotasi eksternal karena menambah pinggul. Membantu paha satu sama lain. Meremas paha satu sama lain melawan
peregangan pinggul resistensi efektif dalam memperkuat brevis adduktor. Menculik
Membantu rotasi panggul anterior pinggul yang diperpanjang dan diputar secara internal
memberikan peregangan dari adduktor brevis.
Gaya pinggul
Bab
9
O, Depan ramus pubis inferior
Adduktor brevis m. tepat di bawah asal adduktor
longus
I, Turunkan dua pertiga dari

garis pektineal
femur dan separuh atas
bibir medial linea aspera
Adduksi
Rotasi eksternal
ARA. 9.27 • Otot adduktor brevis, pandangan anterior. O, Asal; I, Penyisipan.

Otot adduktor longus ARA. 9.28 Persarafan

(ad-duk´tor lon´gus) Saraf obturator (L3, L4)
ul
ksi Asal Aplikasi, penguatan, dan fl eksibilitas
Pubis anterior tepat di bawah puncaknya Otot dapat diperkuat dengan menggunakan latihan gunting, yang
mengharuskan subjek untuk duduk di lantai dengan kaki
Insersi terbentang lebar sementara pasangan meletakkan kaki atau
Sepertiga tengah linea aspera lengannya di dalam setiap tungkai bawah untuk memberikan
perlawanan. Saat subjek mencoba untuk menyatukan kedua
Tindakan
kakinya, rekannya memberikan perlawanan manual selama
pinggul Penambahan pinggul rentang gerakan. Latihan ini dapat digunakan untuk salah satu atau
Membantu peregangan pinggul Membantu dalam kedua kaki. Adduktor longus diregangkan dengan cara yang sama
rotasi panggul anterior seperti adduktor brevis.
Rabaan
Otot paling menonjol di proksimal pada paha anteromedial hanya di
inferior tulang kemaluan dengan adduksi yang tertahan
O, Anterior pubis
Adduktor longus m.
9
tepat di bawah puncaknya
Aku, sepertiga tengah

Adduksi
dari linea aspera
ARA. 9.28 • Otot adduktor longus, tampak anterior. O, Asal; I, Penyisipan.

Otot adduktor magnus ARA. 9.29 Persarafan

(ad-duk´tor magńus) Anterior: saraf obturator (L2-L4) Posterior: saraf
skiatik (L4, L5, S1-S3) Panggul
Asal adduksi
Tepi seluruh ramus pubis dan iskium serta tuberositas
iskia Otot adduktor magnus digunakan dalam tendangan gaya dada
pada renang dan menunggang kuda. Karena otot adduktor
Insersi (magnus adduktor, adduktor longus, adduktor brevis, dan
Panjang keseluruhan linea aspera, ridge condyloid bagian dalam, dan
tubercle adduktor gracilis) tidak banyak digunakan dalam gerakan biasa- Panggul
ment, beberapa aktivitas yang ditentukan untuk mereka seharusnya luar
Tindakan
disediakan. Beberapa peralatan olahraga modern rotasi
Penambahan pinggul direkayasa untuk memberikan ketahanan terhadap kecanduan pinggul
Rotasi eksternal sebagai adduct pinggul gerakan tion. Latihan adduksi pinggul seperti yang dijelaskan
Perpanjangan pinggul untuk adduktor brevis dan
adduktor longus dapat digunakan untuk memperkuat Panggul
Rabaan
magnus adduktor juga. Mag adduktor perpanjangan
Aspek medial paha antara gracilis dan hamstring medial dari nus diregangkan dengan cara yang sama seperti adduktor brevis
tuberositas iskia ke tuberkulum adduktor dengan adduksi yang dan adduktor longus.
ditahan dari posisi abduksi
O, Tepi seluruh ramus

Bab
Rotasi eksternal dari pubis dan iskium dan
iskia
tuberositas
9
Adduksi I, Seluruh panjang linea aspera,
kondiloid dalam
Adduktor magnus m. ridge, dan adduktor
tuberkel
ARA. 9.29 • Otot adduktor magnus, tampak posterior. O, Asal; I, Penyisipan.

Otot gracilis ARA. 9.30 Persarafan

(grasíl-is) Saraf obturator (L2 – L4)
ul
ksi Asal Aplikasi, penguatan, dan fl eksibilitas
Tepi anteromedial dari ramus yang turun dari pubis Juga dikenal sebagai adduktor gracilis, otot ini melakukan fungsi
yang sama seperti adduktor lainnya tetapi menambahkan sedikit
bantuan pada kelenturan lutut.
Insersi Otot-otot adduktor sebagai satu kelompok (adduktor magnus,
n Permukaan medial anterior tibia tepat di bawah kondilus adduktor longus, adduktor brevis, dan gracilis) dipanggil untuk
beraksi dalam menunggang kuda dan melakukan tendangan
gaya dada dalam renang. Perkembangan yang tepat dari
Tindakan
kelompok adduktor mencegah rasa sakit setelah berpartisipasi
Adduksi pinggul Lemasnya lutut Rotasi dalam olahraga ini. Gracilis diperkuat dengan latihan yang sama
internal pinggul Membantu dengan fleksi seperti yang dijelaskan untuk adduktor pinggul lainnya. Gracilis
pinggul Rotasi internal lutut yang lemah dapat diregangkan dengan cara yang mirip dengan adductors,
ul
n kecuali lutut harus diperpanjang.
i
Rabaan
Tendon tipis pada paha anteromedial dengan lengkungan lutut dan
menahan adduksi tepat di posterior adduktor longus dan medial
ke semitendinosus
pinggul
9 Pinggul internal O, tepi medial anterior ramus

rotasi turun
dari pubis
Gracilis m.
Adduksi
n
i
Kelelahan lutut
I, medial anterior
permukaan tibia
tepat di bawah kondilus
ARA. 9.30 • Otot gracilis, pandangan anterior. O, Asal; I, Penyisipan.

Otot semitendinosus ARA. 9.31 lutut pada saat yang sama, kedua gerakan itu lemah. Saat batang
dibesarkan ke depan dengan lutut lurus, otot hamstring memiliki
(semí-ten-di-no´sus)
tarikan yang kuat Lutut
Asal di panggul belakang dan miringkan ke belakang dengan penuh fl exion
Tuberositas iskia kontraksi. Jika lutut keluar saat gerakan ini terjadi, orang dapat
mengamati bahwa pekerjaan dilakukan oleh otot gluteus
Insersi maximus.
Permukaan medial anterior tibia tepat di bawah kondilus Di sisi lain, saat otot digunakan Panggul
dalam gerakan lutut yang kuat, seperti saat menggantung perpanjangan
lutut dari palang, fleksor pinggul ikut berperan untuk
Tindakan meningkatkan asal usul otot-otot ini dan membuatnya lebih
Fleksi lutut Perpanjangan efektif sebagai eksors lutut. Dengan ekstensi penuh pinggul
pinggul dalam gerakan ini, gerakan kelenturan lutut akan melemah.
Rotasi internal pinggul Otot-otot ini
Rotasi internal dari lutut yang keluar Rotasi digunakan dalam berjalan biasa sebagai ekstensor dari Panggul
panggul posterior pinggul dan biarkan gluteus maximus bersantai di intern
gerakan. rotasi
Rabaan
Semitendinosus paling baik dikembangkan melalui latihan
Aspek posteromedial paha distal dengan kombinasi lutut dan rotasi peregangan lutut melawan perlawanan. Umumnya dikenal sebagai
internal melawan resistensi tepat di distal tuberositas iskia dalam hamstring curl atau leg curl, latihan ini dapat dilakukan dalam posisi
posisi tengkurap dengan pinggul diputar secara internal selama tengkurap di atas meja lutut atau berdiri dengan beban pergelangan kaki
gerakan lutut aktif terpasang. Otot ini ditekankan saat melakukan hamstring curl sambil
berusaha mempertahankannya Lutut
Persarafan
sendi lutut dalam rotasi internal. Ini secara internal intern
Saraf skiatik — divisi tibialis (L5, S1, S2)
posisi diputar membawa penyisipannya sejajar rotasi
Aplikasi, penguatan, dan fl eksibilitas dengan asalnya.
Semitendinosus diregangkan dengan meluruskan lutut
Otot dua sendi ini paling efektif saat berkontraksi untuk
secara maksimal sementara pinggul yang sedikit abduksi dan
memanjangkan pinggul atau mengeluarkan lutut. Saat terjadi
diputar ke dalam.
ekstensi pinggul dan kelenturan
Bab
O, tuberositas iskiadika
Panggul Rotasi internal pinggul

perpanjangan
Semitendinosus m.
Kelelahan lutut
Lutut
intern
ARA. 9.31 • rotasi
Otot semitendinosus, I, medial anterior

tampilan posterior. O, Asal; permukaan tibia
I, Penyisipan. tepat di bawah
kondilus

Otot semimembranosus ARA. 9.32 Persarafan

(semí-mem´bra-no´sus) Saraf skiatik — divisi tibialis (L5, S1, S2)
n
Tuberositas iskia Baik semitendinosus dan semimembranosus bertanggung
jawab atas rotasi internal lutut, bersama dengan otot popliteus,
Insersi yang dibahas dalam Bab 10. Karena cara mereka
ul
Permukaan posteromedial dari kondilus tibialis medial menyilangkan sendi, otot sangat penting dalam memberikan
njangan
stabilitas medial yang dinamis ke Sendi lutut.
Tindakan
Fleksi lutut Perpanjangan

pinggul Semimembranosus paling baik dikembangkan dengan
Rotasi internal pinggul melakukan leg curl. Rotasi internal lutut sepanjang rentang
Rotasi internal dari lutut yang keluar Rotasi menonjolkan aktivitas otot ini. Semimembranosus diregangkan
ul panggul posterior dengan cara yang sama seperti semitendinosus.
n
i Rabaan
Sebagian besar tertutup oleh otot lain, tendon dapat dirasakan di
aspek posteromedial lutut persis jauh ke tendon semitendinosus
dengan kombinasi gerakan lutut dan rotasi internal melawan
resistensi
n
i
Pinggul internal O, tuberositas iskiadika

rotasi
Ekstensi pinggul
Semimembranosus m.
Lutut
fl exion
I, permukaan Posteromedial
dari tibialis medial
kondilus
Lutut
intern
rotasi
ARA. 9.32 • Otot semimembranosus, tampak posterior. O, Asal; I, Penyisipan.

Otot bisep femoris ARA. 9.33 Persarafan

(bi´seps femór-is) Kepala panjang: saraf skiatik — divisi tibialis (S1 – S3) Kepala pendek:
Lutut
saraf skiatik — divisi peroneal (L5, S1, S2)
Asal fl exion

Kepala panjang: tuberositas iskia
Kepala pendek: separuh bawah linea aspera, dan punggung Otot semitendinosus, semimembranosus, dan biseps femoris
dikenal sebagai hamstring. Otot-otot ini, bersama dengan gluteus Panggul
condyloid lateral
Insersi otot maximus, digunakan dalam perpanjangan pinggul perpanjangan

Kondilus lateral tibia dan kepala fibula saat lutut lurus atau hampir lurus. Jadi, dalam lari, lompat, lompat,
dan lompat, otot-otot ini digunakan bersama. Paha belakang
Tindakan
digunakan tanpa bantuan gluteus maximus, saat digantung di
Fleksi lutut Perpanjangan palang di dekat lutut. Demikian pula, gluteus maximus digunakan
pinggul tanpa bantuan the Panggul
Rotasi eksternal pinggul
Rotasi eksternal dari lutut yang keluar Rotasi paha belakang saat lutut keluar sementara luar
panggul posterior pinggul diperpanjang. Ini terjadi saat bangun rotasi
dari posisi lutut ke posisi berdiri.
Rabaan
Biceps femoris paling baik dikembangkan melalui ikal hamstring
Aspek posterolateral dari paha distal dengan kombinasi lutut dan seperti yang dijelaskan untuk semitendinosus, tetapi lebih ditekankan
rotasi eksternal melawan resistensi dan tepat di distal tuberositas jika lutut dipertahankan dalam rotasi eksternal di seluruh rentang
iskia dalam posisi tengkurap dengan pinggul diputar secara gerakan, yang membawa asal dan penyisipan lebih sejajar satu sama
eksternal selama pengangkatan lutut aktif lain. Bisep femo- Lutut
ris diregangkan dengan merentangkan lutut secara maksimal luar

sementara fl exing diputar secara eksternal dan sedikit rotasi
pinggul adducted.
Rotasi eksternal pinggul

Bab
O, Ischial
Bisep femoris m.
Ekstensi pinggul tuberositas
Kepala pendek
Kepala panjang
O, Setengah bagian bawah
linea aspera,
Kelelahan lutut dan lateral
punggungan condyloid
I, kondilus lateral tibia,

kepala fibula
Rotasi luar lutut
ARA. 9.33 • Otot bisep femoris, tampak posterior. O, Asal; I, Penyisipan.

Otot gluteus maximus ARA. 9.34 Aplikasi, penguatan, dan fl eksibilitas

(glu´te-us maksí-mus) Otot gluteus maximus beraksi saat gerakan antara panggul dan
ul
tulang paha mendekati dan melampaui 15 derajat ekstensi.
njangan Asal
Akibatnya, ini tidak digunakan secara ekstensif dalam berjalan
Seperempat posterior puncak ilium, permukaan posterior kaki biasa. Ini penting dalam ekstensi paha dengan rotasi
sakrum dan tulang ekor dekat ilium, dan fasia daerah lumbal eksternal.
Tindakan kuat dari otot gluteus maximus terlihat saat berlari,

Insersi melompat, melompat, dan melompat. Perpanjangan paha yang
ul Punggung miring (tuberositas gluteal) pada permukaan lateral kuat diamankan saat kembali berdiri dari posisi jongkok,
trokanter mayor dan pita iliotibial dari fasciae latae terutama dengan barbel pemberat ditempatkan di bahu.
i
Tindakan
Latihan ekstensi pinggul dari posisi condong ke depan atau
Perpanjangan pinggul tengkurap dapat digunakan untuk mengembangkan otot ini.
Rotasi eksternal pinggul Otot ini paling ditekankan ketika pinggul dimulai dari posisi
ul
Serat atas: membantu penculikan pinggul Serat terlentang dan bergerak ke ekstensi penuh dan abduksi,
ikan bawah: membantu adduksi pinggul Rotasi panggul dengan lutut keluar 30 derajat atau lebih untuk mengurangi
posterior keterlibatan hamstring dalam tindakan.
Rabaan
Gluteus maximus diregangkan dalam posisi terlentang dengan
Berlari ke bawah dan ke lateral antara krista iliaka posterior
ul gerakan pinggul penuh ke aksila ipsilateral dan kemudian ke aksila
superior, celah anal di medial, dan lipatan gluteal di inferior,
ksi kontralateral dengan lutut terbuka. Rotasi pinggul internal secara
ditekankan dengan ekstensi pinggul, rotasi eksternal, dan
bersamaan menonjolkan peregangan ini.
abduksi
Persarafan
Saraf gluteal inferior (L5, S1, S2)
Luar
rotasi
9 Gluteus
maximus m.
I, Punggungan miring
O, Posterior seperempat puncak (tuberositas gluteal)

ilium, permukaan posterior di permukaan lateral
sakrum dan tulang ekor di dekat trokanter mayor
ilium, dan fasia daerah lumbal dan pita iliotibial fascia
latae
Perpanjangan
ARA. 9.34 • Otot gluteus maximus, tampilan posterior. O, Asal; I, Penyisipan.

Otot gluteus medius ARA. 9.35 Persarafan

(glu´te-us me´di-us) Saraf gluteal superior (L4, L5, S1)
Asal Aplikasi, penguatan, dan fl eksibilitas Panggul
Permukaan lateral ilium tepat di bawah puncak Tindakan khas gluteus medius dan gluteus penculikan
otot minimus terlihat saat berjalan. Karena berat tubuh
Insersi digantung pada satu kaki, otot-otot ini mencegah pelvis yang
Permukaan posterior dan tengah dari trokanter mayor femur berlawanan dari kendur. Kelemahan pada gluteus medius dan
gluteus minimus dapat menyebabkan gaya berjalan
Trendelenburg, yang ditandai dengan batang yang meluncur ke
Tindakan
samping
Panggul
Penculikan pinggul kelemahan saat pelvis kontralateral turun. Dengan intern
Rotasi panggul lateral ke sisi ipsilateral kelemahan ini, lawan panggul individu akan rotasi
Serat anterior: rotasi internal, fleksasi pinggul, dan rotasi panggul kendur pada beban karena penculik pinggul
anterior pada sisi yang menahan beban tidak cukup kuat untuk mempertahankan sisi
Serat posterior: rotasi eksternal, ekstensi pinggul, dan rotasi yang berlawanan pada atau mendekati level.
panggul posterior Latihan rotasi eksternal pinggul yang dilakukan melawan
resistensi dapat memberikan beberapa penguatan gluteus medius,
Rabaan
tetapi ini adalah kekuatan terbaik-
Sedikit di depan dan beberapa inci di atas trokanter mayor dengan Ened dengan melakukan gerakan mengangkat kaki atau pinggul Gaya pinggul
elevasi aktif panggul berlawanan dari posisi berdiri atau abduksi latihan penculikan seperti yang dijelaskan untuk tensor
aktif saat berbaring miring pada panggul kontralateral fasciae latae. Gluteus medius paling baik diregangkan dengan
menggerakkan pinggul ke adduksi ekstrem di depan ekstremitas yang
berlawanan lalu di belakangnya.
Panggul
Gluteus medius m. O, permukaan lateral ilium luar

tepat di bawah rotasi
puncak
I, Posterior dan
permukaan tengah
Bab
lebih besar
9
trochanter dari
tulang paha
Penculikan
Panggul
Luar perpanjangan
rotasi
Intern
rotasi
ARA. 9.35 • Otot gluteus medius, tampak posterior. O, Asal; I, Penyisipan.

Otot gluteus minimus ARA. 9.36 Aplikasi, penguatan, dan fl eksibilitas

(glu´te-us miní-mus) Baik gluteus minimus dan gluteus medius digunakan untuk
mempertahankan abduksi pinggul yang tepat saat berlari.
ul Asal Hasilnya, kedua otot ini dilatih secara efektif dalam berlari,
ikan
Permukaan lateral ilium tepat di bawah asal gluteus medius melompat, dan melompat, di mana beban dipindahkan dengan
paksa dari satu kaki ke kaki lainnya. Seiring bertambahnya usia
tubuh, otot gluteus medius dan gluteus minimus cenderung
Insersi kehilangan keefektifannya. Musim semi masa muda, sejauh
Permukaan anterior trokanter mayor femur menyangkut pinggul, berada di otot-otot ini. Untuk mendapatkan
dorongan yang hebat di kaki, otot-otot ini harus dikembangkan
Tindakan
ul
sepenuhnya.
Penculikan pinggul
n
i
Rotasi panggul lateral ke sisi ipsilateral Rotasi Gluteus minimus paling baik diperkuat dengan melakukan
internal saat femur mencabut Fleksi pinggul latihan abduksi pinggul yang serupa dengan yang dijelaskan
untuk otot tensor fasciae latae dan gluteus medius. Ini juga
Rotasi panggul anterior dapat dikembangkan dengan melakukan latihan rotasi internal
pinggul melawan resistensi manual. Peregangan otot ini
Rabaan
dilakukan dengan adduksi pinggul yang ekstrem dengan sedikit
Jauh ke dalam gluteus medius; ditutupi oleh tensor fasciae latae
rotasi eksternal.
antara krista iliaka anterior dan trokanter mayor selama rotasi
pinggul
internal dan abduksi
Persarafan
Saraf gluteal superior (L4, L5, S1)
O, permukaan lateral ilium tepat
di bawah asal
Gluteus minimus m. gluteus medius
9 I, permukaan anterior
Penculikan
dari trokanter yang lebih besar
tulang paha
Intern
rotasi
ARA. 9.36 • Otot gluteus minimus, tampak posterior. O, Asal; I, Penyisipan.

Otot tensor fasciae latae ARA. 9.37 Persarafan

(ten´sor fasíe la´te) Saraf gluteal superior (L4, L5, S1)
Asal Aplikasi, penguatan, dan fl eksibilitas Panggul
Krista iliaka anterior dan permukaan ilium tepat di bawah Otot tensor fasciae latae membantu mencegah penculikan
puncak rotasi luar pinggul seperti yang dikeluarkan oleh otot-otot fleksor
lainnya.
Insersi Otot tensor fasciae latae digunakan saat terjadi fleksi dan rotasi internal.
Seperempat dari paha ke dalam saluran iliotibial, yang pada Ini adalah gerakan yang lemah namun penting dalam membantu
gilirannya menyisipkan ke tuberkulum Gerdy dari anterolateral mengarahkan kaki ke depan sehingga kaki diletakkan lurus ke depan saat
tibial condyle berjalan dan berlari. Jadi, dari Gaya pinggul
Tindakan
posisi terlentang, mengangkat kaki dengan rotasi internal pasti dari tulang
Penculikan pinggul Fleksi paha akan memanggilnya untuk beraksi.
pinggul Tensor fasciae latae dapat dikembangkan dengan melakukan
Kecenderungan untuk memutar pinggul ke dalam saat pinggul itu memancarkan latihan penculikan pinggul melawan gravitasi dan resistensi saat dalam
rotasi panggul anterior posisi berbaring menyamping. Ini dilakukan hanya dengan menculik
pinggul yang ke atas dan
Rabaan Panggul
lalu perlahan turunkan kembali untuk bersandar pada intern
Anterolateral, antara krista iliaka anterior dan trokanter mayor kaki lainnya. Peregangan dapat diterapkan dengan tetap memakai rotasi
selama rotasi internal, fleksi, dan abduksi sisi dan memiliki pasangan yang secara pasif menggerakkan
pinggul bagian bawah menjadi ekstensi penuh, adduksi, dan rotasi
eksternal.
O, krista iliaka anterior dan

permukaan ilium tepat di
bawah krista
Gaya pinggul
Tensor fasciae
Bab
9
latae m.
Penculikan pinggul
I, Seperempat dari paha ke saluran

iliotibial, yang pada gilirannya
menyisipkan ke tuberkulum Gerdy
dari anterolateral tibial condyle
ARA. 9.37 • Otot tensor fasciae latae, pandangan anterior. O, Asal; I, Penyisipan.

Enam otot rotator lateral dalam— piriformis, Gemellus superior: saraf sakral (L5, S1, S2) Gemellus
inferior: cabang dari pleksus sakralis (L4, L5, S1, S2)
gemellus superior, gemellus inferior, obturator
externus, obturator internus, quadratus femoris ARA. Obturator eksternus: saraf obturator (L3, L4) Obturator
ul 9.38 internus: cabang dari pleksus sakralis (L4, L5, S1, S2)
(pi-ri-for´mis)
i Quadratus femoris: cabang dari pleksus sakralis (L4, L5, S1)
(je-melús su-pe´ri-or)
(je-melús in-fe´ri-or)
(ob-tu-ra´tor eks-terńus) Aplikasi, penguatan, dan fl eksibilitas
(ob-tu-ra´tor in-terńus)
Enam rotator lateral digunakan dengan kuat dalam gerakan
(kwad-ra´tus femór-is)
rotasi eksternal tulang paha, seperti dalam olahraga di mana
Asal individu lepas landas dengan satu kaki dari rotasi internal awal.
Melempar bola bisbol dan mengayunkan tongkat bisbol, di
Sakrum anterior, bagian posterior iskium, dan foramen obturator
mana pinggulnya berputar, adalah contoh yang umum.
Insersi Berdiri dengan satu kaki dan secara paksa menjauhkan tubuh
Aspek superior dan posterior trokanter mayor dari kaki itu dilakukan dengan kontraksi otot-otot ini, dan ini dapat
diulangi untuk tujuan penguatan. Seorang mitra dapat
Tindakan memberikan perlawanan saat perkembangan berlangsung. Enam
Rotasi eksternal pinggul rotator lateral dalam dapat diregangkan dalam posisi terlentang
dengan pasangan yang berputar secara pasif di dalam dan
Rabaan sedikit keluar dari pinggul.
Meskipun tidak dapat diraba secara langsung, palpasi dalam mungkin dilakukan
antara trokanter mayor superior posterior dan foramen obturatori dengan Dari catatan khusus, saraf skiatik biasanya melewati bagian
subjek yang rentan selama relaksasi gluteus maximus sementara secara pasif inferior dari otot piriformis tetapi dapat melewatinya. Akibatnya,
menggunakan tungkai bawah yang diluruskan pada lutut untuk secara pasif sesak pada otot piriformis dapat menyebabkan kompresi pada
memutar femur secara internal dan eksternal atau secara bergantian saraf skiatik. Piriformis dapat diregangkan dengan menempatkan
berkontraksi / kendurkan sedikit rotator eksternal subjek pada sisi yang tidak terlibat dengan pasangan secara pasif
membawa pinggul ke dalam rotasi internal penuh yang
dikombinasikan dengan adduksi pinggul dan sedikit ke sedang
Persarafan
fleksasi pinggul.
Piriformis: saraf sakral pertama atau kedua (S1, S2)
9 Piriformis m.
Gemellus
superior m.
Sumbat
internus m.
I, Superior dan
aspek posterior
Sumbat
dari trokanter yang lebih besar
externus m.
Quadratus
femoris m.
Gemellus
Luar
m rendah. O, sakrum anterior,
rotasi
bagian posterior
iskium, dan
foramen obturator
ARA. 9.38 • Keenam otot rotator lateral dalam, tampak posterior: piriformis, gemellus superior, gemellus inferior, obturator externus,
obturator internus, dan quadratus femoris. O, Asal; I, Penyisipan.

TINJAU LATIHAN e. Rotasi eksternal

f. Rotasi internal
2. Apa bedanya berjalan dengan berlari dalam hal
1. Buat daftar bidang di mana setiap gerakan sendi pinggul berikut
penggunaan aksi otot sendi pinggul dan rentang gerak?
terjadi. Sebutkan sumbu rotasi masing-masing untuk setiap
gerakan di setiap bidang.
3. Cari tahu tentang gangguan pinggul yang umum seperti
Sebuah. Lengkungan
osteoartritis, otot pangkal paha, otot hamstring, bursitis trokanterik
b. Perpanjangan
mayor, dan epifisis femoralis yang tergelincir. Laporkan temuan
c. Adduksi
Anda di kelas.
d. Penculikan
4. Bagan analisis otot • Sendi pinggul
Lengkapi bagan dengan membuat daftar otot-otot yang terutama terlibat dalam setiap gerakan.
Lengkungan Perpanjangan
Penculikan Adduksi
Rotasi eksternal Rotasi internal
5. Grafik aksi otot antagonis • Korset sendi pinggul dan panggul
Lengkapi grafik dengan mendaftar otot atau bagian otot yang antagonis dalam tindakannya ke otot di kolom kiri.
Agonis Antagonis
Bab
Gluteus maximus
Gluteus medius 9
Gluteus minimus
Bisep femoris
Semimembranosus / Semitendinosus
Adduktor magnus / Adduktor brevis
Adduktor longus
Gracilis
Rotator lateral
Rektus femoris
Sartorius
Pektineus
Iliopsoas
Tensor fasciae latae

LATIHAN LABORATORIUM saya. Semitendinosus

j. Adduktor magnus
k. Adduktor longus
1. Cari bagian korset panggul dan sendi pinggul berikut ini pada
l. Adduktor brevis
kerangka manusia dan pada subjek:
3. Bersiaplah untuk menunjukkan pada kerangka manusia,
Sebuah. Kerangka
menggunakan karet gelang panjang, di mana setiap otot memiliki asal
1. Ilium
dan sisipannya.
2. Iskium
4. Bedakan antara gerakan pinggul dan gerakan tubuh dengan melakukan
3. Pubis
masing-masing secara individual dan kemudian keduanya secara bersamaan.
4. Simfisis pubis
5. Asetabulum
5. Peragakan gerakan dan buat daftar otot-otot yang terutama
6. Rami (naik dan turun)
bertanggung jawab atas gerakan pinggul berikut:
7. Foramen obturator
8. Tuberositas ischial
Sebuah. Lengkungan
9. Tulang belakang iliaka anterior superior
b. Perpanjangan
10. Trochanter yang lebih besar
c. Adduksi
11. Trochanter kecil
d. Penculikan
b. Subyek
e. Rotasi eksternal
1. Puncak ilium
f. Rotasi internal
2. Tulang belakang iliaka anterior superior
6. Bagaimana gaya berjalan dipengaruhi oleh kelemahan pada
3. Tuberositas iskia
otot gluteus medius? Mintalah rekan laboratorium untuk
4. Trochanter lebih besar
menunjukkan pola gaya berjalan yang terkait dengan
kelemahan gluteus medius. Apa nama gaya berjalan
subjek manusia?
disfungsional ini?
Sebuah. Gracilis
7. Bagaimana ketegangan iliopsoas bilateral memengaruhi postur
b. Sartorius
dan pergerakan tulang belakang lumbar dalam posisi berdiri?
c. Gluteus maximus
Peragakan dan diskusikan efek ini dengan rekan laboratorium.
d. Gluteus medius
e. Gluteus minimus
8. Bagaimana sesak hamstring bilateral dapat memengaruhi
f. Bisep femoris
postur dan pergerakan tulang belakang lumbar dalam posisi
g. Rektus femoris
berdiri? Peragakan dan diskusikan efek ini dengan rekan
h. Semimembranosus
laboratorium.
9. Grafik analisis gerakan latihan sendi pinggul

9 Setelah menganalisis setiap latihan di bagan, bagi masing-masing latihan menjadi dua fase gerakan utama, seperti fase mengangkat dan fase menurunkan.
Untuk setiap fase, tentukan gerakan sendi pinggul apa yang terjadi, dan kemudian buat daftar otot sendi pinggul yang terutama bertanggung jawab untuk
menyebabkan / mengendalikan gerakan tersebut. Di samping setiap otot di setiap gerakan, tunjukkan jenis kontraksi sebagai berikut: I — isometrik; C —
konsentris; E — eksentrik.
Push-up
Berjongkok
Angkat mati
Kereta luncur pinggul
Ke depan terjang
Mendayung
olahraga
Mesin tangga

10. Bagan analisis keterampilan olahraga pinggul
Analisis setiap keterampilan dalam bagan, dan buat daftar gerakan sendi pinggul kanan dan kiri di setiap fase keterampilan. Anda mungkin lebih
suka menuliskan posisi awal sendi pinggul untuk fase berdiri. Setelah setiap gerakan, buat daftar otot-otot sendi pinggul yang terutama bertanggung
jawab untuk menyebabkan / mengendalikan gerakan. Di samping setiap otot di setiap gerakan, tunjukkan jenis kontraksi sebagai berikut: I —
isometrik, C — konsentris; E — eksentrik. Mungkin diinginkan untuk meninjau konsep analisis di Bab 8 untuk berbagai tahap.
(R)
Baseball
nada
(L)
(R)
Sepak bola
punting
(L)
(R)
Berjalan
(L)
(R)
Lapangan sofbol
(L)
(R)
Lulus sepak bola
(L)
(R)
Memukul
(L)
Bab
(R)
Bowling
(L)
9
(R)
Bola basket
tembakan melompat
(L)

Referensi Prentice KAMI: Prinsip pelatihan atletik: berbasis kompetensi

pendekatan, ed 15, New York, 2014, McGraw-Hill.
Saladin KS: Anatomi & fisiologi: kesatuan bentuk dan fungsi, ed

Bidang D: Anatomi: palpasi dan tanda permukaan, ed 3, Oxford, 5, New York, 2010, McGraw-Hill.
2001, Butterworth-Heinemann.
Seeley RR, Stephens TD, Tate P: Anatomi & fisiologi, ed 8, Baru
Hamilton N, Weimer W, Luttgens K: Kinesiologi: dasar ilmiah dari York, 2008, McGraw-Hill.
gerak manusia, ed 12, New York, 2012, McGraw-Hill.
Shier D, Butler J, Lewis R: Anatomi dan fisiologi manusia Hole, ed
Hislop HJ, Montgomery J: Tes otot Daniels dan Worthingham: 12, New York, 2010, McGraw-Hill.
ed 4, Gainesville, FL, 2002, Megabooks.
Kendall FP, McCreary EK, Provance, PG, Rodgers MM, Romani
Batu RJ, Batu JA: Atlas otot rangka, ed 6, New York,
WA: Otot: pengujian dan fungsi, dengan postur dan nyeri, ed 5, Baltimore, 2005,
2009, McGraw-Hill.
Lippincott Williams & Wilkins.
Thibodeau GA, Patton KT: Anatomi & fisiologi, ed 9, St. Louis,
Lindsay DT: Anatomi manusia fungsional, St. Louis, 1996, Mosby.
1993, Mosby.
Lysholm J, Wikland J: Cedera pada pelari, Jurnal Olahraga Amerika
Obat 15: 168, September – Oktober 1986.
McGraw-Hill.
Magee DJ: Penilaian fisik ortopedi, ed 5, Philadelphia, 2008,
Saunders.
Muscolino JE: Manual sistem otot: otot rangka dari

Noahes TD, dkk: Fraktur stres panggul pada pelari jarak jauh,
Jurnal Kedokteran Olahraga Amerika 13: 120, Maret – April 1985. For additional resources and a list of related websites,
Oatis CA: Kinesiologi: mekanika dan patomekanika manusia visit www.mhhe.com/floyd19e.
gerakan, ed 2, Philadelphia, 2008, Lippincott Williams & Wilkins.
pter

Worksheet Exercises
Worksheet 1
a. Iliopsoas c. Sartorius e. Adductor brevis g. Adductor magnus

b. Rectus femoris d. Pectineus f. Adductor longus h. Gracilis
Chapter

Worksheet Exercises
Worksheet 2
a. Semitendinosus c. Biceps femoris e. Gluteus medius g. Tensor fasciae latae

b. Semimembranosus d. Gluteus maximus f. Gluteus minimis
pter

C HAPTER 10
T HE K NEE J OINT
Objectives
To identify on a human skeleton selected bony features of
T theknee
he bodyjoint
and is
is the
verylargest
complex. It is primarily
diarthrodial joint in
j a hinge joint. The combined functions of weight bearing and
the knee locomotion place considerable stress, strain, compression, and
j To explain the cartilaginous and ligamentous structures torsion on the knee joint. Powerful knee joint extensor and flexor
of the knee joint muscles, combined with a strong ligamentous structure, provide
a strong functioning joint in most instances.
j To draw and label on a skeletal chart muscles and
ligaments of the knee joint
j To palpate the superficial knee joint structures and

muscles on a human subject
j To demonstrate and palpate with a fellow student all the Bones FIG. 10.1
movements of the knee joint and list their respective planes of
motion and axes of rotation The enlarged femoral condyles articulate on the enlarged
condyles of the tibia, somewhat in a horizontal line. Because the
j To name and explain the actions and importance of the
femur projects downward at an oblique angle toward the
quadriceps and hamstring muscles
midline, its medial condyle is slightly larger than the lateral
j To list and organize the muscles that produce the condyle.
movements of the knee joint and list their antagonists
The top of the medial and lateral tibial condyles, known as Chapter
j To determine, through analysis, the knee movements and

muscles involved in selected skills and exercises
the medial and lateral tibial plateaus, serve as receptacles for
the femoral condyles. The tibia is the medial bone in the leg and 10
bears much more of the body’s weight than the fibula. The fibula
serves as the attachment for some very important knee joint
structures, although it does not articulate with the femur or
patella and is not part of the knee joint.

The patella is a sesamoid (floating) bone contained within
the quadriceps muscle group and the patellar tendon. Its
j Self-grading quizzes location allows it to serve the quadriceps in a fashion similar to
j Anatomy flashcards the work of a pulley by creating an improved angle of pull. This
j Animations results in a greater mechanical advantage when performing
Related websites
j
knee extension.

Femur
shaft
Medial
epicondyle
Lateral epicondyle Lateral epicondyle

Patellar surface Lateral condyle
Intercondylar fossa
Base of patella
Medial Articu la r facets
condyle
Apex of patella
Intercondylar Lateral condyle
eminence Apex
Medial Head of fibula
Gerdy’s tubercle condyle
Tibial
tuberosity
Proximal
tibiofibular joint
Lateral surface
Anterior crest
Fibula Tibia Fibula
A B
FIG. 10.1 • Bones of the right knee—femur, patella, tibia, and fibula. A, Anterior view; B, Posterior view.
Key bony landmarks of the knee include the superior and anterolateral aspect of the lateral tibial condyle, is the insertion
inferior poles of the patella, the tibial tuberosity, Gerdy’s point for the iliotibial tract of the tensor fasciae latae.
pter tubercle, the medial and lateral femoral condyles, the upper
0
anterior medial surface of the tibia, and the head of the fibula. The upper anteromedial surface of the tibia just below the
The three vasti muscles of the quadriceps originate on the medial condyle serves as the insertion for the sartorius, gracilis,
proximal femur and insert along with the rectus femoris on the and semitendinosus. The semimembranosus inserts
superior pole of the patella. Their specific insertion into the posteromedially on the medial tibial condyle. The head of the
patella varies in that the vastus medialis and vastus lateralis fibula is the primary location of the biceps femoris insertion,
insert into the patella from a superomedial and superolateral although some of its fibers insert on the lateral tibial condyle.
angle, respectively. The superficial rectus femoris and the The popliteus origin is located on the lateral aspect of the lateral
vastus intermedius, which lies directly beneath it, both attach to femoral condyle.
the patella from the superior direction. From here their insertion
is ultimately on the tibial tuberosity by way of the large patellar Additionally, the tibial collateral ligament originates on the
tendon, which runs from the inferior patellar pole to the tibial medial aspect of the upper medial femoral condyle and inserts
tuberosity. Gerdy’s tubercle, located on the on the medial surface of the tibia. Laterally, the shorter fibula
collateral originates on the lateral femoral condyle very close to
the popliteus origin and inserts on the head of the fibula.

Joints FIGS. 10.2, 10.3 has been shown to be significantly more common in females
than males during similar sports such as basketball and soccer.
The knee joint proper, or tibiofemoral joint, is classified as a The mechanism of this injury often involves noncontact rotary
ginglymus joint because it functions like a hinge. It moves forces associated with planting and cutting. Studies have also
between flexion and extension without side-to-side movement shown that the ACL may be disrupted in a hyperextension
into abduction or adduction. However, it is sometimes referred mechanism or solely by a violent contraction of the quadriceps
to as a trochoginglymus joint because of the internal and that pulls the tibia forward on the femur. Recent studies suggest
external rotation movements that can occur during flexion. that ACL injury prevention programs incorporating detailed
Some authorities argue that it should be classified as a conditioning exercises and techniques designed to improve
condyloid or “double condyloid” joint due to its bicondylar neuromuscular coordination and control among the hamstrings
structure. The patellofemoral joint is classified as an arthrodial and quadriceps, maintain proper knee alignment, and utilize
joint due to the gliding nature of the patella on the femoral proper landing techniques may be effective in reducing the
condyles. likelihood of injury.
The ligaments provide static stability to the knee joint, and Fortunately, the posterior cruciate ligament (PCL) is not
contractions of the quadriceps and hamstrings produce dynamic often injured. Injuries of the posterior cruciate usually come
stability. The surfaces between the femur and tibia are about through direct contact with an opponent or with the
protected by articular cartilage, as is true of all diarthrodial playing surface. Many of the PCL injuries that do occur are
joints. In addition to the articular cartilage covering the ends of partial tears with minimal involvement of other knee structures.
the bones, specialized cartilages (see Fig. 10.2), known as the In many cases, even with complete tears, athletes may remain
menisci, form cushions between the bones. These menisci are fairly competitive at a high level after a brief nonsurgical
attached to the tibia and deepen the tibial plateaus, thereby treatment and rehabilitation program.
enhancing stability.
On the medial side of the knee is the tibial (medial) collateral

The medial semilunar cartilage, or, more technically, the ligament (MCL; see Fig. 10.2), which maintains medial stability
medial meniscus, is located on the medial tibial plateau to form by resisting valgus forces or preventing the knee joint from
a receptacle for the medial femoral condyle. The lateral being abducted. Injuries to the tibial collateral occur quite
semilunar cartilage (lateral meniscus) sits on the lateral tibial commonly, particularly in contact or collision sports in which a
plateau to receive the lateral femoral condyle. Both of these teammate or an opponent falls against the lateral aspect of the
menisci are thicker on the outside border and taper down to be knee or leg, causing medial opening of the knee joint and stress
very thin on the inside border. They can slip about slightly and to the medial ligamentous structures. Its deeper fibers are
are held in place by various small ligaments. The medial attached to the medial meniscus, which may be affected with
meniscus is the larger of the two and has a much more open C injuries to the ligament.
appearance than the rather closed C configuration of the lateral
meniscus. Either or both of the menisci may be torn in several
different areas from a variety of mechanisms, resulting in On the lateral side of the knee, the fibular (lateral) collateral Chapter
10
varying degrees of severity and problems. These injuries often ligament (LCL) joins the fibula and the femur. Injuries to this
occur due to the significant compression and shear forces that ligament are infrequent.
develop as the knee rotates while flexing or extending during In addition to the other intraarticular ligaments detailed in
quick directional changes in running. Fig. 10.2, there are numerous other ligaments not shown that
are contiguous with the joint capsule. These ligaments are
generally of lesser importance and will not be discussed
further.*
Two very important ligaments of the knee are the anterior The knee joint (see Fig. 10.3) is well supplied with synovial
and posterior cruciate ligaments, so named because they cross fluid from the synovial cavity, which lies under the patella and
within the knee between the tibia and the femur. These between the surfaces of the tibia and the femur. Commonly, this
ligaments are vital in maintaining the anterior and posterior synovial cavity is called the capsule of the knee. Just posterior
stability of the knee joint, respectively, as well as its rotatory to the patellar tendon is the infrapatellar fat
stability (see Fig. 10.2).
The anterior cruciate ligament (ACL) tear is one of the most * More detailed discussion of the knee is found in anatomy texts and athletic training
manuals.
common serious injuries to the knee and

Femur
Lateral condyle
Medial condyle of femur
of femur
Posterior cruciate ligament
Lateral Anterior cruciate ligament
meniscus Medial meniscus
Fibular (lateral)
collateral ligament Tibial (medial) collateral
ligament
Gerdy's tubercle
Superior tibiofibular joint
Tibial tuberosity
Fibula Tibia
A Anterior view with patella removed

Femur
Anterior cruciate ligament

Ligament of Wrisberg
Medial femoral condyle Lateral femoral condyle
Lateral meniscus
Medial meniscus
Lateral tibial condyle
Medial tibial condyle
Posterior cruciate ligament Fibular (lateral) collateral

ligament
Tibial (medial)
Superior tibiofibular joint
collateral ligament
Tibia Fibula
B Posterior view
pter
Patellar tendon
0
Lateral tibial
Anterior cruciate Transverse plateau
ligament ligament
Medial tibial
plateau Infrapatellar
fat pad
Synovial
membrane
Tibial (medial)
collateral ligament
Medial meniscus
Posterior oblique Fibular (lateral) FIG. 10.2 • Ligaments and menisci of

ligament collateral ligament the right knee. A, Anterior view with
Ligament of
Posterior cruciate Lateral
Wrisberg patella removed; B, Posterior view;
ligament meniscus
C, Superior view with femur removed.
C Superior view with femur removed

Suprapatellar
Femur bursa
Synovial
membrane
Bursa under lateral head of
gastrocnemius m.
Patellar
tendon
Superior pole of patella
Patella
Synovial
membrane
Subcutaneous
Articular prepatellar
cartilage bursa
Inferior pole of patella
Meniscus Infrapatellar
fat pad
Joint Subcutaneous
cavity infrapatellar
filled with bursa
synovial
fluid
Infrapatellar
bursa
Tibia
Patellar tendon
Creek
FIG. 10.3 • Knee joint, sagittal view.
pad, which is often an insertion point for synovial folds of tissue Hyperextension
known as plica . A plica is an anatomical variant among some

individuals that may be irritated or inflamed with injuries or 0
Neutral
overuse of the knee. More than 10 bursae are located around
the knee, some of which are connected to the synovial cavity.
Bursae are located where they can absorb shock or reduce
friction. Chapter
n
10
o
i
x
The knee can usually extend to 180 degrees, or a straight

e
l
line, although it is not uncommon for some knees to

F
90
hyperextend up to 10 degrees or more. When the knee is in full 150
extension, it can move from there to about 150 degrees of
flexion. With the knee flexed 30 degrees or more, approximately FIG. 10.4 • Active motion of the knee. Flexion is measured in
30 degrees of internal rotation and 45 degrees of external degrees from the zero starting position,
rotation can occur (Fig. 10.4). which is an extended straight leg with the subject either prone or
supine. Hyperextension is measured in degrees opposite the zero
Due to the shape of the medial femoral condyle, the knee starting point.
must “screw home” to fully extend. As the knee approaches full
extension, the tibia must externally rotate approximately 10
degrees to achieve proper alignment of the tibial and femoral rotation of the knee. During initial flexion from a fully extended
condyles. In full extension, due to the close congruency of the position, the knee “unlocks” by the tibia’s rotating internally, to a
articular surfaces, there is no appreciable degree, from its externally rotated position to achieve flexion.

Movements FIG. 10.5 The gastrocnemius muscle, discussed in Chapter 11, also
assists minimally with knee flexion.
Flexion and extension of the knee occur in the sagittal plane, The muscle group that extends the knee is located in the
n whereas internal and external rotation occur in the horizontal anterior compartment of the thigh and is known as the
plane. The knee will not allow rotation unless it is flexed 20 to quadriceps. It consists of four muscles: the rectus femoris, the
30 degrees or more. vastus lateralis, the vastus intermedius, and the vastus
medialis. All four muscles work together to pull the patella
Flexion: bending or decreasing the angle between the femur and superiorly, which in turn pulls the leg into extension at the knee
the lower leg; characterized by the heel moving toward the by its attachment to the tibial tuberosity via the patellar tendon.
ion
buttocks
Extension: straightening or increasing the angle between the femur
The central line of pull for the entire quadriceps runs from
and the lower leg
the anterior superior iliac spine (ASIS) to the center of the
External rotation: rotary movement of the lower leg laterally away
patella. The line of pull of the patellar tendon runs from the
from the midline
center of the patella to the center of the tibial tuberosity. The
Internal rotation: rotary movement of the lower leg medially toward angle formed by the intersection of these two lines at the patella
the midline is known as the Q angle or quadriceps angle (Fig. 10.6).
al Normally, in the anatomical position, this angle will be 15
n Muscles FIG 9.12 degrees or less for males and 20 degrees or less for females.
Generally, females have higher angles due to a wider pelvis.
Some of the muscles involved in knee joint movements were
Dynamic Q angles vary significantly during planting and cutting
discussed in Chapter 9 because of their biarticular arrangement
activities. Higher Q angles generally predispose people, in
with the hip and the knee joints. These will not be covered fully
varying degrees, to a variety of potential knee problems,
in this chapter. The knee joint muscles that have already been
including patellar subluxation or dislocation, patellar
addressed are
compression syndrome, chondromalacia, and ligamentous
injuries.
al Knee extensor: rectus femoris
n
Knee flexors: sartorius, biceps femoris, semitendinosus,
semimembranosus, and gracilis
pter
Flexion Extension Internal rotation External rotation

A B C D
FIG. 10.5 • Movements of the right knee.

The hamstring muscle group is located in the posterior well as the rectus femoris, sartorius, and gracilis, are biarticular
compartment of the thigh and is responsible for knee flexion. (two-joint) muscles.
The hamstrings consist of three muscles: the semitendinosus, As an example, the sartorius muscle becomes a better flexor
the semimembranosus, and the biceps femoris. The at the knee when the pelvis is rotated posteriorly and stabilized
semimembranosus and semitendinosus muscles (medial by the abdominal muscles, thus increasing its total length by
hamstrings) are assisted by the popliteus in internally rotating moving its origin farther from its insertion. This is exemplified by
the knee, whereas the biceps femoris (lateral hamstring) is trying to flex the knee and cross the legs in the sitting position.
responsible for knee external rotation. One usually leans backward to flex the legs at the knees. This is
also illustrated by kicking a football. The kicker invariably leans
well backward to raise and fix the origin of the rectus femoris
Two-joint muscles are most effective when either the origin muscle to make it more effective as an extensor of the leg at the
or the insertion is stabilized to prevent movement in the knee. And when youngsters hang by the knees, they flex the
direction of the muscle when it contracts. Additionally, muscles hips to fix or raise the origin of the hamstrings to make the latter
are able to exert greater force when lengthened than when more effective flexors of the knees.
shortened. All the hamstring muscles, as
Iliac crest The sartorius, gracilis, and semitendinosus all join together
distally to form a tendinous expansion known as the pes
anserinus , which attaches to the anteromedial aspect of the
proximal tibia below the level of the tibial tuberosity. This
attachment and the line of pull these muscles have
Anterior superior posteromedially to the knee enable them to assist with knee
iliac spine
flexion, particularly once the knee is flexed and the hip is
Anterior inferior externally rotated. The medial and lateral heads of the
iliac spine
gastrocnemius attach posteriorly on the medial and lateral
Greater trochanter femoral condyles, respectively. This relationship to the knee
provides the gastrocnemius with a line of pull to assist with knee
flexion.
Knee joint muscles—location

Muscle location is closely related to muscle function with the
Femur
knee. While viewing the muscles, in Fig. 9.12, correlate them
Q angle
with Table 10.1.
Anterior
Primarily knee extension Chapter
Rectus femoris*
Vastus medialis 10
Vastus intermedius
Patella
Vastus lateralis
Posterior
Primarily knee flexion
Biceps femoris*
Semimembranosus*
Tibial tuberosity
Semitendinosus*
Tibia
Sartorius*
Gracilis*
Popliteus
FIG. 10.6 • Q angle, represented by the angle between the Gastrocnemius*
line from the anterior superior iliac
spine to the central patella and the line from the central patella
to the tibial tuberosity. * Two-joint muscles; hip actions are discussed in Chapter 9, and ankle actions are
discussed in Chapter 11.

TABLE 10.1 • Agonist muscles of the knee joint
Plane of
Superior Extension of
Anterior inferior aspect of the knee Straight down anterior
iliac spine of the ilium the patella thigh from anterior Femoral
Rectus Flexion of the
and groove and patellar Sagittal inferior iliac spine to patella nerve
femoris hip
(posterior) above tendon with resisted hip flexion/knee (L2–L4)
the acetabulum to tibial Anterior pelvic extension
tuberosity rotation
Anteromedial distal 1/3

Upper
of thigh just above the
border of
superomedial patella
Vastus Upper 2/3 of the patella Femoral
Extension of and deep to the rectus
inter- anterior surface of and patellar Sagittal nerve
the knee femoris, with extension
medius femur tendon (L2–L4)
of the knee, particularly full
to tibial
extension against
tuberosity
resistance
Anterior muscles
Intertrochanteric
line, anterior and Slightly distal to greater
inferior borders Lateral trochanter down the
of the greater border of anterolateral aspect
Vastus trochanter, the patella of the thigh to the Femoral
Extension of
lateralis gluteal tuberosity, and patellar Sagittal superolateral patella, nerve
the knee
(externus) upper half of tendon with extension of (L2–L4)
the linea aspera, to tibial the knee, particularly
and entire lateral tuberosity full extension against
intermuscular resistance
septum
Medial half
Anterior medial side of the
of upper
thigh just above the
Whole length of border of
Vastus superomedial patella, Femoral
linea aspera and patella and Extension of
medialis Sagittal with extension of nerve
medial condyloid patellar the knee
(internus) the knee, particularly (L2–L4)
ridge tendon
full extension against
to tibial
resistance
tuberosity
pter

TABLE 10.1 (continued) • Agonist muscles of the knee joint
Plane of
Flexion of the knee Long head:

Long head: Posterolateral aspect
sciatic
ischial Extension of the hip Posterior Sagittal of distal thigh with combined
nerve—tibial
tuberosity. knee flexion
Head of pelvic rotation division
Short head: and external rotation
the fibula (S1–S3)
Biceps lower half against resistance; just
and lateral External rotation of Short head:
femoris of the linea distal to the ischial
condyle of the knee sciatic
aspera, tuberosity in a prone
the tibia nerve—
and lateral Transverse position with hip
peroneal
condyloid External rotation of internally rotated during
division
ridge the hip active knee flexion
(L5, S1, S2)
With subject sitting, knee flexed

90 degrees, palpate deep to the
Internal rotation of gastrocnemius medially on the
Transverse
Posterior Upper the knee as it flexes posterior proximal tibia and
surface posterior
Tibial nerve
Popliteus of lateral medial proceed superolaterally
(L5, S1)
condyle of surface of toward lateral epicondyle
femur tibia of tibia just deep to
Posterior muscles
Flexion of the knee Sagittal fibular collateral ligament,

while subject internally
rotates knee
Extension of the hip Flexion

Largely covered by other
Postero- of the knee Posterior pelvic Sagittal muscles, tendon can be felt at
medial posteromedial Sciatic
rotation
Semi- Ischial surface of aspect of knee just nerve—tibial
membranosus tuberosity the medial Internal rotation of deep to semitendinosus division
tibial the hip tendon with combined (L5, S1, S2)
condyle Transverse knee flexion and internal
Internal rotation of rotation against resistance
the knee
Extension of the hip Flexion Posteromedial aspect

Upper of the distal thigh with
of the knee Posterior pelvic Sagittal
anterior combined knee flexion Chapter
Sciatic
medial rotation and internal rotation
Semi-
tendinosus
Ischial
tuberosity
surface of
the tibia
Internal rotation of
against resistance; just
distal to ischial tuberosity
nerve—tibial
division
10
the hip (L5, S1, S2)
just below
Transverse in a prone position with
the condyle Internal rotation of hip internally rotated
the knee during active knee flexion
Note: The sartorius and gracilis assist, although not primarily, with knee flexion and internal rotation and are discussed in detail in Chapter 9. The gastrocnemius,
discussed in Chapter 11, assists to some degree with knee flexion.
consisting of the semitendinosus, semimembranosus, biceps

Nerves
femoris (long head), and popliteus, are innervated by the tibial
The femoral nerve (Fig. 9.20) innervates the knee division of the sciatic nerve (Fig. 9.22). The biceps femoris short
extensors—rectus femoris, vastus medialis, vastus intermedius, head is supplied by the peroneal nerve (Fig. 11.10).
and vastus lateralis. The knee flexors,

Quadriceps muscles FIG. 10.7 (the largest muscle of the group), vastus intermedius, and
vastus medialis. All attach to the patella and by the patellar
(kwod´ri-seps)
tendon to the tuberosity of the tibia. All are superficial and
The ability to jump is essential in nearly all sports. Individuals palpable, except the vastus intermedius, which is under the
ion who have good jumping ability always have strong quadriceps rectus femoris. The vertical jump is a simple test that may be
muscles that extend the leg at the knee. The quadriceps used to indicate the strength or power of the quadriceps. It is
function as a decelerator when it is necessary to decrease generally desired that this muscle group be 25% to 33%
speed for changing direction or to prevent falling when landing. stronger than the hamstring muscle group (knee flexors).
This deceleration function is also evident in stopping the body
when coming down from a jump. The contraction that occurs in
the quadriceps during braking or decelerating actions is Development of the strength and endurance of the
xion eccentric. This eccentric action of the quadriceps controls the quadriceps, or “quads,” is essential for maintenance of
slowing of movements initiated in previous phases of the sport patellofemoral stability, which is often a problem in many
skill. physically active individuals. This problem is exacerbated by the
quads’ being particularly prone to atrophy when injuries occur.
The muscles of the quadriceps may be developed by resisted
The muscles are the rectus femoris (the only two-joint knee extension activities from a seated position; however,
muscle of the group), vastus lateralis full-range knee extensions may be contraindicated with certain
patellofemoral conditions. Performing functional weight-bearing
activities such as step-ups or squats is particularly useful for
strengthening and endurance.
Rectus femoris muscle FIG. 9.24

(rek´tus femó-ris)
Origin
Anterior inferior iliac spine of the ilium and superior margin of the
acetabulum
Rectus femoris Insertion

Superior aspect of the patella and patellar tendon to the tibial
tuberosity
Action
Vastus intermedius m.
Flexion of the hip Extension of
pter the knee Anterior pelvic
rotation
0 Vastus lateralis m.
Vastus medialis m.
Palpation
Straight down anterior thigh from anterior inferior iliac spine to
patella, with resisted knee extension and hip flexion
Innervation
Femoral nerve (L2–L4)

When the hip is flexed, the rectus femoris becomes shorter,
which reduces its effectiveness as an extensor of the knee. The
FIG. 10.7 • Tibial tuberosity work is then done primarily by the three vasti muscles.
Quadriceps
muscle group,
anterior view. Also see the rectus femoris discussion in Chapter 9, p. 252
(Fig. 9.24).

Vastus lateralis (externus) muscle Innervation
FIG. 10.8
(vas´t́us lat-er-a´ĺis)
Application, strengthening, and flexibility Knee
Origin All three of the vasti muscles function with the extension
Intertrochanteric line, anterior and inferior borders of the greater rectus femoris in knee extension. They are typically used in
trochanter, gluteal tuberosity, upper half of the linea aspera, and walking and running and must be used to keep the knee
entire lateral intermuscular septum straight, as in standing. The vastus lateralis has a slightly
superior lateral pull on the patella and, as a result, is
occasionally blamed in part for common lateral patellar
Insertion
subluxation and dislocation problems.
Lateral border of the patella and patellar tendon to the tibial
tuberosity The vastus lateralis is strengthened through knee extension
Action activities against resistance. See Appendix 3 for more
commonly used exercises for the vastus lateralis and other
Extension of the knee
muscles in this chapter. Stretching occurs by pulling the knee
Palpation into maximum flexion, such as by standing on one leg and
Slightly distal to the greater trochanter down the anterolateral aspect pulling the heel of the other leg up to the buttocks.
of the thigh to the superolateral patella, with extension of the knee,
particularly full extension against resistance
O, Intertrochanteric line,
anterior and inferior
borders of the greater
trochanter, upper half
of the linea aspera, and
entire lateral
intermuscular septum
Chapter
10
Vastus lateralis m.
I, Lateral border of patella, patellar

Knee tendon to tibial tuberosity
extension
FIG. 10.8 • Vastus lateralis muscle, anterior view. O, Origin; I, Insertion.

Vastus intermedius muscle FIG. 10.9 Application, strengthening, and flexibility

(vas´t́us in´ter-me´di-us) The three vasti muscles all contract in knee extension. They are
used together with the rectus femoris in running, jumping,
Origin hopping, skipping, and walking. The vasti muscles are primarily
ion
Upper two-thirds of the anterior surface of the femur responsible for extending the knee while the hip is flexed or
being flexed. Thus, in doing a knee bend with the trunk bent
Insertion forward at the hip, the vasti are exercised with little involvement
Upper border of the patella and patellar tendon to the tibial of the rectus femoris. The natural activities mentioned above
tuberosity develop the quadriceps.
Action
Extension of the knee If done properly, squats with a barbell of varying weights on
the shoulders, depending on strength, are an excellent exercise
Palpation for developing the quadriceps. Caution should be used, along
Anteromedial distal one-third of thigh just above the superomedial with strict attention to proper technique, to avoid injuries to the
patella and deep to the rectus femoris, with extension of the knee, knees and lower back. Leg press exercises and knee
particularly full extension against resistance extensions with weight machines are other good exercises. Full
knee flexion stretches all of the quadriceps musculature.
Innervation
pter O, Upper two-thirds

of anterior surface
0 Vastus intermedius m.
of femur
Knee extension
I, Upper border of patella and
patellar tendon to tibial
tuberosity
FIG. 10.9 • Vastus intermedius muscle, anterior view. O, Origin; I, Insertion.

Vastus medialis (internus) muscle Innervation
FIG. 10.10
(vas´t́us me-di-a´ĺis)
Application, strengthening, and flexibility Knee
Origin The vastus medialis is thought to be very important extension

in maintaining patellofemoral stability because of the oblique
Whole length of the linea aspera and the medial condyloid
attachment of its distal fibers to the superior medial patella. This
ridge
portion of the vastus medialis is referred to as the vastus
Insertion medialis obliquus (VMO). The vastus medialis is strengthened
Medial half of the upper border of the patella and patellar tendon similarly to the other quadriceps muscles by squats, knee
to the tibial tuberosity extensions, and leg presses, but the VMO is not really
emphasized until the last 10 to 20 degrees of knee extension.
Action Full knee flexion stretches all the quadriceps muscles.
Extension of the knee
Palpation
Anterior medial side of the thigh just above the superomedial
patella, with extension of the knee, particularly full extension
against resistance
O, Whole length of linea aspera

and medial
condyloid ridge
Chapter
Vastus medialis m. 10
I, Medial half of the upper border of the patella

and patellar tendon to the tibial tuberosity
Knee
extension
FIG. 10.10 • Vastus medialis muscle, anterior view. O, Origin; I, Insertion.

Hamstring muscles FIG. 10.11 semitendinosus and semimembranosus perform internal

rotation. Rotation of the knee permits pivoting movements and
The hamstring muscle group, consisting of the biceps femoris, change in direction of the body. This rotation of the knee is vital
n semimembranosus, and semitendinosus, is covered in complete in accommodating to forces developing at the hip or ankle
detail in Chapter during directional changes in order to make the total movement
9, but further discussion is included here because of its more functional as well as more fluid in appearance. See
importance in knee function. Figures
Muscle strains involving the hamstrings are very common in
ion
football and other sports that require explosive running. This 9.31, 9.32, and 9.33 on pages 259, 260, and 261 for the
muscle group is often referred to as the running muscle semitendinosus, semimembranosus, and biceps femoris,
because of its function in acceleration. The hamstring muscles respectively.
are antagonists to the quadriceps muscles at the knee and are
named for their cordlike attachments at the knee. All the
hamstring muscles originate on the ischial tuberosity of the
pelvic bone, with the exception of the short head of the biceps
femoris, which originates on the lower half of the linea aspera
al
and lateral condyloid ridge. The semitendinosus and
n
semimembranosus insert on the anteromedial and
posteromedial sides of the tibia, respectively. The biceps
femoris inserts on the lateral tibial condyle and head of the
fibula— hence the saying “Two to the inside and one to the
outside.” The short head of the biceps femoris originates on the
linea aspera of the femur.
al
n
Special exercises to improve the strength and flexibility of
this muscle group are important in decreasing knee injuries.
Inability to touch the floor with the fingers when the knees are
straight is largely a result of a lack of flexibility of the
hamstrings. The hamstrings may be strengthened by performing Semitendinosis m.
knee or hamstring curls on a knee table against resistance.
Tight or inflexible hamstrings are also contributing factors in
al painful conditions involving the lower back and knee. The (long head)
n Biceps femoris m.
flexibility of these muscles may be improved by performing
(short head)
slow, static stretching exercises, such as flexing the hip slowly
while maintaining knee extension in a long sitting position.
pter
0 Semimembranosus m.
The hamstrings are primarily knee flexors in addition to

serving as hip extensors. Rotation of the knee can occur when it
is in a flexed position. Once the knee is flexed approximately 20
degrees, it may rotate by actions of the hamstring muscles. The
biceps femoris externally rotates the lower leg at the knee. The
al
n
FIG. 10.11 • The hamstring muscle group, posterior

view.

Popliteus muscle FIG. 10.12 Application, strengthening, and flexibility

(pop´li-teús) The popliteus muscle is the only true flexor of the leg at the knee. All
other flexors are twojoint muscles. The popliteus is vital in providing
Origin posterolateral stability to the knee. It assists the medial hamstrings in
Posterior surface of the lateral condyle of the femur internal rotation of the lower Knee
Insertion
leg at the knee and is crucial in internally rotating internal
rotation
Upper posterior medial surface of the tibia the knee to unlock it from the “screwed home” full extension
Action position.
Hanging from a bar with the legs flexed at the knee strenuously
Flexion of the knee exercises the popliteus muscle. Also, the less strenuous activities of
Internal rotation of the knee as it flexes walking and Knee
flexion
Palpation running exercise this muscle. Specific efforts to strengthen this
With subject sitting, knee flexed 90 degrees, palpate deep to the muscle combine knee internal rotation and flexion exercises
gastrocnemius medially on the posterior proximal tibia and against resistance. Stretching of the popliteus is difficult but may
proceed superolaterally toward lateral epicondyle of tibia just deep be done through passive full knee extension without flexing the
to fibular collateral ligament, while subject internally rotates knee. hip. Passive maximum external rotation with the knee flexed
approximately 20 to 30 degrees also stretches the popliteus.
Innervation
Tibial nerve (L5, S1)
Chapter
10
O, Posterior surface
of lateral condyle
Flexion
of femur
Popliteus m.
Internal I, Upper posterior

rotation medial surface
of tibia
FIG. 10.12 • Popliteus muscle, posterior view. O, Origin; I, Insertion.

REVIEW EXERCISES injuries, meniscal injuries, medial collateral ligament

injuries, patellar tendon tendonitis, plica syndrome, anterior
knee pain, osteochondritis dissecans, patella
1. List the planes in which each of the following movements
subluxation/dislocation, knee bracing, quadriceps
occurs. List the axis of rotation for each movement in each
rehabilitation.
plane.
4. Research preventive and rehabilitative exercises to
a. Extension of the leg at the knee
strengthen the knee joint, and report your findings in class.
b. Flexion of the leg at the knee
c. Internal rotation of the leg at the knee
5. Which muscle group about the knee would be most
d. External rotation of the leg at the knee Research the
important for an athlete with a torn anterior cruciate
2. acceptability of deep knee bends and duck-walk activities in
ligament to develop? Why? For an athlete with a torn
a physical education program, and report your findings in
posterior cruciate ligament? Why?
class. Prepare a report on the knee on one of the following
3. topics: anterior cruciate ligament
6. Muscle analysis chart • Knee joint
Flexion Extension
7. Antagonistic muscle action chart • Knee joint
Complete the antagonistic muscle action chart by listing the muscle(s) or parts of muscles that are antagonist in their actions to the muscles
in the left column.
Agonist Antagonist
pter
Biceps femoris
0 Semitendinosus
Semimembranosus
Popliteus
Rectus femoris
Vastus lateralis
Vastus intermedius
Vastus medialis

LABORATORY EXERCISES Note: Palpate the previously studied hip joint muscles as
they are performing actions at the knee.
1. Locate the following bony landmarks on a human skeleton

a. Gracilis f. Rectus femoris
and on a subject:
b. Sartorius g. Vastus lateralis
a. Skeleton
c. Biceps femoris h. Vastus intermedius
1. Head and neck of femur
d. Semitendinosus i. Vastus medialis
2. Greater trochanter
e. Semimembranosus j. Popliteus
3. Shaft of femur
3. Be prepared to indicate on a human skeleton, by using a
4. Lesser trochanter
long rubber band, the origin and insertion of the muscles
5. Linea aspera
listed in Question 2. Demonstrate the following movements,
6. Adductor tubercle
4. and list the muscles primarily responsible for each.
7. Medial femoral condyle
8. Lateral femoral condyle
a. Extension of the leg at the knee
9. Patella
b. Flexion of the leg at the knee
10. Fibula head
c. Internal rotation of the leg at the knee
11. Medial tibial condyle
d. External rotation of the leg at the knee
12. Lateral tibial condyle
5. With a laboratory partner, determine how and why
13. Tibial tuberosity
maintaining the position of full knee extension limits the
14. Gerdy’s tubercle
ability to maximally flex the hip both actively and passively.
b. Subject
Does maintaining excessive hip flexion limit the ability to
1. Greater trochanter
accomplish full knee extension?
2. Adductor tubercle
3. Medial femoral condyle
6. With a laboratory partner, determine how and why
4. Lateral femoral condyle
maintaining the position of full knee flexion limits the ability
5. Patella
to maximally extend the hip both actively and passively.
6. Fibula head
Does maintaining excessive hip extension limit the ability to
7. Medial tibial condyle
accomplish full knee flexion?
8. Lateral tibial condyle
9. Tibial tuberosity
7. Compare and contrast the bony, ligamentous, articular, and
10. Gerdy’s tubercle
cartilaginous aspects of the medial knee joint with those of
2. How and where can the following muscles be palpated on a
the lateral knee joint.
human subject?
8. Knee joint exercise movement analysis chart
After analyzing each exercise in the chart, break each into two primary movement phases, such as a lifting phase and a lowering phase.
For each phase, determine what knee joint movements occur, and then list the knee joint muscles primarily responsible for
causing/controlling those movements. Beside each muscle in each movement, indicate the type of contraction as follows: I—isometric; Chapter

10
Exercise Movement(s) Agonist(s)—(contraction type) Movement(s) Agonist(s)—(contraction type)
Push-up
Squat
Dead lift
Hip sled
Forward lunge
Rowing exercise
Stair machine

9. Knee joint sport skill analysis chart
Analyze each skill in the chart, and list the movements of the right and left knee joints in each phase of the skill. You may prefer to list the
initial position the knee joint is in for the stance phase. After each movement, list the knee joint muscle(s) primarily responsible for
causing/controlling the movement. Beside each muscle in each movement, indicate the type of contraction as follows: I—isometric;
C—concentric; E—eccentric. It may be desirable to review the concepts for analysis in Chapter 8 for the various phases.
(R)
Baseball
pitch (L)
(R)
Football
punt (L)
(R)
Walking
(L)
(R)
Softball
pitch (L)
(R)
Soccer
pass
(L)
(R)
Batting
(L)
(R)
Bowling
(L)
(R)
Basketball
jump shot (L)
References Oatis CA: Kinesiology: the mechanics and pathomechanics of human

Prentice WE: Principles of athletic training: a competency based

Baker BE, et al: Review of meniscal injury and associated sports, approach, ed 15, New York, 2014, McGraw-Hill.
pter American Journal of Sports Medicine 13:1, January–February 1985.
0
Field D: 2001, Butterworth-Heinemann.
Anatomy: palpation and surface markings, ed 3, Oxford, Shier D, Butler J, Lewis R: Hole’s human anatomy and physiology, ed
Garrick JG, Regna RK: Prophylactic knee bracing, American Journal 12, New York, 2010, McGraw-Hill.
of Sports Medicine 15:471, September–October 1987.
Sieg KW, Adams SP: Illustrated essentials of musculoskeletal anatomy,
Hamilton N, Weimer W, Luttgens K: Kinesiology: scientific basis of ed 4, Gainesville, FL, 2002, Megabooks.
Stone RJ, Stone JA; Atlas of the skeletal muscles, ed 6, New York,
Hislop HJ, Montgomery J: Daniels and Worthingham’s muscle testing: 2009, McGraw-Hill
McGraw-Hill.
Kelly DW, et al: Patellar and quadriceps tendon ruptures—jumping
Wroble RR, et al: Pattern of knee injuries in wrestling, a six-year study,
knee, American Journal of Sports Medicine 12:375, September– October 1984.
American Journal of Sports Medicine 14:55, January–February 1986.
Lysholm J, Wikland J: Injuries in runners, American Journal of Sports

Medicine 15:168, September–October 1986.
Magee DJ: Orthopedic physical assessment, ed 5, Philadelphia, 2008,

Saunders. For additional resources and a list of related websites,
Muscolino JE: The muscular system manual: the skeletal muscles of visit www.mhhe.com/floyd19e.

Worksheet Exercises
Worksheet 1
a. Rectus femoris c. Vastus intermedius e. Biceps femoris g. Semimembranosus

b. Vastus lateralis d. Vastus medialis f. Semitendinosus h. Popliteus
Chapter
10

Worksheet Exercises
Worksheet 2
Label and indicate with arrows the following movements of the knee joint. For each motion, complete the sentence by supplying the plane in
which it occurs and the axis of rotation, as well as the muscles causing the motion.
a. Flexion occurs in the ______________________________ plane about the _____________________________ axis and is accomplished by concentric
contractions of the _______________________________________________________
______________________________________________________________________________________________ muscles.
b. Extension occurs in the ______________________________ plane about the ____________________________ axis and is accomplished by
concentric contractions of the ____________________________________________
_________________________________________________________________________________________________ muscles.
c. Internal rotation occurs in the ________________________________ plane about the ____________________________ axis and is accomplished by
concentric contractions of the ________________________________________________
_____________________________________________________________________________________________________ muscles.
d. External rotation occurs in the _________________________________ plane about the ________________________ axis and is accomplished by
concentric contractions of the ________________________________________________
__________________________________________________________________________________________________ muscles.
pter
A B
C D

C HAPTER 11
T HE A NKLE AND
F OOT J OINTS
Objectives
T thecomplexity
he 26 bones, of
19the
large muscles,
foot manyby
is evidenced small
j To identify on a human skeleton the most important bone (intrinsic) muscles, and more than 100 ligaments that make up
features, ligaments, and arches of the ankle and foot its structure.
Support and propulsion are the two functions of the foot.
Proper functioning and adequate development of the muscles of
j To draw and label on a skeletal chart the muscles the foot and practice of proper foot mechanics are essential for
of the ankle and foot everyone. In our modern society, foot trouble is one of the most
common ailments. Quite often, people develop poor foot
j To demonstrate and palpate with a fellow student the
movements of the ankle and foot and list their respective mechanics or gait abnormalities secondary to improper footwear
planes of motion and axes of rotation or other relatively minor problems. Poor foot mechanics early in
life inevitably leads to foot discomfort in later years.
j To palpate the superficial joint structures and muscles of

the ankle and foot on a human subject Walking may be divided into stance and swing phases (Fig.
11.1). The stance phase is further divided into three
components—heel-strike, midstance, and toe-off. Midstance
j To list and organize the muscles that produce movement
may be further separated into loading response, midstance, and
of the ankle and foot and list their antagonists
terminal stance. Normally, heel-strike is characterized by
landing on the heel with the foot in supination and the leg in
j To determine, through analysis, the ankle and foot external rotation, followed immediately by pronation and internal
movements and muscles involved in selected skills and rotation of
exercises.
the foot and leg, respectively, during midstance . Chapter
The foot returns to supination and the leg returns

to external rotation immediately prior to and dur- 11
ing toe-off . The swing phase occurs when the foot leaves the
ground and the leg moves forward to another point of contact.
for additional information and study material for this chapter, including: The swing phase may be divided into initial swing, midswing,
and terminal swing. Problems often arise when the foot is too
rigid and does not pronate adequately or when the foot remains
j Self-grading quizzes in pronation past midstance. If the foot remains too rigid and
j Anatomy flashcards does not pronate adequately, then impact forces will not be
j Animations absorbed through the gait, resulting in shock being transmitted
j Related websites up the

kinetic chain. If the foot overpronates or remains in pronation The fitness revolution that has occurred during the past four
too much past midstance, then propulsive forces are diminished decades has resulted in great improvements in shoes available
and additional stresses are placed on the kinetic chain. Walking for sports and recreational activities. In the past, a pair of
differs from running in that one foot is always in contact with the sneakers would suffice for most activities. Now there are
ground and there is a point at which both feet contact the basketball, baseball, football, jogging, soccer, tennis, walking,
ground whereas in running there is a point at which neither foot and cross-training shoes. Good shoes are important, but there
is in contact with the ground, and both feet are never in contact is no substitute for adequate muscle development, strength, and
with the ground at the same time. proper foot mechanics.
Stance Phase (60% of total) Swing Phase
Initial Contact Loading Midstance Terminal Preswing Initial Swing Midswing Terminal
(heel-strike) Response Stance (toe-off) Swing
External Internal External

rotation rotation rotation
of tibia of tibia of tibia
Supination Pronation Supination
FIG. 11.1 • Walking gait cycle.
pter

Bones to each of the five toes. The toes are known as the phalanges.
There are three individual bones in each phalange, except for
Each foot has 26 bones, which collectively form the shape of an the great toe, which has only two. Each of these bones is known
arch. They connect with the thigh and the remainder of the body as a phalanx. Finally, there are two sesamoid bones located
through the fibula and tibia (Figs. 11.2 and 11.3). Body weight is beneath the first metatarsophalangeal joint and contained within
transferred from the tibia to the talus and the calcaneus. It the flexor hallucis longus tendons.
should be noted that the talus is one of the few bones involved
in locomotion that has no muscle attachments.
The distal ends of the tibia and fibula are enlarged and
protrude horizontally and inferiorly. These bony protrusions,
The anterior portion of the talus is wider than its posterior known as malleoli, serve as a sort of pulley for the tendons of
portion, and this is a factor in making the ankle stabler in the muscles that run directly posterior to them. Specifically, the
dorsiflexion than in plantar flexion. peroneus brevis and peroneus longus are immediately behind
the lateral malleolus. The muscles immediately posterior to the
In addition to the talus and calcaneus, there are five other medial malleolus may be remembered by the phrase “Tom,
bones in the rear foot and midfoot, known as the tarsals. Dick, and Harry” with the “T” standing for the tibialis posterior,
Between the talus and the three cuneiform bones lies the the “D” for the flexor digitorum longus, and the “H” for the flexor
navicular. The cuboid is located between the calcaneus and the hallucis longus. This bony arrangement increases the
fourth and fifth metatarsals. Distal to the tarsals are the five mechanical
metatarsals, which in turn correspond
Intercondylar eminence Medial Lateral condyle

condyle
Head of fibula Apex
Head of fibula
Proximal tibiofibular Tibial
joint tuberosity
Lateral surface Interosseous

membrane
Anterior crest
Tibia
Fibula
Chapter
11
Distal tibiofibular joint
Medial
malleolus Lateral malleolus
Lateral malleolus
A B
FIG. 11.2 • Right tibia and fibula. A, Anterior view; B, Posterior view.

Proximal interphalangeal
(PIP) joints
Distal
interphalangeal
Distal phalanx I (DIP) joints
Interphalangeal Phalanges
Distal
(IP) joint
phalanx V
Proximal phalanx I
Forefoot Middle
phalanx V Head
Proximal
Metatarsal
II phalanx V Body
I III Metatarsal
IV III II I
IV bones
Metatarsophalangeal V
V
(MP) joints Base
Medial cuneiform
Intermediate cuneiform Transverse
Midfoot tarsal joint
Lateral cuneiform
Navicular Cuboid
Talus
Calcaneus Tarsal bones
Rearfoot Trochlear surface

Key to tarsal bones
of talus
Subtalar joint
Calcaneal Distal group
tubercle
Tuberosity of calcaneus Proximal group
A B
FIG. 11.3 • Right foot. A, Superior (dorsal) view; B, Inferior (plantar) view.
advantage of these muscles in performing their actions of

Joints
inversion and eversion. The base of the fifth metatarsal is
enlarged and prominent to serve as an attachment point for the The tibia and fibula form the tibiofibular joint, a syndesmotic
peroneus brevis and tertius. amphiarthrodial joint (see Fig. 11.2). The bones are joined at
both the proximal and distal tibiofibular joints. In addition to the
The inner surface of the medial cuneiform and the base of ligaments supporting both of these joints, there is a strong,
the first metatarsal provide insertion points for the tibialis dense interosseus membrane between the shafts of these two
anterior, while the undersurfaces of the same bones serve as bones. Although only minimal movement is possible between
the insertion for the peroneus longus. The tibialis posterior has these bones, the distal joint does become sprained occasionally
multiple insertions on the lower inner surfaces of the navicular, in heavy contact sports such as football. A common component
cuneiform, and second through fifth metatarsal bases. The tops of this injury involves the ankle, or talocrural, joint being in
and undersurfaces of the bases of the second through fifth dorsiflexion, which, by making the ankle more stable, allows the
distal phalanxes are the insertion points for the extensor ligamentous stress to be transferred to the syndesmosis joint
pter digitorum longus and the flexor digitorum longus, respectively. when the dorsiflexed ankle is forced into external rotation. This
Similarly, the top and undersurface of the base of the first distal injury, a sprain of the syndesmosis joint, is commonly referred
1 phalanx provide insertions for the extensor hallucis longus and to as a high ankle sprain and primarily involves the anterior
flexor hallucis longus, respectively. inferior tibiofibular ligament. Secondarily, and with more severe
injuries, the posterior tibiofibular ligament, interosseus ligament,
and interosseus membrane may be involved.
The posterior surface of the calcaneus is very prominent

and serves as the attachment point for the Achilles tendon of
the gastrocnemius–soleus complex.

The ankle joint, technically known as the talocrural joint, is a flexion/dorsiflexion, the true inversion mechanism places more
hinge or ginglymus-type joint (Fig. 11.4). Specifically, it is the stress on the calcaneofibular ligament. Less common are
joint made up of the talus, the distal tibia, and the distal fibula. excessive eversion forces causing injury to the deltoid ligament
The ankle joint allows approximately 50 degrees of plantar on the medial aspect of the ankle.
flexion and 15 to 20 degrees of dorsiflexion (Fig. 11.5). Greater
range of dorsiflexion, particularly in weight bearing, is possible Ligaments in the foot and the ankle maintain the position of
when the knee is flexed, which reduces the tension of the an arch. All 26 bones in the foot are connected with ligaments.
biarticular gastrocnemius muscle. The fibula rotates on its axis 3 This brief discussion focuses on the longitudinal and transverse
to 5 degrees externally with dorsiflexion of the ankle and 3 to 5 arches.
degrees internally during plantar flexion. The syndesmosis joint
widens by approximately 1 to 2 millimeters during full There are two longitudinal arches (Fig. 11.6). The medial
dorsiflexion. longitudinal arch, important for shock absorption, is located on
the medial side of the foot and extends from the calcaneus bone
to the talus, the navicular, the three cuneiforms, and the distal
ends of the three medial metatarsals. The medial longitudinal
Inversion and eversion, though commonly thought to be arch, often implicated in a variety of foot problems, is primarily
ankle joint movements, technically occur in the subtalar and supported dynamically by the tibialis posterior and tibialis
transverse tarsal joints. These joints, classified as gliding or anterior muscles. The lateral longitudinal arch, important in
arthrodial, combine to allow approximately 20 to 30 degrees of balance, is located on the lateral side of the foot and extends
inversion and 5 to 15 degrees of eversion. There is minimal from the calcaneus to the cuboid and the distal ends of the
movement within the remainder of the intertarsal and fourth and fifth metatarsals. Individual long arches can be high,
tarsometatarsal arthrodial joints. medium, or low, but a low arch is not necessarily a weak arch.
The phalanges join the metatarsals to form the

metatarsophalangeal joints, which are classified as
condyloid-type joints. The metatarsophalangeal (MP) joint of the The transverse arch (see Fig. 11.6) assists in adapting the
great toe flexes 45 degrees and extends 70 degrees, whereas foot to the ground and extends across the foot from the first
the interphalangeal (IP) joint can flex from 0 degrees of full metatarsal to the fifth metatarsal. The distal transverse arch,
extension to 90 degrees of flexion. The MP joints of the four also a common source of foot problems, is supported by the
lesser toes allow approximately 40 degrees of flexion and 40 intrinsic muscles of the foot such as the lumbricals, adductor
degrees of extension. The MP joints also abduct and adduct hallucis, and flexor digiti minimi. These muscles may be
minimally. The proximal interphalangeal (PIP) joints in the strengthened through a towel crunch exercise in which the
lesser toes flex from 0 degrees of extension to 35 degrees of metatarsophalangeal joints are flexed to grab a towel. The long
flexion. The distal interphalangeal (DIP) joints flex 60 degrees plantar ligament, longest of all the ligaments of the tarsals,
and extend 30 degrees. There is much variation from joint to originates on the plantar surface of the calcaneus anterior to the
joint and from person to person in all these joints. calcaneal tuberosity and inserts on the plantar surface of the
cuboid with superficial fibers con-
Ankle sprains are one of the most common injuries among

physically active people. Sprains involve the stretching or tinuing forward to the bases of the second, third, Chapter
tearing of one or more ligaments. There are far too many and fourth metatarsal bones (see Fig. 11.4, A
ligaments in the foot and ankle to discuss in this text, but a few and B). The plantar fascia, sometimes referred to 11
of the ankle ligaments are shown in Fig. 11.4. Far and away the as the plantar aponeurosis, is a broad structure
most common ankle sprain results from excessive inversion, extending from the medial calcaneal tuberosity to the proximal
usually while in some degree of plantar flexion. This most phalanges of the toes. It assists in stabilizing the medial
commonly results in damage to the anterior talofibular ligament, longitudinal arch and in propelling the body forward during the
particularly when in greater amounts of plantar flexion. When latter part of the stance phase. A common painful condition
closer to neutral plantar involving the plantar fascia is known as plantar fasciitis.

Tibia
Fibula
Anterior and posterior
tibiofibular ligaments
Lateral malleolus
Calcaneofibular ligament
Posterior talofibular Anterior talofibular ligament

ligament
Dorsal talonavicular ligament
Bifurcate ligament
Achilles
tendon
(cut)
A
Metatarsal heads
Cuboid
Dorsal calcaneocuboid C
Calcaneus Tendon of peroneus
ligament brevis m. Fifth metatarsal Tibia
bone
Interosseous talocalcaneal Fibula
Long plantar ligament Interosseous
ligament
ligament
Medial Posterior
malleolus tibiofibular
ligament
Lateral
Deltoid malleolus
ligament
Posterior
talofibular
ligament
Calcaneofibular
ligament
Posterior tibiotalar ligament Posterior

talocalcaneal
Deltoid Tibiocalcaneal ligament
ligament
ligament Tibia
Tibionavicular ligament
Anterior tibiotalar ligament
Medial
malleolus
Dorsal talonavicular ligament
Dorsal cuneonavicular
ligaments
Achilles tendon (cut)
First metatarsal bone
pter Posterior talocalcaneal ligament
1 B
Medial talocalcaneal ligament
Sustentaculum tali
Navicular
Calcaneus
Tendon of tibialis Calcaneal tubercle
Dorsal tarsometatarsal anterior m. (cut) Long plantar ligament Tendon of tibialis posterior m. (cut) Plantar
ligament calcaneonavicular ligament
FIG. 11.4 • Right ankle joint. A, Lateral view; B, Medial view; C, Posterior view.

Ne
utr
al
(p
Ex
lan
0
ten
tar
sio
fle
n
xio
90 90
n)
Neutral Neutral
20
0 Extension 0
Flexion
Flexion
(dorsiflexion) 45
90 70
90
50 90 90 0
90 0 0
Ankle joint Inversion Eversion Metatarsophalangeal Interphalangeal

joint joint
A B C
Extension 0
40 Abduction Abduction
Extension Adduction Adduction
30
0
0
0
40
60 35 Flexion
Flexion Flexion
Distal Proximal Metatarsophalangeal Toe spread

interphalangeal joint interphalangeal joint joint
FIG. 11.5 • Active motion of the ankle, foot, and toes. A, Dorsiflexion and plantar flexion are measured in degrees from the right-angle
Creek
neutral position or in percentages of motion as compared to the opposite ankle;

B, Inversion and eversion normally are estimated in degrees or expressed in percentages as compared to the opposite foot; C, Flexion and
extension of the great toe; D, ROM for the lateral four toes.
Cuneiform
bones
Cuboid
Talus
Medial
Calcaneus
longitudinal arch
Navicular
bone Transverse
arch
Transverse arch
Longitudinal arch Chapter

Lateral
11
First metatarsal bone longitudinal
arch
Phalanxes of
big toe
FIG. 11.6 • Longitudinal and transverse arches. A, Medial

Bases of B view of the right foot
metatarsals
showing both arches; B, Inferior (plantar) view; C, Transverse
view through the bases of the metatarsal bones
showing a portion of the transverse arch.
Transverse arch
C

Movements FIG. 11.7 Toe flexion: movement of the toes toward the plantar surface of the
foot
Dorsiflexion (flexion): dorsal flexion; movement of the top of the Toe extension: movement of the toes away from the plantar
ankle and foot toward the anterior tibia
surface of the foot
n
Pronation: a combination of ankle dorsiflexion, subtalar eversion,
Plantar flexion (extension): movement of the ankle and foot away and forefoot abduction (toe-out)
from the tibia
Supination: a combination of ankle plantar flexion, subtalar
Eversion: turning the ankle and foot outward; abduction, away from inversion, and forefoot adduction (toe-in)
the midline; weight is on the medial edge of the foot
Inversion: turning the ankle and foot inward; adduction, toward the
midline; weight is on the lateral edge of the foot
r
n
verse
and
ar
on
verse
and
ar
ion
Dorsiflexion Plantar flexion
A B
pter
Transverse tarsal and Transverse tarsal and FIG. 11.7 • Movements of the right ankle and foot.
subtalar eversion subtalar inversion
C D

Great toe
MTP and IP
flexion
Great toe
MTP and IP
extension
Flexion of the toes Extension of the toes

E F
Pronation Supination
G H
FIG. 11.7 (continued) • Movements of the right ankle and foot.
Chapter
11

Ankle and foot muscles FIGS 11.8, 11.9 together join to the Achilles tendon. Muscles that are evertors
are located more to the lateral side, whereas the invertors are
The large number of muscles in the ankle and foot may be located medially.
easier to learn if grouped according to location and function. In The lower leg is divided into four compartments, each
general, the muscles located on the anterior aspect of the ankle containing specific muscles (Fig. 11.9). Tightly surrounding and
and foot are the dorsal flexors and/or toe extensors. Those on binding each compartment is a dense fascia, which facilitates
the posterior aspect are plantar flexors and/or toe flexors. venous return and prevents excessive swelling of the muscles
Specifically, the gastrocnemius and the soleus collectively are during exercise. The anterior compartment contains the
known as the dorsiflexor group, consisting of the tibialis anterior, peroneus
tertius, extensor digitorum longus,
triceps surae , due to their three heads, which
Vastus
Biceps femoris
lateralis
Sartorius
Tendon of gracilis
Iliotibial
tract
Plantaris Tendon of
Patella
semimembranosus
Common Tendon of
fibular nerve semitendinosus
Head of fibula
Lateral head of
gastrocnemius
Peroneus longus
Soleus Medial head of
Tibialis anterior gastrocnemius
Tibia
Extensor digitorum Tibialis anterior

longus
Soleus
Achilles
tendon
Peroneus
brevis Tendon of
Extensor hallucis plantaris
longus
Achilles Flexor
Peroneus tertius Tibialis posterior
tendon digitorum
longus
Lateral Inferior extensor
malleolus Flexor hallucis
retinaculum
pter longus
1
Flexor
retinaculum
A
Creek
Abductor hallucis (cut)
FIG. 11.8 • Right Lower leg, ankle, and foot muscles. A, Lateral view; B, Medial view.

and extensor hallucis longus. The lateral compartment contains and then deep to it, but superficial to the soleus, to insert on the
the peroneus longus and peroneus brevis—the two most middle one-third of the posterior calcaneal surface just medial to
powerful evertors. The posterior compartment is divided into the Achilles tendon. The deep posterior compartment muscles,
deep and superficial compartments. The gastrocnemius, soleus, except for the popliteus, are plantar flexors but also function as
and plantaris are located in the superficial posterior invertors. Although most common with the anterior
compartment, while the deep posterior compartment is compartment, any of these components are subject to a
composed of the flexor digitorum longus, flexor hallucis longus, condition known as compartment syndrome. This condition may
popliteus, and tibialis posterior. All the muscles of the superficial be acute or chronic and may occur secondarily to injury, trauma,
posterior compartment are primarily plantar flexors. The or overuse. Symptoms include sharp pain, particularly with
plantaris, absent in some humans, is a vestigial biarticular increased movement actively or passively, swelling, and
muscle that contributes minimally to ankle plantar flexion and weakness in the muscles of the involved compartment.
knee flexion. It originates on the inferior aspect of the lateral Depending on the severity, emergency surgery may be
supracondylar line of the distal femur posteriorly, runs just indicated to release the fascia in order to prevent permanent
medial to the lateral head of the gastrocnemius tissue damage, although many compartment
Popliteal artery
and vein
Patellar tendon
Medial head of Plantaris (cut)
gastrocnemius (cut)
Patella Lateral head of
Tibial nerve gastrocnemius (cut)
Patellar tendon Popliteus

Common fibular
Tuberosity nerve (cut)
of tibia
Peroneus longus Posterior tibial Soleus (cut)
artery
Medial head of
Anterior tibial
Tibialis anterior gastrocnemius
artery
Tibial nerve
Tibia Peroneal artery
Extensor digitorum
Flexor digitorum
longus Soleus longus
Peroneus longus
Peroneus brevis Tibialis posterior

Flexor hallucis
longus
Extensor hallucis Posterior tibial
longus artery
Tibial nerve Chapter

Superior
Inferior
extensor
retinaculum Tendon of tibialis
Peroneus brevis 11
extensor posterior
retinaculum
Achilles
tendon Peroneal artery
Creek
k
ee
Cr
C D
FIG. 11.8 (continued) • Right Lower leg, ankle, and foot muscles. C, Anterior view; D, Deep posterior view.

Ankle and foot muscles by function

Posterior
compartment Note: A number of the ankle and foot muscles are capable of
helping produce more than one movement.
Superficial posterior Deep posterior
compartment compartment
Flexes knee Plantar flexes foot Plantar flexors
Plantar flexes foot Inverts foot
Flexes toes Gastrocnemius
Posterior Flexor digitorum longus
Flexor hallucis longus
Peroneus (fibularis) longus
Fibula
Peroneus (fibularis) brevis
Plantaris
Soleus
Tibia Tibialis posterior
Evertors
Nerves and Peroneus (fibularis) longus
vessels Lateral compartment
Plantar flexes foot Peroneus (fibularis) brevis
Anterior Everts foot Peroneus (fibularis) tertius
Dorsiflexes foot Dorsiflexors
Inverts foot Tibialis anterior
Everts foot
Peroneus (fibularis) tertius
Extends toes
Extensor digitorum longus (extensor of the lesser toes)
FIG. 11.9 • Cross section of the left leg, demonstrating

the muscular compartments. Extensor hallucis longus (extensor of the great toe)
Invertors
Tibialis anterior
Tibialis posterior
Flexor digitorum longus (flexor of the lesser toes)
syndromes may be adequately addressed with proper acute
management.
Flexor hallucis longus (flexor of the great toe)
Due to the heavy demands placed on the musculature of the
legs in the running activities of most sports, both acute and
Ankle and foot muscles by compartment
chronic injuries are common. “Shin splints” is a common term
used to describe a painful condition of the leg that is often
Tibialis anterior
associated with running activities. This condition is not a specific
diagnosis but rather is attributed to a number of specific
musculotendinous injuries. Most often the tibialis posterior,
Peroneus (fibularis) tertius
medial soleus, or tibialis anterior is involved, but the extensor
Lateral compartment
digitorum longus may also be involved. Shin splints often occur
Peroneus (fibularis) longus
as a result of an inappropriate level of flexibility, strength, and
Peroneus (fibularis) brevis
pter endurance for the specific demands of the activity and may be
Deep posterior compartment
prevented in part by stretching the plantar flexors and
1 strengthening the dorsiflexors.
Tibialis posterior
Popliteus
Superficial posterior compartment
Additionally, painful cramps caused by acute muscle spasm
Gastrocnemius (medial head)
in the gastrocnemius and soleus occur somewhat commonly
Gastrocnemius (lateral head)
and may be relieved through active and passive dorsiflexion.
Soleus
Also, a very disabling injury involves the complete rupture of the
Plantaris
strong Achilles tendon, which connects these two plantar flexors
to the calcaneus. While viewing the muscles in Figs. 11.8 and
11.9, correlate them with Table 11.1.

TABLE 11.1 • Agonist muscles of the ankle and foot joints
Plane of
Medial head:
posterior sur- Plantar flexion of
face of the Posterior sur- the ankle
medial femoral face of the Upper half of the posterior
Gastroc- Tibial nerve
condyle Lateral calcaneus Sagittal aspect of the lower leg
nemius (S1, S2)
head: posterior (Achilles
Superficial posterior compartment
surface of the tendon) Flexion of the
lateral femoral knee
condyle
Posteriorly under the

Posterior sur-
gastrocnemius muscle on the
face of the Posterior sur-
medial and lateral sides of the
proximal fibula face of the
Plantar flexion of lower leg, particularly while prone Tibial nerve
Soleus and calcaneus Sagittal
the ankle with knee flexed approximately (S1, S2)
proximal 2/3 (Achilles
of the posterior tendon)
90 degrees and actively
tibial surface
plantarflexing ankle
The tendon may be palpated
Inversion of both proximally

Posterior sur- Inferior surfaces Frontal
the foot and distally immediately
face of the of the navicular,
behind medial malleolus
upper half of cuneiform, and
with inversion and plantar flexion
Tibialis the interosseus cuboid bones Tibial nerve
and is better distinguished from
posterior membrane and and bases of the 2nd, (L5, S1)
flexor
the adjacent 3rd, and
digitorum longus and
surfaces of the 4th metatarsal
Plantar flexion of flexor hallucis longus if toes can
tibia and fibula bones Sagittal
the ankle be maintained in slight extension
Flexion of the
four lesser toes The tendon may be palpated
at the metatarso- immediately poste-
Deep posterior compartment
phalangeal and the rior to the medial malleolus and

proximal and distal tibialis posterior and immediately
Middle 1/3 of Base of the Sagittal
Flexor interphalangeal anterior to
the posterior distal phalanx Tibial nerve
digitorum joints the flexor hallucis
surface of the of each of the (L5, S1)
longus longus with flexion of the lesser
tibia four lesser toes Plantar flexion of
toes while maintaining great toe
the ankle
extension, ankle dorsiflexion, and
Chapter
Inversion of
foot eversion
11
Frontal
the foot
Flexion of the great toe at

Most posterior of three
the metatarsophalangeal
tendons immediately
and
Base of the behind medial malleolus;
Middle 2/3 of interphalangeal
Sagittal
Flexor distal phalanx between medial soleus
the posterior joints Tibial nerve
hallucis of the great and tibia with active great toe
surface of the (L5, S1, S2)
longus toe; plantar Plantar flexion of flexion while maintaining
fibula
surface the ankle extension of four lesser toes,
ankle dorsiflexion, and foot
Inversion of
Frontal eversion
the foot

TABLE 11.1 (continued) • Agonist muscles of the ankle and foot joints
Plane of
Upper lateral side of tibia just

Eversion of the foot Frontal distal to fibular head and down to
Head and Undersurfaces Superficial
immediately posterior to lateral
Peroneus upper 2/3 of the medial peroneal
malleolus; just posterolateral
(fibularis) of the lateral longus cuneiform and nerve
surface of the 1st metatarsal Plantar flexion of (L4, L5,
Sagittal from tibialis anterior and extensor
fibula bone the ankle S1)
digitorum longus
Lateral compartment
with active eversion
Tendon of muscle at
Eversion of the foot Frontal proximal end of 5th metatarsal;
Superficial
Mid to lower just proximal and posterior to
Peroneus Tuberosity of peroneal
2/3 of the lat- lateral malleolus; immediately
(fibularis) the 5th meta- nerve
eral surface of deep
brevis tarsal bone (L4, L5,
the fibula Plantar flexion of anteriorly and posteriorly
Sagittal S1)
the ankle to peroneus longus with active
eversion
Dorsiflexion of the Just medial to distal fibula; lateral

Sagittal to extensor digitorum longus Deep
Superior ankle
Peroneus Distal 1/3 of (fibularis) tendon on anterolateral aspect of peroneal
aspect of the
the anterior foot, down to medial side of base nerve
base of the
tertius fibula of 5th metatarsal with dorsiflexion (L4, L5,
5th metatarsal Eversion of the foot Frontal
and eversion S1)
Extension of the
four lesser toes at the Second muscle to lateral side of
Lateral con-
metatarsopha- anterior tibial border; upper
dyle of the
Tops of the langeal and the lateral side of tibia between Deep
tibia, head of
Extensor middle and proximal and distal tibialis anterior medially and peroneal
Sagittal
the fibula, and
digitorum distal phalan- interphalangeal fibula laterally; divides into four nerve
upper 2/3 of
longus ges of the four joints tendons just distal to anterior (L4, L5,
the anterior
lesser toes ankle with active toe extension S1)
surface of the Dorsiflexion of the
fibula ankle
Eversion of the foot Frontal
Extension of great
toe at the
metatarsophalangeal and From dorsal aspect of great toe
Deep
Middle 2/3 Base of the interphalangeal to just lateral to tibialis anterior
Sagittal
Extensor peroneal
of the medial distal phalanx joints and medial to extensor
hallucis nerve
surface of the of the great digitorum longus at anterior
pter longus Dorsiflexion of the (L4, L5,
anterior fibula toe ankle joint
1
ankle S1)
Weak inversion of
Frontal
the foot
Dorsiflexion of the First muscle to the lateral side of

Inner surface Sagittal
ankle the anterior tibial border, Deep
Upper 2/3 of the medial
particularly palpa- peroneal
Tibialis of the lateral cuneiform and
ble with fully active ankle nerve
anterior surface of the the base of
dorsiflexion; most promi- (L4, L5,
tibia the 1st meta- Inversion of the foot Frontal
nent tendon crossing the ankle S1)
tarsal bone
anteromedially
Note: The plantaris is not included because its contribution to knee flexion and plantar flexion is relatively minimal.

Nerves hallucis, flexor hallucis brevis, first lumbrical, and flexor

digitorum brevis. The lateral plantar nerve supplies the adductor
As described in Chapter 9, the sciatic nerve originates from the hallucis, quadratus plantae, lumbricals (2, 3, and 4), dorsal
sacral plexus and becomes the tibial nerve and peroneal nerve. interossei, plantar interossei, abductor digiti minimi, and flexor
The tibial division of the sciatic nerve (Fig. 9.22) continues down digiti minimi.
to the posterior aspect of the lower leg to innervate the
gastrocnemius (medial head), soleus, tibialis posterior, flexor The peroneal, or fibular, nerve (Fig. 11.10) divides just
digitorum longus, and flexor hallucis longus. Just before below the head of the fibula to become the superficial and deep
reaching the ankle, the tibial nerve branches to become the peroneal nerves. The superficial branch innervates the
medial and lateral plantar nerves, which innervate the intrinsic peroneus longus and peroneus brevis, while the deep branch
muscles of the foot. The medial plantar nerve innervates the innervates the tibialis anterior, extensor digitorum longus,
abductor extensor hallucis longus, peroneus tertius, and extensor
digitorum brevis.
L4
L5
S1
S2
Peroneal (fibular) nerve
Short head of
Cr
biceps femoris m.
ee
k
Tibialis anterior m.
Peroneus longus m.
Extensor digitorum longus m. Chapter
Superficial peroneal (fibular)
nerve 11
Peroneus brevis m.
Deep peroneal (fibular) nerve
Extensor hallucis longus m.

Peroneus tertius m.
Extensor digitorum brevis m.

Extensor hallucis brevis m.
FIG. 11.10 • Muscular and cutaneous distribution of
the peroneal (fibular) nerve.

Gastrocnemius muscle FIG. 11.11 the gastrocnemius is a biarticular muscle, it is more effective as
a knee flexor if the ankle is dorsiflexed and more effective as a
(gas-trok-ne´mi-us)
plantar flexor of the foot if the knee is held in extension. This is
Origin observed when one sits too close to the steering wheel in
Medial head: posterior surface of the medial femoral condyle driving a car, which significantly shortens the entire muscle,
reducing its effectiveness. When the knees are bent, the muscle
r
Lateral head: posterior surface of the lateral femoral condyle becomes an ineffective plantar flexor, and it is more difficult to
n
depress the brakes. Running, jumping, hopping, and skipping
exercises all depend significantly on the gastrocnemius and
Insertion
soleus to propel the body upward and forward. Heel-raising
Posterior surface of the calcaneus (Achilles tendon)
exercises with the knees in full extension and the toes resting
Action on a block of wood are an excellent way to strengthen the
n
Plantar flexion of the ankle Flexion muscle through the full range of motion. Holding a barbell on the
of the knee shoulders can increase the resistance. See Appendix 3 for more
commonly used exercises for the gastrocnemius and other
Palpation muscles in this chapter.
Easiest muscle in the lower extremity to palpate; upper
one-half of posterior aspect of lower leg
Innervation
The gastrocnemius may be stretched by standing and
Tibial nerve (S1, S2)
placing both palms on a wall about 3 feet away and leaning into
Application, strengthening, and flexibility the wall. The feet should be pointed straight ahead, and the
The gastrocnemius and soleus together are known as the heels should remain on the floor. The knees should remain fully
triceps surae with triceps referring to the heads of the medial extended throughout the exercise to accentuate the stretch on
and lateral gastrocnemius and the soleus and surae referring to the gastrocnemius.
the calf. Because
O, Posterior surfaces of two Medial head

condyles of femur
Lateral head
Knee flexion
Gastrocnemius m.
pter
I, Posterior surface
of calcaneus
FIG. 11.11 • Gastrocnemius muscle, posterior view. O,

Origin; I, Insertion. Plantar
flexion

Soleus muscle FIG. 11.12 knee is flexed. When one rises up on the toes, the soleus
muscle can plainly be seen on the outside of the lower leg if one
(so´le-us)
has exercised the legs extensively, as in running and walking.
Origin
Posterior surface of the proximal fibula and proximal two-thirds The soleus muscle is used whenever the ankle plantar flexes. Any
of the posterior tibial surface movement with body weight Ankle
on the foot with the knee flexed or extended calls plantar
Insertion
it into action. When the knee is flexed slightly, flexion
Posterior surface of the calcaneus (Achilles tendon)
the effect of the gastrocnemius is reduced, placing more work
Action on the soleus. Running, jumping, hopping, skipping, and
Plantar flexion of the ankle dancing on the toes are all exercises that depend heavily on the
soleus. It may be strengthened through any plantar flexion
Palpation exercise against resistance, particularly if the knee is flexed
Posteriorly under the gastrocnemius muscle on the medial and slightly to deemphasize the gastrocnemius. Heel-raising
lateral sides of the lower leg, particularly prone with knee flexed exercises as described for the gastrocnemius, except with the
approximately 90 degrees and actively plantarflexing ankle knees flexed slightly, are one way to isolate this muscle for
strengthening. Resistance may be increased by holding a
barbell on the shoulders.
Innervation
Tibial nerve (S1, S2)
Application, strengthening, and flexibility The soleus is stretched in the same manner as the
The soleus muscle is one of the most important plantar flexors gastrocnemius, except that the knees must be flexed slightly,
of the ankle. Some anatomists believe that it is nearly as which releases the stretch on the gastrocnemius and places it
important in this movement as the gastrocnemius. This is on the soleus. Again, it is important to attempt to keep the heels
especially true when the on the floor.
Soleus m.
O, Posterior surface of
proximal fibula and
proximal two-thirds
of posterior tibial
surface
Chapter
11
FIG. 11.12 • Soleus muscle,

I, Posterior surface
posterior view. O, Origin; I, of calcaneus
Insertion. Plantar
flexion

Peroneus (fibularis) longus Application, strengthening, and flexibility

The peroneus longus muscle passes posteroinferiorly to the
verse muscle FIG. 11.13
lateral malleolus and under the foot from the outside to under
and (per-o-neús lon´gus)
ar the inner surface. Because of its line of pull, it is a strong evertor
on Origin and assists in plantar flexion.
Head and upper two-thirds of the lateral surface of the fibula
When the peroneus longus muscle is used effectively with
the other ankle flexors, it helps bind the transverse arch as it
Insertion
contracts. Developed without the other plantar flexors, it would
Undersurfaces of the medial cuneiform and first metatarsal produce a weak, everted foot. In running, jumping, hopping, and
bones skipping, the foot should be placed so that it is pointing forward
Action to ensure proper development of the group. Walking barefoot or
r in stocking feet on the inside of the foot (everted position) is the
n
Eversion of the foot
best exercise for this muscle.
Plantar flexion of the ankle
Palpation
Upper lateral side of the tibia; just distal to fibular head and down to Eversion exercises to strengthen this muscle may be
immediately posterior to lateral malleolus; just posterolateral from performed by turning the sole of the foot outward while
the tibialis anterior and extensor digitorum longus with active resistance is applied in the opposite direction.
eversion
The peroneus longus may be stretched by passively taking
Innervation
the foot into extreme inversion and dorsiflexion while the knee is
Superficial peroneal nerve (L4, L5, S1)
flexed.
O, Head and upper two-thirds

of lateral
Peroneus longus m. surface of fibula
pter
1
Plantar I, Undersurfaces of
flexion medial cuneiform and
Foot first metatarsal bones
eversion
FIG. 11.13 • Peroneus longus muscle, lateral plantar views, right leg and foot. O, Origin; I, Insertion.

Peroneus (fibularis) brevis Innervation
muscle FIG. 11.14 Superficial peroneal nerve (L4, L5, S1)

Transverse
(per-o-neús bre´vis) Application, strengthening, and flexibility tarsal and

subtalar
Origin The peroneus brevis muscle passes posteroinferiorly to the lateral
malleolus to pull on the base of eversion
Mid to lower two-thirds of the lateral surface of the fibula
the fifth metatarsal. It is a primary evertor of the foot and assists
in plantar flexion. In addition, it aids in maintaining the lateral
Insertion longitudinal arch as it depresses the foot.
Tuberosity of the fifth metatarsal
The peroneus brevis muscle is exercised with other plantar
Action
flexors in the powerful movements
Ankle
Eversion of the foot of running, jumping, hopping, and skipping. It plantar
Plantar flexion of the ankle may be strengthened in a fashion similar to that flexion
Palpation for the peroneus longus by performing eversion
exercises, such as turning the sole of the foot outward against
Tendon of the muscle at the proximal end of the fifth metatarsal
resistance.
just proximal and posterior to the lateral malleolus; immediately
The peroneus brevis is stretched in the same manner as the
deep anteriorly and posteriorly to the peroneus longus with
peroneus longus.
active eversion
O, Mid to lower
two-thirds of lateral
Peroneus brevis m. surface of fibula
Chapter
11
Plantar
flexion I, Tuberosity of
Foot fifth metatarsal
eversion
FIG. 11.14 • Peroneus brevis muscle, lateral and plantar views, right leg and foot. O, Origin; I, Insertion.

Peroneus (fibularis) tertius Innervation

Deep peroneal nerve (L4, L5, S1)
verse muscle FIG. 11.15
and (per-o-neús ter´shi-us) Application, strengthening, and flexibility
ar
on Origin The peroneus tertius, absent in some humans, is a small
muscle that assists in dorsiflexion and eversion. Some
Distal third of the anterior fibula
authorities refer to it as the fifth tendon of the extensor digitorum
Insertion longus. It may be strengthened by pulling the foot up toward the
Superior aspect of the base of the fifth metatarsal shin against a weight or resistance. Everting the foot against
resistance, such as weighted eversion towel drags, can also be
Action
used for strength development.
Eversion of the foot
n
Dorsiflexion of the ankle
Palpation The peroneus tertius may be stretched by passively taking

the foot into extreme inversion and plantar flexion.
Just medial to distal fibula; lateral to the extensor digitorum longus
tendon on the anterolateral aspect of the foot, down to the medial
side of the base of the fifth metatarsal with dorsiflexion and
eversion
O, Distal third
of anterior fibula
Peroneus tertius m.
pter I, Superior aspect

of base of fifth
1 metatarsal
Ankle dorsiflexion
FIG. 11.15 • Peroneus tertius muscle, anterior view, right

leg and foot. O, Origin; I, Insertion.
Foot eversion

Extensor digitorum longus Innervation
muscle FIG. 11.16 Deep peroneal nerve (L4, L5, S1)
(eks-ten´sor dij-i-to´rum lon´gus) Application, strengthening, and flexibility 2nd–5th

MTP, PIP,
Origin Strength is necessary in the extensor digitorum and DIP
longus muscle to maintain balance between the extension
Lateral condyle of the tibia, head of the fibula, and upper
plantar and dorsal flexors.
two-thirds of the anterior surface of the fibula
Action that involves dorsal flexion of the ankle and extension
of the toes against resistance strengthens both the extensor
Insertion digitorum longus and the extensor hallucis longus muscles. This
Tops of the middle and distal phalanxes of the four lesser toes may be accomplished by manually applying a
Ankle
dorsal
downward force on the toes while attempting to flexion
Action
extend them up.
Extension of the four lesser toes at the metatarsophalangeal and The extensor digitorum longus may be stretched by
the proximal and distal interphalangeal joints passively taking the four lesser toes
into full flexion while the foot is inverted and Transverse
Dorsiflexion of the ankle plantarflexed. tarsal and
Eversion of the foot subtalar
eversion
Palpation
Second muscle to the lateral side of the anterior tibial border; upper O, Lateral condyle
of tibia
lateral side of the tibia between the tibialis anterior medially and
the fibula laterally; divides into four tendons just distal to anterior
ankle with active toe extension
Extensor digitorum
longus m.
O, Head of fibula, upper

two-thirds
of anterior
surface of fibula
Chapter
Ankle 11
dorsiflexion
Toe extension
FIG. 11.16 • Extensor digitorum longus muscle, anterior I, Tops of middle and distal
view, right leg and foot. O, Foot eversion
phalanxes
Origin; I, Insertion. of four lesser toes

Extensor hallucis longus muscle Palpation
FIG. 11.17
From the dorsal aspect of the great toe to just lateral to the tibialis
oe
anterior and medial to the extensor digitorum longus at the
(eks-ten´sor hal-u´sis lon´gus)
nd IP anterior ankle joint
sion Origin
Innervation
Middle two-thirds of the medial surface of the anterior fibula

Insertion
The four dorsiflexors of the foot—tibialis anterior, extensor
Top of the base of the distal phalanx of the great toe
digitorum longus, extensor hallucis longus, and peroneus
Action tertius—may be exercised by attempting to walk on the heels
Dorsiflexion of the ankle with the ankle flexed dorsally and toes extended. Extension of
Extension of the great toe at the metatarsophalangeal and the great toe, as well as ankle dorsiflexion against resistance,
interphalangeal joints will provide strengthening for this muscle.
Weak inversion of the foot
The extensor hallucis longus may be stretched by passively
verse
taking the great toe into full flexion while the foot is everted and
and
plantarflexed.
ar
ion
Extensor hallucis O, Middle two-thirds

longus m. of medial surface
of anterior fibula
pter
1
Ankle
dorsiflexion
• Extensor hallucis longus muscle, anterior

Toe extension
FIG. 11.17
view, right leg and foot. O, I, Top of base of distal
phalanx of
great toe

Tibialis anterior muscle FIG. 11.18 Application, strengthening, and flexibility

(tib-i-a´lis an-te´ri-or) By its insertion, the tibialis anterior muscle is in a fine position to hold
up the inner margin of the foot. However, as it contracts concentrically, Ankle
Origin
Upper two-thirds of the lateral surface of the tibia it dorsiflexes the ankle and is used as an antago- dorsal
flexion
Insertion nist to the plantar flexors of the ankle. The tibialis anterior is
forced to contract strongly when a person ice skates or walks on
Inner surface of the medial cuneiform and the base of the first
the outside of the foot. It strongly supports the medial
metatarsal bone
longitudinal arch in inversion.
Action
Dorsiflexion of the ankle Turning the sole of the foot to the inside Transverse
Inversion of the foot against resistance to perform inversion exercises tarsal and
is one way to strengthen this muscle. Dorsal flex- subtalar
Palpation
ion exercises against resistance may also be used inversion
First muscle to the lateral side of the anterior tibial border, for this purpose. Walking barefoot or in stocking feet on the
particularly palpable with fully active ankle dorsiflexion; most outside of the foot (inversion) is an excellent exercise for the
prominent tendon crossing the ankle anteromedially tibialis anterior muscle.
The tibialis anterior may be stretched by passively taking the
Innervation foot into extreme eversion and plantar flexion.
O, Upper two-thirds
of lateral surface
of tibia
Tibialis anterior m.
Chapter
11
I, Inner surface of medial
cuneiform,
base of first
Ankle metatarsal bone
dorsiflexion
FIG. 11.18 • Tibialis anterior muscle, anterior

view, right leg and foot. O,
Foot inversion

Tibialis posterior muscle FIG. 11.19 Application, strengthening, and flexibility

(tib-i-a´lis pos-te´ri-or) Passing down the back of the leg, under the medial malleolus,
then forward to the navicular and medial cuneiform bones, the
Origin
tibialis posterior muscle pulls down from the underside and,
Posterior surface of the upper half of the interosseus membrane when contracted concentrically, inverts and plantar flexes the
and adjacent surfaces of the tibia and fibula foot. As a result, it is in position to support the medial
r
n
longitudinal arch. Shin splints is a slang term frequently used to
Insertion describe an often chronic condition in which the tibialis
posterior, tibialis anterior, and extensor digitorum longus
Inferior surfaces of the navicular, cuneiform, and cuboid bones
muscles are inflamed. This inflammation is usually a tendinitis of
and bases of the second, third, and fourth metatarsal bones
one or more of these structures but may be a result of stress
fracture, periostitis, tibial stress syndrome, or compartment
verse Action syndrome. Sprints and long-distance running are common
l and Plantar flexion of the ankle
causes, particularly if the athlete has not developed appropriate
ar
ion Inversion of the foot strength, flexibility, and endurance in the lower-leg musculature.
Palpation
The tendon may be palpated both proximally and distally
immediately behind the medial malleolus with inversion and
plantar flexion and is better distinguished from the flexor digitorum Use of the tibialis posterior muscle in plantar flexion and
longus and flexor hallucis longus if the toes can be maintained in inversion gives support to the longitudinal arch of the foot. This
slight extension muscle is generally strengthened by performing heel raises, as
described for the gastrocnemius and soleus, as well as
Innervation inversion exercises against resistance.

The tibialis posterior may be stretched by passively taking
the foot into extreme eversion and dorsiflexion while the knee
and toes are passively flexed.
I, Inferior surfaces of the navicular,

cuneiform, and
cuboid bones and bases of the
second, third, and fourth
metatarsal bones
pter
1 O, Posterior surface
of upper half of
interosseous
membrane,
adjacent surfaces
of tibia and fibula
FIG. 11.19 • Tibialis

posterior muscle, posterior
and plantar views. O,
Plantar flexion of ankle Origin; I, Insertion.
Foot inversion

Flexor digitorum longus muscle Application, strengthening, and flexibility

FIG. 11.20 Passing down the back of the lower leg under
the medial malleolus and then forward, the flexor 2nd–5th
(fleksór dij-i-to´rum lon´gus)
digitorum longus muscle draws the four lesser MTP, PIP,
Origin toes down into flexion toward the heel as it and DIP
Middle third of the posterior surface of the tibia plantar flexes the ankle. It is very important in flexion
helping other foot muscles maintain the longitudinal arch. Some
Insertion
of the weak foot and ankle conditions result from ineffective use
Base of the distal phalanx of each of the four lesser toes
of the flexor
digitorum longus. Walking barefoot with the toes Transverse
Action curled downward toward the heel and with the tarsal and
Flexion of the four lesser toes at the metatarsophalangeal and the foot inverted will exercise this muscle. It may be subtalar
proximal and distal interphalangeal joints strengthened by performing towel grabs against inversion
resistance in which the heel rests on the floor while the toes
Inversion of the foot extend to grab a flat towel and then flex to pull the towel under
Plantar flexion of the ankle the foot. This may be repeated numerous times, with a small
weight placed on the opposite end of the towel for added
Palpation
resistance.
The tendon may be palpated immediately posterior to the medial
malleolus and tibialis posterior and immediately anterior to the The flexor digitorum longus may be stretched Ankle
plantar
flexor hallucis longus with flexion of the four lesser toes while by passively taking the four lesser toes into flexion
maintaining great toe extension, ankle dorsiflexion, and foot extreme extension while the foot is everted and
eversion dorsiflexed. The knee should be flexed.
Innervation
Flexor digitorum longus m.
I, Base of distal
phalanx of each
of the four lesser toes
O, Middle third Chapter

of posterior
surface of tibia
11
Toe
flexion
FIG. 11.20 • Flexor digitorum longus

muscle, posterior and
plantar views. O, Origin; I,
Plantar flexion of ankle Insertion.
Foot inversion

Flexor hallucis longus muscle FIG. 11.21 of the flexor digitorum longus muscle or together with it. If these
two muscles are poorly developed, they cramp easily when they
(fleksór hal-u´sis lon´gus)
are called on to do activities to which they are unaccustomed.
toe Origin
and
xion Middle two-thirds of the posterior surface of the fibula These muscles are used effectively in walking if the toes are
used (as they should be) in maintaining balance as each step is
Insertion
taken. Walking “with the toes” rather than “over” them is an
Base of the distal phalanx of the great toe, plantar surface
important action for them.
verse Action
When the gastrocnemius, soleus, tibialis posterior, peroneus
and
Flexion of the great toe at the metatarsophalangeal and longus, peroneus brevis, flexor digitorum longus, flexor
ar
ion interphalangeal joints digitorum brevis, and flexor hallucis longus muscles are all used
Inversion of the foot effectively in walking, the strength of the ankle is evident. If an
Plantar flexion of the ankle ankle and a foot are weak, in most cases it is because of lack of
use of all the muscles just mentioned. Running, walking,
Palpation jumping, hopping, and skipping provide exercise for this muscle
Most posterior of the three tendons immediately behind the medial group. The flexor hallucis longus muscle may be specifically
malleolus; between the medial soleus and the tibia with active strengthened by performing towel grabs as described for the
great toe flexion while maintaining extension of the four lesser flexor digitorum longus muscle.
r toes, ankle dorsiflexion, and foot eversion
n
The flexor hallucis longus may be stretched by passively

Innervation
taking the great toe into extreme extension while the foot is
Tibial nerve (L5, S1, S2)
everted and dorsiflexed. The knee should be flexed.
Pulling from the underside of the great toe, the flexor hallucis
longus muscle may work independently
O, Middle two-thirds
of posterior
surface of fibula
pter Flexor hallucis longus m.
1
of great
toe, plantar surface
FIG. 11.21 • Flexor hallucis longus

muscle, medial
Plantar flexion of ankle
view, right leg and foot. O, Origin;
I, Insertion. Toe flexion
Foot inversion

Intrinsic muscles of the foot phalange. Because of these two muscles’ insertion and action
on the fifth toe, the name “quinti” is sometimes used instead of
FIGS. 11.22, 11.23
“minimi.”
The intrinsic muscles of the foot have their origins and Four muscles act on the great toe. The abductor hallucis is
insertions on the bones within the foot (Figs. 11.22 and 11.23). solely responsible for abduction of the great toe but assists the
One of these muscles, the extensor digitorum brevis, is found flexor hallucis brevis in flexing the great toe at the
on the dorsum of the foot. This muscle includes a band that metatarsophalangeal joint. The adductor hallucis is the sole
attaches to the base of the first proximal phalanx and is adductor of the great toe, while the extensor digitorum brevis is
sometimes labeled the extensor hallucis brevis. The remainder the only intrinsic extensor of the great toe at the
of the muscles are found in a plantar compartment in four layers metatarsophalangeal joint.
on the plantar surface of the foot, as follows:
The four lumbricals are flexors of the second, third, fourth,
and fifth phalanges at their metatarsophalangeal joints, while
the quadratus plantae muscles are flexors of these phalanges at
First (superficial) layer: abductor hallucis, flexor digitorum brevis,
their distal interphalangeal joints. The three plantar interossei
abductor digiti minimi (quinti)
are adductors and flexors of the proximal phalanxes of the third,
Second layer: quadratus plantae, lumbricals (four)
fourth, and fifth phalanges, while the four dorsal interossei are
Third layer: flexor hallucis brevis, adductor hallucis, flexor digiti
abductors and flexors of the second, third, and fourth
minimi (quinti) brevis
phalanges, also at their metatarsophalangeal joints. The flexor
Fourth (deep) layer: dorsal interossei (four), plantar interossei
digitorum brevis flexes the middle phalanxes of the second,
(three)
third, fourth, and fifth phalanges. The extensor digitorum brevis,
The intrinsic foot muscles may be grouped by location as as previously mentioned, is an extensor of the great toe but also
well as by the parts of the foot on which they act. The abductor extends the second, third, and fourth phalanges at their
hallucis, flexor hallucis brevis, and adductor hallucis all insert metatarsophalangeal joints.
either medially or laterally on the proximal phalanx of the great
toe. The abductor hallucis and flexor hallucis brevis are located
somewhat medially, whereas the adductor hallucis is more
centrally located beneath the metatarsals. There are two muscles that act solely on the fifth toe. The
proximal phalanx of the fifth phalange is abducted by the
abductor digiti minimi and is flexed by the flexor digiti minimi
The quadratus plantae, four lumbricals, four dorsal brevis.
interossei, three plantar interossei, flexor digitorum brevis, and Refer to Table 11.2 for further details regarding the intrinsic
extensor digitorum brevis are all located somewhat centrally. All muscles of the foot.
are beneath the foot except the extensor digitorum brevis, which Muscles are developed and maintain their strength only
is the only intrinsic muscle in the foot located in the dorsal when they are used. One factor in the great increase in weak
compartment. Although the entire extensor digitorum brevis has foot conditions is the lack of exercise to develop these muscles.
its origin on the anterior and lateral calcaneus, some anatomists Walking is one of the best activities for maintaining and
refer to its first tendon as the extensor hallucis brevis in order to developing the many small muscles that help support the arch
maintain consistency in naming according to function and of the foot. Some authorities advocate walking without shoes or
location. with shoes
designed to enhance proper mechanics. Addition- Chapter

ally, towel exercises such as those described for
11
Located laterally beneath the foot are the abductor digiti
minimi and the flexor digiti minimi brevis, which both insert on the flexor digitorum longus and flexor hallucis
the lateral aspect of the base of the proximal phalanx of the fifth longus are helpful in strengthening the intrinsic
muscles of the foot.

A B
toe
Fibrous
and
digital Tendons of flexor
xion
sheaths digitorum brevis Tendon of
(cut) flexor
hallucis
Tendon of longus
flexor hallucis
th Lumbricals longus Flexor hallucis
PIP, brevis
IP Flexor hallucis
Lumbricals
n brevis
Flexor digiti
minimi brevis Flexor digiti Tendon of
minimi brevis flexor digitorum
Abductor
longus
digiti minimi Flexor digitorum
brevis Quadratus
Plantar plantae
interosseous Abductor
hallucis Abductor
digiti minimi
Flexor digitorum
Plantar
brevis (cut)
aponeurosis (cut)
Abductor
Calcaneal hallucis (cut)
tuberosity
Plantar
C D
ligaments
Articular
Tendon of capsules
lumbrical (cut)
Tendon of
flexor digitorum
brevis (cut) Tendons of flexor Sesamoid
digitorum longus bones
(cut)
Transverse head
Plantar and
Dorsal
interossei Oblique head of
interossei
adductor hallucis
Flexor hallucis Plantar
brevis interossei
Opponens
digiti Tendon of
minimi peroneus
longus
Tendon of flexor
hallucis longus (cut) Tendon of
tibialis
Quadratus posterior
Tendon of flexor
plantae digitorum longus
pter
(cut) (cut) Long plantar
1
ligament
Peroneus
brevis
tendon
FIG. 11.22 • The four musculotendinous layers of the plantar aspect of the right foot, detailing the intrinsic muscles. A, First (superficial)
layer; B, Second layer; C, Third layer; D, Fourth (deep) layer.

Anterior tibial artery and deep

fibular nerve
Superior extensor
retinaculum Great toe
Tendon of tibialis anterior Medial MTP and IP
Peroneus tertius
malleolus extension
Tendon of extensor
digitorum longus Anterior medial malleolar artery
Lateral malleolus
Tendon of extensor hallucis longus
Inferior extensor
retinaculum
Dorsalis pedis artery
Extensor digitorum
Deep fibular nerve
brevis
Extensor hallucis brevis

Tendon of peroneus
brevis
Tuberosity of fifth
metatarsal bone
Arcuate artery
Tendon of peroneus tertius
Abductor hallucis
Abductor digiti minimi
Tendons of extensor First dorsal interosseous

digitorum brevis
Tendons of extensor Tendon of extensor hallucis brevis

digitorum longus
Extensor expansions
Dorsal digital arteries
Dorsal digital branches of

superficial fibular nerve
FIG. 11.23 • Anterior view of dorsum of right foot. Creek
TABLE 11.2 • Intrinsic muscles of the foot
Tuberosity of Medial and lateral aspects of MP and PIP Cannot be Medial plantar
Flexor calcaneus, plantar 2nd, 3rd, 4th, and 5th middle flexion of palpated nerve (L4, L5)
digitorum aponeurosis phalanxes 2nd, 3rd,
brevis 4th, and 5th
phalanges Chapter
Abductor
digiti minimi
Tuberosity of
calcaneus, plantar
Lateral aspect of 5th
proximal phalanx
MP abduc-
tion of 5th
Cannot be
palpated
Lateral plantar
11
Superficial layer
nerve (S1, S2)

(quinti) aponeurosis phalange
Tuberosity of Medial aspect of base of 1st MP flexion, On the plantar Medial plantar
calcaneus, flexor proximal phalanx abduction of aspect of the foot from nerve (L4, L5)
retinaculum, 1st phalange medial tuber-
Abductor plantar aponeurosis cle of calcaneus
hallucis to medial side of great
toe proximal
phalanx with great
toe abduction

TABLE 11.2 (continued) • Intrinsic muscles of the foot
Medial head: Lateral margin of flexor DIP flexion Cannot be Lateral plantar
medial surface digitorum longus tendon of 2nd, 3rd, palpated nerve (S1, S2)
of calcaneus 4th, and 5th
Quadratus
Lateral head: phalanges
plantae
lateral border
of inferior surface
Second layer
of calcaneus
Tendons of flexor Dorsal surface of 2nd, 3rd, 4th, MP flexion Cannot be 1st lumbricals:
digitorum longus and 5th proximal phalanxes of 2nd, 3rd, palpated medial plantar
4th, and 5th nerve (L4, L5)
Lumbricals
phalanges 2nd, 3rd, 4th
(4)
lumbricals:
lateral plantar
nerve (S1, S2)
Oblique head: 2nd, Lateral aspect of base of 1st MP adduc- Cannot be Lateral plantar
3rd, and 4th proximal phalanx tion of 1st palpated nerve (S1, S2)
metatarsals and sheath phalange
of peroneus longus
tendon
Transverse head:
Adductor
plantar metatarso-
hallucis
phalangeal liga-
ments of 3rd, 4th, and
5th phalan-
ges and trans-
Third layer
verse metatarsal
ligaments
Cuboid, lateral Medial head: medial MP flexion of Cannot be Medial plantar

Flexor cuneiform aspect of 1st proximal 1st phalange palpated nerve
hallucis phalanx (L4, L5, S1)
brevis Lateral head: lateral aspect of 1st

proximal phalanx
Flexor Base of 5th Lateral aspect of base of 5th MP flexion of Cannot be Lateral plantar
digiti minimi metatarsal, sheath of proximal phalanx 5th phalange palpated nerve (S2, S3)
(quinti) peroneus longus
brevis tendon
Bases and medial Medial aspects of bases of 3rd, MP adduction Cannot be Lateral plantar
Plantar shafts of 3rd, 4th, and 4th, and 5th proximal phalanxes and flexion palpated nerve (S1, S2)
Fourth layer
pter interossei 5th metatarsals of 3rd, 4th,
1
(3) and 5th
phalanges

TABLE 11.2 (continued) • Intrinsic muscles of the foot
Two heads on 1st interosseus: medial MP abduction Cannot be Lateral plantar

shafts of adjacent aspect of 2nd proximal and flexion of palpated nerve (S1, S2)
metatarsals phalanx 2nd, 3rd, and
Dorsal
2nd, 3rd, and 4th interossei: 4th phalanges
interossei (4)
lateral aspects of 2nd, 3rd, and
4th proximal phalanxes
Fourth layer
Anterior and lat- Base of proximal phalanx of 1st Assists in MP As a mass anterior Deep peroneal to and
Extensor dig-
eral calcaneus, phalange, lateral extension of slightly nerve (L5, S1)
itorum brevis
lateral talocalcaneal sides of extensor digitorum 1st phalange ligament, inferior below lateral
(including
longus tendons of 2nd, and extension malleolus on dor-
extensor hal-
extensor retinaculum 3rd, and 4th phalanges of middle three sum of foot
lucis brevis)
phalanges
REVIEW EXERCISES 3. Discuss the value of proper footwear in various sports and
activities.
4. What are orthotics and how do they function? Research
5. common foot and ankle disorders, such as flat feet, lateral
ankle sprains, high ankle sprains, bunions, plantar fasciitis,
plane.
and hammertoes. Report your findings in class.
a. Plantar flexion
b. Dorsiflexion
6. Research the anatomical factors related to the prevalence
c. Inversion
of inversion versus eversion ankle sprains and report your
d. Eversion
findings in class.
e. Flexion of the toes
7. Report orally or in writing on magazine articles that rate
f. Extension of the toes
running and walking shoes.
2. Why are “low arches” and “flat feet” not synonymous terms?
8. Muscle analysis chart • Ankle, transverse tarsal and subtalar joints, and toes
Ankle
Dorsiflexion Plantar flexion

Chapter
11
Transverse tarsal and subtalar joints
Eversion Inversion
Toes
Flexion Extension

9. Grafik aksi otot antagonis • Pergelangan kaki, sendi tarsal dan subtalar melintang, dan jari kaki
Lengkapi grafik dengan mendaftar otot atau bagian otot yang antagonis dalam tindakannya ke otot di kolom kiri.
Agonis Antagonis
Gastrocnemius
Soleus
Tibialis posterior
Fleksor digitorum longus
Peroneus longus / Peroneus brevis
Peroneus tertius
Ekstensor digitorum longus
Ekstensor hallucis longus
LATIHAN LABORATORIUM h. Fleksor digitorum longus

saya. Flexor hallucis longus
j. Tibialis posterior
1. Temukan landmark tulang pergelangan kaki dan kaki berikut
3. Peragakan dan palpasi itu berikut
pada kerangka manusia dan pada subjek:
gerakan:
Sebuah. Plantar fl exion dari pergelangan kaki
Sebuah. Maleolus lateral
b. Dorsi fl exion pada pergelangan kaki
b. Maleolus medial
c. Pembalikan kaki
c. Calcaneus
d. Eversi kaki
d. Navicular
e. Fleksi jari kaki
e. Tiga tulang paku
f. Perpanjangan jari-jari kaki
f. Tulang metatarsal
4. Minta rekan laboratorium untuk berdiri di atas jari kaki
g. Falang dan phalanx individu
(mengangkat tumit) dengan lutut terentang penuh dan
kemudian ulangi dengan lutut terangkat kira-kira 20 derajat.
subjek manusia?
Posisi latihan mana yang tampaknya lebih sulit
Sebuah. Tibialis anterior
dipertahankan untuk jangka waktu yang lama dan
b. Ekstensor digitorum longus
mengapa? Apa implikasinya untuk memperkuat otot-otot ini?
c. Peroneus longus
Untuk meregangkan otot-otot ini?
d. Peroneus brevis
e. Soleus
1 f. Gastrocnemius
g. Ekstensor hallucis longus
5. Grafik analisis gerakan latihan pergelangan kaki dan kaki
Setelah menganalisis setiap latihan di bagan, bagi masing-masing latihan menjadi dua fase gerakan utama, seperti fase mengangkat dan fase menurunkan. Untuk setiap
fase, tentukan apa yang terjadi pada gerakan sendi pergelangan kaki dan kaki, dan kemudian buat daftar otot-otot sendi pergelangan kaki dan kaki yang terutama
bertanggung jawab untuk menyebabkan / mengendalikan gerakan tersebut. Di samping setiap otot di setiap gerakan, tunjukkan jenis kontraksi sebagai berikut: I —
isometrik; C — konsentris; E — eksentrik.

Push-up
Berjongkok
Angkat mati
Kereta luncur pinggul
Ke depan terjang
Olahraga dayung
Mesin tangga
6. Bagan analisis keterampilan olahraga sendi pergelangan kaki dan kaki
Analisis setiap keterampilan dalam bagan, dan buat daftar gerakan pergelangan kaki kanan dan kiri serta sendi kaki di setiap fase keterampilan. Anda
mungkin lebih suka mencantumkan posisi awal sendi pergelangan kaki dan kaki untuk fase berdiri. Setelah setiap gerakan, buat daftar otot-otot sendi
pergelangan kaki dan kaki yang terutama bertanggung jawab untuk menyebabkan / mengendalikan gerakan. Di samping setiap otot di setiap gerakan,
tunjukkan jenis kontraksi sebagai berikut: I — isometrik; C — konsentris; E — eksentrik. Mungkin diinginkan untuk meninjau konsep analisis di Bab 8 untuk
berbagai tahap. Asumsikan tangan / kaki kanan dominan jika memungkinkan.
(R)
Baseball
nada
(L)
(R)
Sepak bola
menyepak bola
(L)
(R)
Berjalan
(L)
(R)
Lapangan sofbol
(L)
Bab
(R)
Sepak bola
lulus
(L) 11
(R)
Memukul
(L)
(R)
Bowling
(L)
(R)
Bola basket
tembakan melompat
(L)

Referensi Prentice KAMI: Prinsip pelatihan atletik: berbasis kompetensi

pendekatan, ed 15, New York, 2014, McGraw-Hill.
Rockar PA: Sendi subtalar: anatomi dan gerakan sendi, Jurnal dari
Astrom M, Arvidson T: Keselarasan dan gerakan sendi dalam keadaan normal Terapi Fisik Ortopedi dan Olahraga 21: 6, Juni 1995.
kaki, Jurnal Terapi Fisik Ortopedi dan Olahraga 22: 5, November 1995.
Saladin KS: Anatomi & fisiologi: kesatuan bentuk dan fungsi, ed
5, New York, 2010, McGraw-Hill.
Booher JM, Thibodeau GA: Penilaian cedera atletik, ed 4, Baru
Sammarco GJ: Cedera kaki dan pergelangan kaki dalam olahraga, Jurnal Amerika
Obat olahraga 14: 6, November – Desember 1986.
Bidang D: Anatomi: palpasi dan tanda permukaan, ed 3, Oxford,
Seeley RR, Stephens TD, Tate P: Anatomi & fisiologi, ed 8, Baru
2001, Butterworth-Heinemann.
Gench BE, Hinson MM, Harvey PT: Kinesiologi anatomi,
Dubuque, IA, 1995, Eddie Bowers.
Hamilton N, Weimer W, Luttgens K: Kinesiologi: dasar ilmiah dari
Batu RJ, Batu JA: Atlas otot rangka, ed 6, New York,
gerak manusia, ed 12, New York, 2012, McGraw-Hill.
2009, McGraw-Hill.
Hislop HJ, Montgomery J: Tes otot Daniels dan Worthingham:
Thibodeau GA, Patton KT: Anatomi & fisiologi, ed 9, St. Louis,
1993, Mosby.
Lindsay DT: Anatomi manusia fungsional, St. Louis, 1996, Mosby.
Magee DJ: Penilaian fisik ortopedi, ed 5, Philadelphia, 2008, McGraw-Hill.
Saunders.
Muscolino JE: Manual sistem otot: otot rangka dari

Oatis CA: Kinesiologi: mekanika dan patomekanika manusia Untuk sumber daya tambahan dan daftar situs web terkait,
gerakan, ed 2, Philadelphia, 2008, Lippincott Williams & Wilkins. kunjungi www.mhhe.com/floyd19e.


Lembar Kerja 1
Dengan menggunakan krayon atau spidol berwarna, gambar dan beri label pada lembar kerja otot-otot berikut. Tunjukkan asal dan penyisipan masing-masing otot
dengan "O" dan "I," masing-masing, dan gambarkan asal dan penyisipan pada tampilan anterior atau posterior sebagaimana berlaku.
Sebuah. Tibialis anterior e. Peroneus tertius saya. Tibialis posterior
b. Ekstensor digitorum longus f. Soleus j. Fleksor digitorum longus
c. Peroneus longus g. Gastrocnemius k. Flexor hallucis longus
d. Peroneus brevis h. Ekstensor hallucis longus
Bab
11


Lembar Kerja 2
Beri label dan tunjukkan dengan panah gerakan sendi talokrural, tarsal transversal, dan subtalar berikut ini. Untuk setiap gerakan, selesaikan kalimat
dengan memasok bidang tempat gerakan itu terjadi dan sumbu rotasi serta otot-otot yang menyebabkan gerakan tersebut.
Sebuah. Dorsi fl exion terjadi pada bidang _______________________________ sekitar sumbu ______________________________ dan dicapai dengan
kontraksi konsentris dari otot _________________________________________________
______________________________________________________________________________________________________.
b. Plantar fl exion terjadi di bidang _________________________________ di sekitar sumbu __________________________ dan dicapai dengan
kontraksi konsentris dari otot _______________________________________________
______________________________________________________________________________________________.
c. Eversi terjadi pada bidang _____________________________ di sekitar sumbu ___________________________ dan dilakukan dengan
kontraksi konsentris otot _______________________________________________________
_______________________________________________________________________________________________.
d. Pembalikan terjadi pada bidang _______________________________ di sekitar sumbu _________________________________ dan dilakukan
dengan kontraksi konsentris dari otot _______________________________________________
________________________________________________________________________________________________.
SEBUAH B
C D

C HAPTER 12
T DIA T JALANKAN DAN
S PINAL C OLUMN
Tujuan
j Untuk mengidentifikasi dan membedakan berbagai jenis vertebra
T Batang dan tulang
dalam kinesiologi belakang
yang menyajikan
tidak ditemukan dalammasalah
penelitian
dari bagian tubuh lainnya. Kolom vertebral cukup rumit, terdiri dari
di kolom tulang belakang 24 vertebra artikulasi dengan tambahan 9 vertebra yang tidak dapat
digerakkan. Vertebra ini berisi kolom tulang belakang, dengan 31
j Untuk memberi label pada bagan kerangka jenis-jenis
pasang saraf tulang belakangnya. Sebagian besar akan setuju
vertebra dan ciri-ciri pentingnya
bahwa itu adalah salah satu bagian tubuh manusia yang lebih
j Untuk menggambar dan memberi label pada bagan kerangka kompleks.
beberapa otot batang dan tulang belakang
Bagian anterior batang berisi otot perut, yang agak berbeda
j Untuk mendemonstrasikan dan meraba dengan sesama siswa
dari otot lain di mana beberapa bagian dihubungkan oleh fasia
gerakan tulang belakang dan batang dan membuat daftar bidang
dan pita tendon sehingga tidak melekat dari tulang ke tulang.
gerak masing-masing dan sumbu rotasi
Selain itu, ada banyak otot intrinsik kecil yang bekerja di kepala,
tulang belakang, dan dada yang membantu stabilisasi atau
j Untuk meraba pada subjek manusia beberapa otot respirasi tulang belakang, tergantung lokasinya. Otot-otot ini
batang dan tulang belakang umumnya terlalu dalam untuk diraba dan akibatnya tidak akan
mendapatkan perhatian penuh seperti yang diterima otot
j Untuk membuat daftar dan mengatur otot yang menghasilkan superfisial yang lebih besar dalam bab ini.
gerakan utama batang dan tulang belakang serta
antagonisnya
j Untuk menentukan, melalui analisis, gerakan dan otot batang dan

tulang belakang yang terlibat dalam keterampilan dan latihan yang
dipilih
Tulang
Kolom vertebral
Struktur tulang yang rumit dan kompleks dari kolom vertebral
Sumber Daya Pusat Pembelajaran Online terdiri dari 24 ver-
tebrae (dapat digerakkan secara bebas) dan 9 yang menyatu Bab
(Gambar 12.1). Kolom ini selanjutnya dibagi menjadi
12
fl oyd19e untuk informasi tambahan dan bahan pelajaran untuk bab ini, 7 vertebra serviks (leher), 12 toraks (dada)
termasuk:
vertebrae, dan 5 vertebra lumbar (punggung bawah). Sakrum (korset
j Kuis penilaian mandiri panggul posterior) dan tulang ekor (ekor) masing-masing terdiri dari
j Kartu anatomi 5 dan 4 tulang belakang yang menyatu.
j Animasi
j Situs web terkait

Vertebra serviks pertama masing-masing. Vertebrae C3 hingga L5 memiliki arsitektur yang mirip:
(atlas) masing-masing memiliki blok tulang di anterior, yang dikenal sebagai tubuh,
Serviks Vertebra serviks kedua foramen vertebra yang berada di tengah untuk dilewati sumsum tulang
wilayah (sumbu)
belakang, proses transversal yang memproyeksikan secara lateral ke setiap
(cembung
anterior) Ruas sisi, dan proses spinosus yang memproyeksikan ke posterior dengan
prominens
mudah. jelas.
Serviks ketujuh
ruas
Dada pertama
Tulang belakang memiliki tiga kurva normal di dalam vertebra
ruas yang dapat digerakkan. Kurva tulang belakang primer sebelum
kelahiran dan singkat setelahnya berbentuk kifotik, atau berbentuk
C. Ketika perkembangan otot terjadi dan aktivitas meningkat,
Thoracic kurva sekunder, yang bersifat lordotik, berkembang di daerah
wilayah Sisi tulang rusuk
(cekung
serviks dan lumbar. Kurva toraks cekung di anterior dan cembung
anterior) di posterior, sedangkan kurva serviks dan lumbal cembung di
Intervertebral anterior dan cekung di posterior. Akhirnya, kurva sakralis,
foramina termasuk tulang ekor, cekung di anterior dan di posterior
cembung. Lekuk tulang belakang yang normal memungkinkannya
Tubuh menyerap pukulan dan guncangan.
Diskus intervertebralis
Depan Belakang
Keduabelas Penyimpangan yang tidak diinginkan dari kelengkungan normal
vertebra toraks
terjadi karena sejumlah faktor. Konkavitas posterior yang
Lumbar pertama
meningkat dari lumbar dan kurva serviks dikenal sebagai lordosis , dan
ruas
peningkatan cekung anterior dari kurva toraks normal dikenal
Pinggang sebagai kifosis . Tulang belakang lumbal mungkin mengalami
wilayah
(cembung Proses melintang pengurangan kurva lordotik normalnya, menghasilkan tampilan
anterior) punggung tegak yang disebut sebagai kifosis lumbal . Skoliosis terdiri
Proses berputar
dari lengkungan lateral atau deviasi ke samping tulang belakang.
Vertebra lumbal kelima
Tanjung sakral
Thorax
Fondasi kerangka dada dibentuk oleh 12 pasang tulang rusuk (Gbr.
12.3). Tujuh pasang adalah tulang rusuk sejati, karena mereka
Sakral dan Tulang kelangkang
menempel langsung ke tulang dada melalui tulang rawan kosta yang
tulang ekor
daerah terpisah. Lima pasang dianggap tulang rusuk palsu. Dari jumlah
(cekung tersebut, tiga pasang menempel secara tidak langsung ke tulang
anterior)
dada melalui tulang rawan kosta bersama dan dua pasang tulang
Tulang sulbi
rusuk mengambang, dengan ujung bebas. Manubrium, tubuh
sternum, dan proses xiphoid adalah tulang dada lainnya. Semua
FIG. 12.1 • Complete vertebral column, left lateral view.
tulang rusuk menempel di posterior vertebra toraks.
The first two cervical vertebrae are unique in that their Penanda tulang kunci untuk menemukan otot leher
shapes allow for extensive rotary movement of the head to the termasuk proses mastoid, proses transversal dan spinosus
sides, as well as movement forward and backward. The bones tulang belakang leher, proses spinosus dari empat vertebra
pter
in each region of the spine have slightly different sizes and toraks atas, manubrium sternum, dan klavikula medial. Proses
2 shapes to allow for various functions (Fig. 12.2). The vertebrae

increase in size from the cervical region to the lumbar region,
spinosus dan transversal dari tulang belakang dada dan tulang
rusuk posterior adalah area kunci perlekatan untuk otot
primarily because they have to support more weight in the lower posterior tulang belakang. Otot batang anterior memiliki
back than in the neck. The first two cervical vertebrae are perlekatan di perbatasan delapan tulang rusuk bawah, tulang
known as the atlas and the axis, rawan kosta tulang rusuk, puncak iliaka, dan

Posterior arch Spinous process

Transverse (bifid)
process
Vertebral foramen
Superior articular Transverse Posterior arch

facet (articulates process
with occipital condyle) Vertebral foramen
Facet for dens Transverse
Transverse foramen Body Superior articular
Anterior arch
foramen facet
Dens
A
B
Vertebral
Spinous
foramen Superior articular facet
process
Superior Lamina
Transverse
articular
process
facet Spinous process
Body
Transverse
foramen
Transverse
foramen
Inferior articular facet

C Body D
Spinous process
Transverse proce ss
Superior costal facet
Superior articular
Lamina
facet
Transverse
costal
facet Transverse
process
Superior
Vertebral
articular Transverse
foramen Body
facet costal process
Superior Spinous
costal process
facet
Body
Inferior
E F costal facet
Vertebral Spine
Lamina Superior articular
foramen
Superior articular process
process
Transverse Transverse
process process
Body Body
Inferior articular Chapter
12
Spine process
G
H
FIG. 12.2 • Vertebral column. A, Atlas (first cervical vertebra), superior view; B, Axis (second cervical vertebra), superior view; C, Typical
cervical vertebra, superior view; D, Typical cervical vertebra, lateral
view; E, Typical thoracic vertebra, superior view; F, Typical thoracic vertebra, lateral view; G, Third lumbar vertebra, superior view; H, Third
lumbar vertebra, lateral view.

Neck
Head
Spinous process
Facet
Tubercle
Shaft Tubercle
Anterior
end
Costal groove Neck

Head
A
Facet
FIG. 12.3 • Thorax. A, Typical left rib (posterior
view); B, Articulations of a left
rib with a thoracic vertebra (superior view);
C, Thoracic cage, including the thoracic vertebrae,
the sternum, the ribs, and the costal cartilages that Shaft
attach the ribs to the sternum.
Anterior end
(sternal end)
B
Sternal notch
Sternal angle Thoracic vertebra
Clavicular notch
1
2
Manubrium
3
True ribs 4 Body

(vertebrosternal Sternum
ribs)
5
6
Xiphoid
process
7
Ribs
pter False
2
9
Costal
ribs (vertebrochondral cartilage
ribs)
10
11
Floating ribs 12
(vertebral ribs)

the pubic crest. The transverse processes of the upper four classified as arthrodial or gliding-type joints because of their
lumbar vertebrae also serve as points of insertion for the limited, gliding movements.
quadratus lumborum, along with the lower border of the twelfth As shown in Fig 12.4, B and D, the anterior longitudinal
rib. ligament runs the entire length of the spine from the base of the
skull to the sacrum and attaches to the anterior surface of each
vertebral body. The posterior longitudinal ligament is located
Joints
inside the vertebral canal, attaching on the posterior vertebral
The first joint in the axial skeleton is the atlantooccipital joint, bodies, and runs from the axis to the sacrum. The ligamentum
formed by the occipital condyles of the skull sitting on the flavum binds the laminae of adjacent vertebrae together. The
articular fossa of the first vertebra, which allows capital flexion interspinous ligaments connect the spinous processes, and the
and extension or flexion and extension of the head on the neck. intertransverse ligaments connect the transverse processes.
Although this is a separate articulation, its movements are often The ligamentum nuchae connects the tips of the cervical
grouped with those of the cervical spine. The atlas (C1) in turn spinous processes
sits on the axis (C2) to form the atlantoaxial joint (Fig. 12.4, A). Except
for the atlantoaxial joint, there is not a great deal of movement
possible between any two vertebrae. However, the cumulative
Lamina
effect of combining the movement from several adjacent
Anterior Spinous
vertebrae allows for substantial movements within a given area. longitudinal process
Most of the rotation within the cervical region occurs in the ligament
Interspinal
atlantoaxial joint, which is classified as a trochoid or pivot-type Body of ligament
joint. The remainder of the vertebral articulations are vertebra
Supraspinal
Intervertebral ligament
disk Intervertebral
foramen
Posterior
longitudinal
Atlas
ligament
Ligamentum flavum
B
Annulus
fibrosus
Facet of Nucleus
Axis
superior articular pulposus
Articular process
facets Intervertebral
Posterior
disk
longitudinal
ligament
A
Inferior articular
process
Superior articular
Interspinous
Inferior process
Loose joint capsule ligament
articular Synovial cavity
process
Articular cartilages
Supraspinous
ligament
Superior
articular Anterior
process longitudinal
Ligamentum
ligament
flavum
C Articular cartilages slide.
D Chapter
FIG. 12.4 • Articular facets of the vertebrae. A, The facets of the superior and inferior articular processes articulate between adjacent 12
cervical vertebrae; B, Ligaments limit motion between vertebrae, shown in
sagittal section through three lumbar vertebrae; C, Articular cartilages slide back and forth on each other, a motion allowed by the loose
articular capsule; D, Intervertebral articulations. Vertebrae articulate with adjacent vertebrae at both their superior and inferior articular
processes. Intervertebral disks separate the bodies of adjacent vertebrae.

from the occipital protuberance to all seven cervical vertebrae, spinal nerve root, causing a variety of symptoms, including
and the supraspinous ligament connects the tips of the spinous radiating pain, tingling, numbness, and weakness in the
processes of the remaining vertebrae. dermatomes and myotomes of the extremity supplied by the
spinal nerve (Fig. 12.5).
Gliding movement occurs between the superior and inferior A substantial number of low back problems are caused by
articular processes that form the facet joints of the vertebrae, as improper use of the back over time. These improper mechanics
depicted in Figs. 12.2 and often result in acute strains and muscle spasm of the lumbar
12.4, C and D. Located in between and adhering to the articular extensors and chronic mechanical changes leading to disk
cartilage of the vertebral bodies are the intervertebral disks (Fig. herniation. Most problems occur from using the relatively small
12.4, B ). These disks are composed of an outer rim of dense back muscles to lift objects from a lumbar spine flexed position
fibrocartilage known as the annulus fibrosus and a central instead of keeping the lumbar spine in a neutral position while
gelatinous, pulpy substance known as the nucleus pulposus squatting and using the larger, more powerful muscles of the
(Fig. 12.4, D ). This arrangement of compressed elastic material lower extremity. Additionally, our lifestyles chronically place us
allows compression in all directions, along with torsion. With in lumbar flexion, which over time leads to a gradual loss of
age, injury, or improper use of the spine, the intervertebral disks lumbar lordosis. This flat-back syndrome results in increased
become less resilient, resulting in a weakened annulus fibrosus. pressure on the lumbar disk and intermittent or chronic low back
Substantial weakening combined with compression can result in pain.
the nucleus protruding through the annulus, known as a
herniated nucleus pulposus. Commonly referred to as a
herniated or “slipped” disk, this protrusion puts pressure on the
Most of the spinal column movement occurs in the cervical
and lumbar regions. There is, of course, some thoracic
movement, but it is slight in comparison with that of the neck
and low back. In discussing movements of the head, it must be
Blood vessels remembered that this movement occurs between the cranium
and the first cervical vertebra, as well as within the cervical
Vertebral body vertebrae. With the
Nucleus
pulposus Intervertebral
Annulus disk
fibrosus
Pressure
(body weight)
Vertebral
spine Pressure
on spinal
Cavity for cord and
spinal cord nerve root
A
Herniated
disk
Spinous process
Transverse process
Compressed
Spinal cord spinal nerve root in
in vertebral intervertebral foramen
canal
Herniated
portion of disk B
pter
2
Nucleus pulposus Intervertebral
Annulus fibrosus disk
C Superior view
FIG. 12.5 • Intervertebral disks. A, Sagittal section of normal disks; B, Sagittal section of herniated disks;
C, Herniated disk, superior view.

understanding that these motions usually occur together, for The cervical region (Fig. 12.6) can flex 45 degrees and
simplification purposes this text refers to all movements of the extend 45 degrees. The cervical area laterally flexes 45 degrees
head and neck as cervical movements. Similarly, in discussing and can rotate approximately 60 degrees. The lumbar spine,
trunk movements, lumbar motion terminology is used to accounting for most of the trunk movement (Fig. 12.7), flexes
describe the combined motion that occurs in both the thoracic approximately 80 degrees and extends 20 to 30 degrees.
and the lumbar regions. A closer investigation of specific motion Lumbar lateral flexion to each side is usually within 35 degrees,
between any two vertebrae is beyond the scope of this text. and approximately 45 degrees of rotation occurs to the left and
right.
A Neutral B Neutral C Neutral

0° 0° 0°
45° 45° 45°

45°
60° 60°
90° 90°
90° 90° 90° 90°
FIG. 12.6 • Active ROM of the cervical spine. A, Flexion and extension can be estimated in degrees or indicated by the distance the
chin lacks from touching the chest; B, Rotation can be estimated in degrees
or percentages of motion compared in each direction; C, Lateral flexion can be estimated in degrees or indicated by the distance the
ear lacks from reaching the shoulders.
08
0 C7 0
4 4
8 8
12 12
1
16 16 16 12 8 4 0
20
20 8 S1 20 8 24 C7
S1
A B Flexion C
90 8
08 35 8 35 8
30 8
08
Neutral
45 8
90 8
90 8
Neutral 0 8 8 0 Neutral
08
Neutral
45 8 45 8
Extension Lateral bending Rotation

Chapter
D E F G
FIG. 12.7 • Active ROM of the thoracic and lumbar spine. A, Forward flexion. Motion can be estimated in degrees or by measurement
12
from fingertips to leg or to floor; B and C, Using a tape measure to compare
the increased length of the lumbar and thoracic spine from the anatomical position to the fully flexed position (not shown, the reverse
movement may be done to assess the amount of extension); D, Extension (hyperextension) with the subject standing; E, Extension
(hyperextension) with the subject lying prone;
F, Lateral bending; G, Rotation of the spine.

Movements FIG. 12.8 moves toward the chest; in the lumbar region, the thorax moves
toward the pelvis
al Spinal movements are often preceded by the name given to the Spinal extension: return from flexion; posterior movement of the
n
region of movement. For example, flexion of the trunk at the spine in the sagittal plane; in the cervical spine, the head moves
lumbar spine is known as lumbar flexion, and extension of the away from the chest; in the lumbar spine, the thorax moves away
neck is often referred to as cervical extension. Though usually from the pelvis; sometimes referred to as hyperextension
included with cervical flexion and extension, isolated
al movements of the head or the neck at the atlantoccipital joint Lateral flexion (left or right): sometimes referred to as side
ion are technically known as capital flexion and extension. bending; the head moves laterally toward the shoulder, and the
Additionally, as discussed in Chapter 9, the pelvic girdle rotates thorax moves laterally toward the pelvis; both in the frontal plane
as a unit due to movement occurring in the hip joints and the
lumbar spine. Refer to Table 9.1. Spinal rotation (left or right): rotary movement of the spine in the
transverse plane; the chin rotates from neutral toward the
al
shoulder, and the thorax rotates toward one iliac crest
n Spinal flexion: anterior movement of the spine in the sagittal plane;

Reduction: return movement from lateral flexion to neutral in the
in the cervical region, the head
frontal plane
al
n
erally
Cervical extension
Cervical flexion (combined with capital extension)
Capital flexion
(combined with capital flexion) (hyperextension)
C
A B
pter
2
Cervical lateral flexion Cervical rotation
Capital extension to the right to the right
D E F
FIG. 12.8 • Movements of the spine.

Lumbar
flexion
Lumbar
extension
Lumbar
lateral
flexion
Lumbar extension Lumbar lateral flexion Lumbar rotation

Lumbar flexion (hyperextension) to the right to the right Lumbar
rotation
G H I J
unilaterally
FIG. 12.8 (continued) • Movements of the spine.
important in the functioning of the spine, but detailed knowledge

Trunk and spinal column muscles
of these muscles is of limited value to most people who use this
The largest muscle group in this area is the erector spinae text. Consequently, discussion will concentrate on the larger
(sacrospinalis), which extends on each side of the spinal muscles primarily involved in trunk and spinal column
column from the pelvic region to the cranium. It is divided into movements (see Table 12.1) and will only briefly address the
three muscles: the spinalis, the longissimus, and the iliocostalis. smaller muscles.
From the medial to the lateral side, it has attachments in the
lumbar, thoracic, and cervical regions. Thus, the erector spinae So that the muscles of the trunk and spinal column may be
group is actually made up of nine muscle segments. better understood, they can be grouped according to both
Additionally, the sternocleidomastoid and splenius muscles are location and function. It should be noted that some muscles
large muscles involved in cervical and head movements. Large have multiple segments. As a result, one segment of a
abdominal muscles involved in lumbar movements include the particular muscle may be located and perform movement in one
rectus abdominis, external oblique abdominal, and internal region, while another segment of the same muscle may be
oblique abdominal. The quadratus lumborum is involved in the located in another region and perform movements there. Many
lumbar spine movements of lateral flexion and lumbar of the muscles of the trunk and spinal column function in moving
extension. See Table 12.1 for further details. Also, the psoas the spine as well as in aiding respiration. All the muscles of the
major and minor, as discussed in Chapter 9, are involved in thorax are
ipsilateral lateral flexion and in flexion of the lumbar spine.
Chapter
primarily involved in respiration. The abdominal 12

wall muscles are different from other muscles that
you have studied. They do not go from bone to bone in that they
attach from bone to an aponeurosis (fascia) around the rectus
Numerous small muscles are found in the spinal column abdominis area. They are the external oblique abdominal,
region. Many of them originate on one vertebra and insert on internal oblique abdominal, and transversus abdominis.
the next. They are

TABLE 12.1 • Agonist muscles of the spine
Plane of
Extension of head at
Anterolateral
atlantooccipital joint
Sagittal neck, diagonally
Manubrium of Flexion of the cervical spine Spinal
Anterior neck
Sternoclei- between the origin

sternum, anterior Mastoid accessory
domastoid and insertion,
superior surface process Each side: rotation to (Cr11,
(both sides) Transverse particularly with
of medial clavicle contralateral side C2, C3)
rotation to contra-
Each side: lateral flexion to
Frontal lateral side
ipsilateral side
Both sides: extension of the cervical Palpate in lower

Transverse Sagittal Posterior
Spinous pro- spine posterior cervical
processes lateral
cesses of the Each side: rotation to spine just medial
Splenius of the first Transverse branches of
3rd through ipsilateral side to inferior leva-
cervicis three cervical nerves
6th thoracic tor scapulae with
cervical Each side: lateral flexion to four through
vertebrae Frontal resisted ipsilateral
vertebrae ipsilateral side eight (C4–C8)
rotation
Deep to trapezius
Posterior neck
Both sides: extension of the Sagittal head and inferiorly and ster-
Lower half of
cervical spine nocleidomastoid
the ligamentum
superiorly; with Posterior
nuchae and the
Mastoid Transverse subject seated, pal- lateral
spinous pro-
Splenius process and Each side: rotation to ipsilateral pate in posterior branches of
cesses of the
capitis occipital side triangle of neck cervical nerves
7th cervical and
bone between upper tra- four through
upper three or
pezius and sterno- eight (C4–C8)
four thoracic Frontal
Each side: lateral flexion to cleidomastoid with
vertebrae
ipsilateral side resisted rotation to
ipsilateral side
Extension of the spine

Sagittal
Anterior pelvic rotation
Medial iliac crest, Posterior
Posterior
Erector thoracolumbar ribs 1–12, Lateral flexion of the spine
branches of
spinae: aponeurosis from cervical 4–7 Frontal
Lateral pelvic rotation to the spinal
Iliocostalis sacrum, posterior transverse
contralateral side nerves
ribs 3–12 processes
Ipsilateral rotation of the spine
Transverse
and head
Medial iliac crest, Extension of the spine and Deep and difficult
thoracolumbar Cervical 2–6 head Sagittal to distinguish from
aponeurosis from spinous pro- other muscles in
Anterior pelvic rotation
sacrum, lumbar cesses, tho- the cervical tho-
Lateral flexion of the spine and Posterior
Posterior spine
Erector 1–5 transverse racic 1–12 racic regions; with

head branches of
spinae: processes, and transverse subject prone, pal-
Frontal the spinal
Longissimus thoracic 1–5 processes, Lateral pelvic rotation to pate immediately nerves
transverse pro- lower 9 ribs, contralateral side lateral to spinous
cesses, cervical mastoid processes in lum-
Ipsilateral rotation of the spine
5–7 articular process Transverse bar region with
and head
processes active extension
pter Ligamentum Extension of the spine
2nd cervi- Sagittal
nuchae, 7th cervi-
2 cal spinous Anterior pelvic rotation

cal spinous pro-
process, tho- Lateral flexion of the spine and Posterior
Erector cess, thoracic 11
racic 5–12 head branches of
spinae: and 12 spinous Frontal
spinous Lateral pelvic rotation to the spinal
Spinalis processes, and
processes, contralateral side nerves
lumbar 1 and
occipital
2 spinous Ipsilateral rotation of the spine
bone Transverse
processes and head

TABLE 12.1 (continued) • Agonist muscles of the spine
Plane of
Approximately Lateral flexion to the

one-half the ipsilateral side
Frontal With subject prone,
length of the Lateral pelvic rotation
just superior to iliac crest
Lateral lumbar
Posterior inner lower border of to contralateral side

Quadratus and lateral to Branches of
lip of the iliac the 12th rib and the
lumborum Lumbar extension lumbar erector spinae T12, L1 nerves with
crest transverse Sagittal
Anterior pelvic rotation isometric lateral
process of the
flexion
upper four lum- Stabilizes the pelvis
All planes
bar vertebrae and lumbar spine
Both sides: lumbar

flexion
Anteromedial surface
Cartilage of 5th, Sagittal
Both sides: posterior of abdomen, between Intercostal rib cage
Rectus 6th, and 7th
Crest of pubis pelvic rotation and pubic nerves
abdominis ribs and xiphoid
Each side: weak lateral
bone with isometric (T7–T12)
process
flexion to ipsilateral side Frontal trunk flexion
Both sides: lumbar

flexion
Sagittal
Anterior half Both sides: posterior Intercostal
Borders of pelvic rotation With subject supine,
of crest of nerves
lower eight palpate lateral to the rectus
ilium, inguinal Each side: lumbar (T8–T12),
External ribs at side abdominis
ligament, crest lateral flexion to iliohypogastric
oblique of chest between iliac crest
of pubis, and ipsilateral side nerve (T12,
abdominal dovetailing Frontal and lower ribs with active
fascia of rectus L1), and
with serratus Each side: lateral pelvic rotation to the contralateral
abdominis at ilioinguinal
anterior rotation to contralateral side
lower front nerve (L1)
side
Each side: lumbar rotation to

Transverse
contralateral side
Anterior trunk
Both sides: lumbar

flexion
Sagittal
Both sides: posterior
pelvic rotation Intercostal
With subject supine,
Upper half of nerves
Each side: lumbar palpate anterolateral
inguinal liga- Costal cartilage (T8–T12),
Internal lateral flexion to abdomen between
ment, anterior of 8th, 9th, and 2/3 of crest iliohypogastric
oblique ipsilateral side iliac crest and lower ribs
10th ribs and Frontal nerve (T12,
abdominal with active rotation to the
of ilium, and linea alba Each side: lateral pelvic L1), and
ipsilateral side
lumbar fascia rotation to contralateral ilioinguinal
side nerve (L1)
Each side: lumbar rotation to

Transverse
ipsilateral side
Lateral 1/3
With subject supine, Intercostal
of inguinal
Crest of the anterolateral abdo- nerves
ligament, inner Chapter
pubis and the men between iliac (T7–T12),
12
rim of iliac Forced expiration by
Transversus iliopectineal line, crest and lower ribs during iliohypogastric
crest, inner pulling the abdominal Transverse
abdominis abdominal apo- forceful exha- nerve (T12,
surface of cos- wall inward
neurosis to the lation; very difficult L1), and
tal cartilages of
linea alba to distinguish from ilioinguinal
lower six ribs,
abdominal obliques nerve (L1)
lumbar fascia

Muscles that move the head Core Training

Anterior
In recent years, a great deal of attention has focused on core
Rectus capitis anterior
training aimed specifically at muscles in and around the
Longus capitis
abdominal area. Discussions in Chapters 4 and 5 pointed out
Posterior
the importance of the scapula muscles in providing dynamic
Longissimus capitis
stability for proper upper extremity function. The same
Obliquus capitis superior
importance and concepts apply to the abdominal core for total
Obliquus capitis inferior
body functioning. All too often, there is significant focus on
Rectus capitis posterior—major and minor Trapezius,
major muscle groups that are strengthened through typical
superior fibers
exercises like bench press and squats, with minimal attention
Splenius capitis
given to the link between the upper and lower body—the low
back and abdominal core. It is beyond the scope of this text to
Lateral
provide a detailed description of all exercises that may be used
Rectus capitis lateralis
to address this area, but it is important to consider core training
Sternocleidomastoid
in designing programs to improve performance and prevent
Muscles of the vertebral column injury.
Superficial
Erector spinae (sacrospinalis)
Spinalis—capitis, cervicis, thoracis
Longissimus—capitis, cervicis, thoracis In addressing the core, some attention is given to the inner
Iliocostalis—cervicis, thoracis, lumborum core as well as the outer core. The inner core consists of
Splenius cervicis deeper muscles that should be activated as the first step in
Quadratus lumborum stabilizing the trunk and pelvis. These muscles consist of the
Deep diaphragm, transversus abdominis, lumbar multifidus, and the
Longus colli—superior oblique, inferior oblique, vertical muscles of the pelvic floor— those that attach to the bony ring
of the pelvis. Activating these muscles requires a level of focus
Interspinales—entire spinal column and concentration. The outer core consists of the rectus
Intertransversales—entire spinal column abdominis, external obliques, internal obliques, and erector
Multifidus—entire spinal column spinae. These muscles are exercised in a variety of
Psoas minor means—including, but not limited to, sit-ups, V-sit-ups,
Rotatores—entire spinal column crunches, curl-ups, abdominal twists, prone extensions,
Semispinalis—cervicis, thoracis superman exercises, and so on.
Psoas major and minor (see Chapter 9)
Muscles of the thorax

Diaphragm
Intercostalis—external, internal
Levator costarum Nerves
Subcostales
Cranial nerve 11 and the spinal nerves of C2 and C3 innervate
Scalenus—anterior, medius, posterior
the sternocleidomastoid. The posterior lateral branches of C4
Serratus posterior—superior, inferior
through C8 innervate the splenius muscles. The entire erector
Transversus thoracis
spinae group is supplied by the posterior branches of the spinal
nerves, whereas the intercostal nerves of T7 through T12
Muscles of the abdominal wall
innervate the rectus abdominis. Both the internal and external
Rectus abdominis
oblique abdominal muscles receive innervation from the
pter External oblique abdominal (obliquus externus
intercostal nerves (T8–T12), the iliohypogastric nerve (T12, L1),
2 abdominis)
Internal oblique abdominal (obliquus internus
and the ilioinguinal nerve (L1). The same innervation is provided
to the transverse abdominis, except that innervation begins with
abdominis)
the T7 intercostal nerve. Branches from T12 and L1 supply the
Transverse abdominis (transversus abdominis)
quadratus lumborum. Review Figures 2.6, 4.8, 4.9, and 9.19.

Muscles that move the head

All muscles featured here originate on the cervical vertebrae Cervical
flexion
and insert on the occipital bone of the skull, as implied by their
“capitis” name (Figs. 12.9 and 12.10; Table 12.2). Three FIG. 12.9 • Anterior muscles of the neck.
muscles make up
Cervical
extension
Digastric (anterior belly)

Mylohyoid Suprahyoid
Suprahyoid muscles
Stylohyoid Digastric (posterior belly)
muscles
Hyoid bone Levator scapulae
Longus capitis Cervical

Omohyoid (superior belly) Scalenes lateral
Thyroid cartilage flexion

Infrahyoid
Thyrohyoid
muscles Sternohyoid Infrahyoid
Sternothyroid muscles
Cricothyroid
Sternocleidomastoid
Cervical
Thyroid gland
Trapezius rotation
unilaterally
Omohyoid Clavicle
(inferior belly)
FIG. 12.10 • Deep muscles of the posterior neck

and upper back regions.
Rectus capitis posterior minor

Rectus capitis posterior major
Obliquus capitis superior
Splenius capitis Obliquus capitis inferior
Longissimus capitis
Splenius cervicis (cut)

Levator scapulae Levator scapulae (cut)
Scalenus medius
Splenius cervicis
Scalenus posterior Chapter

Serratus posterior
12
superior
Rhomboideus
Longissimus cervicis
minor (cut)
Iliocostalis cervicis
Rhomboideus
major (cut) Longissimus thoracis

TABLE 12.2 • Muscles that move the head
Muscle Origin Insertion Action Innervation
Basilar part of occipital bone Flexion of head

Rectus capitis Anterior surface of
anterior to foramen magnum and stabilization of C1–C3
anterior lateral mass of atlas
Superior surface of Lateral flexion of head and

Rectus capitis Jugular process of occipital bone
transverse processes stabilization of C1–C3
lateralis
of atlas atlantooccipital joint
Lateral portion of inferior nuchal

Rectus capitis Spinous process of Extension and rotation of head
line of occipital bone Posterior rami of C1
posterior (major) axis to ipsilateral side
Medial portion of inferior nuchal

Rectus capitis Posterior tubercle of
line of occipital bone Extension of head Posterior rami of C1
posterior (minor) posterior arch of atlas
Transverse processes of Basilar part of occipital bone Flexion of head and cervical
Longus capitis C1–C3
C3–C6 spine
Occipital bone between

Obliquus capitis Transverse process of Extension and lateral
inferior and superior Posterior rami of C1
superior atlas flexion of head
nuchal lines
Obliquus capitis
Spinous process of axis Transverse process of atlas Rotation of atlas Posterior rami of C1
inferior
Occipital bone, between Posterior primary

Semispinalis Transverse processes of Extension and contralat-
superior and inferior divisions on spinal
capitis C4–T7 eral rotation of head
nuchal lines nerves
the anterior vertebral muscles—the longus capitis, the rectus superior assists the rectus capitis lateralis in lateral flexion of
capitis anterior, and the rectus capitis lateralis. All are flexors of the head. In addition to extension, the rectus capitis posterior
the head and upper cervical spine. The rectus capitis lateralis major is responsible for rotation of the head to the ipsilateral
laterally flexes the head, in addition to assisting the rectus side. It is assisted by the semispinalis capitis, which rotates the
capitis anterior in stabilizing the atlantooccipital joint. head to the contralateral side. The splenius capitis and the
sternocleidomastoid (see Table 12.1) are much larger and more
powerful in moving the head and cervical spine; they are
The rectus capitis posterior major and minor, obliquus covered in detail on the following pages. The remaining muscles
capitis superior and inferior, and semispinalis capitis are located that act on the cervical spine are addressed with the muscles of
posteriorly. All are extensors of the head, except for the the vertebral column.
obliquus capitis inferior, which rotates the atlas. The obliquus
capitis
pter

Sternocleidomastoid muscle FIG. 12.11 Application, strengthening, and flexibility

(ster ́no-kli-do-mas ́toyd) The sternocleidomastoid is primarily responsible for flexion and rotation
of the head and neck. Cervical
flexion
Origin
One side of this muscle may be easily visualized and palpated
Manubrium of the sternum when the head is rotated to the opposite side.
Anterior superior surface of the medial clavicle
Insertion The sternocleidomastoid is easily worked for

strength development by placing the hands on Cervical
Mastoid process
the forehead to apply force posteriorly while lateral
Action using these muscles to pull the head forward into flexion
Extension of the head at the atlantooccipital joint Flexion of the flexion. The hand may also be used on one side of the jaw to
cervical spine apply rotary force in the opposite direction while the
Right side: rotation to the left and lateral flexion to the right sternocleidomastoid is con-
tracting concentrically to rotate the head in the Cervical
Left side: rotation to the right and lateral flexion to the left direction of the hand. rotation
Cervical hyperextension in combination with unilaterally
capital flexion provides some bilateral stretching of the
Palpation
sternocleidomastoid. Each side may be stretched individually.
Anterolateral side of the neck, diagonally between the origin and The right side is stretched by moving into left lateral flexion and
insertion, particularly with rotation to contralateral side right cervical rotation combined with extension. The opposite
movements in extension stretch the left side.
Innervation
Spinal accessory nerve (Cr11, C2, C3)
Extension of head at
Rotation to
the left
External
auditory meatus
Rotation to I, Mastoid
I, Mastoid the right process
process
Lateral flexion
Flexion of
to the left
cervical spine
Sternocleidomastoid m.
Sternocleidomastoid m.
O, Anterior superior
surface of medial
clavicle
O, Manubrium of
O, Manubrium of O, Anterior superior surface of the sternum
the sternum medial clavicle Chapter
A B
12
FIG. 12.11 • Sternocleidomastoid muscle. A, Anterior view; B, Lateral view. O, Origin; I, Insertion.

Splenius muscles (cervicis, capitis) seated, palpate in the posterior triangle of the neck between the
upper trapezius and the sternocleidomastoid with resisted rotation
FIG. 12.12
al to ipsilateral side
ion
(sple ́ni-us) (ser ́vi-sis) (kap ́i-tis)
Innervation
Origin
Posterior lateral branches of cervical nerves four through eight
Splenius cervicis: spinous processes of the third through sixth (C4–C8)
thoracic vertebrae
Splenius capitis: lower half of the ligamentum nuchae and spinous Application, strengthening, and flexibility
al
n processes of the seventh cervical and Any movement of the head and neck into extension, particularly
terally upper three or four thoracic vertebrae extension and rotation, would bring the splenius muscle strongly
into play, together with the erector spinae and the upper
Insertion
trapezius muscles. Tone in the splenius muscle tends to hold
Splenius cervicis: transverse processes of the first three the head and neck in proper posture position.
cervical vertebrae
al Splenius capitis: mastoid process and occipital bone
Action A good exercise for the splenius muscle is to lace the

n
fingers behind the head with it in flexion and then slowly
Both sides: extension of the head (splenius capitis) and neck
contract the posterior head and neck muscles to move the head
(splenius cervicis and capitis)
and neck into full extension. This exercise may also be
Right side: rotation and lateral flexion to the right Left side:
performed by using a towel or a partner for resistance.
rotation and lateral flexion to the left
Palpation The entire splenius may be stretched with maximal flexion of

Splenius cervicis: palpate in lower posterior cervical spine just the head and cervical spine. The right side can be stretched
medial to inferior levator scapulae with resisted ipsilateral rotation through combined movements of left rotation, left lateral flexion,
and flexion. The same movements to the right apply stretch to
Splenius capitis: deep to the trapezius inferiorly and the the left side.
sternocleidomastoid superiorly; with subject
I, Mastoid process and

occipital bone
O, Lower half of the

I, Transverse processes ligamentum nuchae
Splenius m. of the first three cervical
Splenius m. and spinous processes
(cervicis) vertebrae (capitis) of the seventh cervical and
upper three or four thoracic
vertebrae
pter
2 O, Spinous processes
of the third through sixth
thoracic
vertebrae
FIG. 12.12 • Splenius muscles (cervicis on the left, capitis on the right), posterior view. O, Origin;
I, Insertion.

Muscles of the vertebral column processes of their respective vertebrae and generally run posteriorly to
attach to the spinous processes on the vertebrae just above their
In the cervical area, the longus colli muscles are located vertebrae of Cervical
anteriorly and flex the cervical and upper thoracic vertebrae. origin. All are extensors of the spine and contract flexion
Posteriorly, the erector spinae group, the transversospinalis to rotate their respective vertebrae to the contralateral side. The
group, the interspinalintertransverse group, and the splenius all interspinal-intertransverse group lies deep to the rotatores and consists
run vertically parallel to the spinal column (Figs. 12.13 and of the interspinalis and the intertransversarii muscles. As a group, Cervical
12.14; Table 12.3). This location enables them to extend the they laterally flex and extend but do not rotate the extension
spine as well as assist in rotation and lateral flexion. The vertebrae. The interspinalis muscles are extensors that connect from the
splenius and erector spinae group are addressed in detail spinous process of one vertebra to the spinous process of the adjacent
elsewhere in this chapter. The transversospinalis group consists vertebra. The intertransversarii muscles flex the vertebral column laterally
of the semispinalis, multifidus, and rotatores muscles. These by connecting to the transverse Cervical
muscles all originate on the transverse
lateral
processes of adjacent vertebrae.
flexion
Cervical
Splenius capitis (cut) rotation
unilaterally
Third cervical vertebra
Multifidus (cervical portion) Levator scapulae

Longissimus capitis
Interspinalis
1
Lumbar
Semispinalis cervicis 2
Iliocostalis cervicis extension
3
Semispinalis thoracis 4
5
Spinalis thoracis
Lumbar
6
lateral
7 Erector
flexion
spinae
8
Longissimus thoracis
10
Diaphragm
Iliocostalis thoracis
11
12
Lumbar
Iliocostalis lumborum
rotation
Intertransversarii unilaterally
Quadratus lumborum
Multifidus
(lumbar portion)
Chapter
12
FIG. 12.13 • Deep back muscles, posterior view. Right, The erector spinae group of muscles is demonstrated. Left, Those
muscles have been removed to reveal the deeper back muscles.

TABLE 12.3 • Muscles of the vertebral column
Longus colli Transverse processes

Anterior arch of atlas Flexion of cervical spine C2–C7
(superior oblique) of C3–C5
Longus colli Transverse processes of

Bodies of T1–T3 Flexion of cervical spine C2–C7
(inferior oblique) C5 and C6
Longus colli Bodies of C5–C7 and Anterior surface of bodies of

Flexion of cervical spine C2–C7
(vertical) T1–T3 C2–C4
Spinous process of Spinous process of next Extension of spinal Posterior primary ramus
Interspinalis
each vertebra vertebra column of spinal nerves
Tubercles of trans- Tubercles of transverse

Lateral flexion of spinal Anterior primary ramus
Intertransversarii verse processes of processes of next
column of spinal nerves
each vertebra vertebra
Sacrum, iliac spine,

transverse processes Spinous process of 2nd, 3rd,
Extension and contralateral Posterior primary ramus rotation of
Multifidus of lumbar, thoracic, or 4th vertebra above origin
spinal column of spinal nerves
and lower four cervical
vertebrae
Transverse processes Base of spinous process of Extension and contralateral Posterior primary ramus
Rotatores
of each vertebra next vertebra above rotation of spinal column of spinal nerves
Extension and contralat- All divisions, posterior

Semispinalis Transverse processes Spinous processes of
eral rotation of vertebral primary ramus of spinal nerves
cervicis of T1–T5 or T6 C2–C5
column
Extension and contralat-

Semispinalis Transverse processes Spinous processes of C6, C7, Posterior primary ramus
eral rotation of vertebral
thoracis of T6–T10 and T1–T4 of spinal nerves
column
Muscles of the thorax

The thoracic muscles are involved almost entirely in respiration
(Fig. 12.15). During quiet rest, the diaphragm is responsible for
breathing movements. As it contracts and flattens, the thoracic
volume is increased and air is inspired to equalize the pressure.
When larger amounts of air are needed, such as during
Multifidus
exercise, the other thoracic muscles take on a more significant
Rotatores role in inspiration. The scalene muscles elevate the first two ribs
Intertransversarii
to increase the thoracic volume. Further expansion of the chest
is accomplished by the external intercostals. Additional muscles
of inspiration are the levator cos tarum and the serratus
Interspinalis posterior (Fig. 12.16). Forced expiration occurs with contraction
of the internal intercostals, transversus thoracis, and
Transverse
subcostales. All these muscles are detailed in Table 12.4.
process
pter
2 Spinous
process
Right posterolateral view
FIG. 12.14 • Deep muscles associated with

the vertebrae posterolateral view from the right.

Muscles of Inspiration Muscles of Expiration
Sternocleidomastoid
Scalenes
External intercostals
Internal intercostals Internal intercostals

(interchondral part) (excluding interchondral
part)
Diaphragm External abdominal oblique
Internal abdominal oblique
FIG. 12.15 • Muscles of respiration, anterior Transversus abdominis
view.
Rectus abdominis
Superior nuchal line
Longissimus capitis
Splenius capitis Semispinalis cervicis
Serratus posterior
superior
Splenius cervicis
Semispinalis
Erector spinae: thoracis
Iliocostalis
Longissimus
Spinalis
Serratus posterior inferior
Multifidus
12
Internal abdominal Chapter
oblique Quadratus lumborum
External abdominal
oblique (cut)
FIG. 12.16 • Deeper muscles acting on the

vertebral column and thorax.

TABLE 12.4 • Muscles of the thorax
Circumference of Depresses and draws

thoracic inlet from central tendon forward
xiphoid process, Central tendon of in inhalation, reduces
Diaphragm Phrenic nerve (C3–C5)
costal cartilages of diaphragm pressure in thoracic cavity,
ribs 6–12, and lumbar and increases pressure in
vertebrae abdominal cavity
Elevate costal cartilages

Longitudinal ridge on
Internal Superior border of next rib of ribs 1–4 during Intercostal branches of
inner surface of ribs and
intercostals below inhalation, depress all T1–T11
costal cartilages
ribs in exhalation
External Inferior border of Superior border of next rib Intercostal branches of

Elevate ribs
intercostals ribs below T1–T11
Ends of transverse
Outer surface of angle of next Elevates ribs, lateral flexion of
Levator costarum processes of C7, Intercostal nerves
rib below origin thoracic spine
T2–T12
Draws the ventral part of the

Medially on the inner
Inner surface of each rib ribs downward, decreasing the
Subcostales surface of 2nd or 3rd rib Intercostal nerves
near its angle volume of the thoracic cavity
below
Elevates 1st rib, flexion,

Transverse processes Inner border and upper lateral flexion, and Ventral rami of C5, C6,
Scalenus anterior
of C3–C6 surface of 1st rib contralateral rotation of sometimes C4
cervical spine
Elevates 1st rib, flexion,

Transverse processes Superior surface of lateral flexion, and
Scalenus medius Ventral rami of C3–C8
of C2–C7 1st rib contralateral rotation of
cervical spine
Elevates 2nd rib, flexion, lateral

Scalenus Transverse processes flexion, and slight contralateral
Outer surface of 2nd rib Ventral rami of C6–C8
posterior of C5–C7 rotation of
cervical spine
Ligamentum nuchae,
Serratus poste- Superior borders lateral Branches from anterior
spinous processes of Elevates upper ribs
rior (superior) to angles of ribs 2–5 primary rami of T1–T4
C7, T1, and T2 or T3
Counteracts inward pull

Branches from ante-
Serratus poste- Spinous processes of Inferior borders lateral of diaphragm by drawing last 4
rior primary rami of
rior (inferior) T10–T12 and L1–L3 to angles of ribs 9–12 ribs outward and downward
T9–T12
pter Inner surface of

sternum and xiphoid Inner surfaces and
2 Transversus
thoracis
process, sternal ends
of costal cartilages of ribs
inferior borders of costal
cartilages 3–6
Depresses ribs
Intercostal branches of
T3–T6
3–6

Erector spinae muscles* Origin
(sacrospinalis) FIGS. 12.16, 12.17, 12.18 Iliocostalis: medial iliac crest, thoracolumbar aponeurosis from
Lumbar
sacrum, posterior ribs 3–12 Longissimus: medial iliac crest,
(e-rek ́tor spi ́ne) (sa ́kro-spi-na ́lis) extension
thoracolumbar aponeurosis from sacrum, lumbar 1–5
transverse processes and thoracic 1–5 transverse processes,
Iliocostalis cervical 5–7 articular processes
(il ́i-o-kos-ta ́lis): lateral layer
Spinalis: ligamentum nuchae, seventh cervical spinous process, Cervical
Longissimus thoracic 11 and 12 spinous processes, and lumbar 1 and 2 extension
(lon-jis ́i-mus): middle layer spinous processes
Insertion
Spinalis Iliocostalis: posterior ribs 1–12, cervical 4–7 transverse processes
Lumbar
lateral
(spi-na ́lis): medial layer Longissimus: cervical 2–6 spinous processes, thoracic flexion
* This muscle group includes the iliocostalis, the longissimus dorsi, the spinalis 1–12 transverse processes, lower nine ribs, mastoid process
dorsi, and divisions of these muscles in the lumbar, thoracic, and cervical sections
of the spinal column. Spinalis: second cervical spinous process, thoracic
5–12 spinous processes, occipital bone Cervical

lateral
flexion
Cervical lateral
m.
flexion
Cervical lateral flexion Cervical m.
lateral flexion
m.
Cervical
m.
m. extension
Cervical
Cervical extension extension Lumbar
rotation
unilaterally
m.
m.
Cervical
m. rotation
unilaterally
Lumbar lateral Lumbar

Lumbar lateral
flexion lateral
flexion
flexion
Lumbar extension
Lumbar extension
Lumbar
m. extension
Chapter
12
A B C
FIG. 12.17 • Erector spinae (sacrospinalis) muscle, posterior view. A, Iliocostalis lumborum, thoracis, and cervicis; B, Longissimus
thoracis, cervicis, and capitis; C, Spinalis thoracis, cervicis, and capitis.

Action exercise, it is very important to always use correct technique to

Extension, lateral flexion, and ipsilateral rotation of the spine avoid back injuries. Voluntary static contraction of the erector
and head spinae in the standing position can provide a mild exercise and
Anterior pelvic rotation improve body posture.
Lateral pelvic rotation to contralateral side
The erector spinae and the various divisions may be
Palpation strengthened through numerous forms of back extension
Deep and difficult to distinguish from other muscles in the cervical exercises. These are usually done in a prone or face-down
and thoracic regions; with subject prone, palpate immediately position in which the spine is already in some state of flexion.
lateral to spinous processes in lumbar region with active The subject then uses these muscles to move part or all of the
extension spine toward extension against gravity. A weight may be held in
Innervation the hands behind the head to increase resistance.
Posterior branches of the spinal nerves
Application, strengthening, and flexibility Maximal hyperflexion of the entire spine stretches the
The erector spinae muscles function best when the pelvis is erector spinae muscle group. Stretch may be isolated to specific
posteriorly rotated. This lowers the origin of the erector spinae segments through specific movements. Maximal flexion of the
and makes it more effective in keeping the spine straight. As the head and cervical spine stretches the capitis and cervicis
spine is held straight, the ribs are raised, thus fixing the chest segments. Flexion combined with lateral flexion to one side
high and consequently making the abdominal muscles more accentuates the stretch on the contralateral side. Thoracic and
effective in holding the pelvis up in front and flattening the lumbar flexion places the stretch primarily on the thoracis and
abdominal wall. lumborum segments.
An exercise known as the dead lift, employing a barbell,

uses the erector spinae in
extending the spine. In this exercise, the subject
Splenius longus (cut)
bends over, keeping the arms and legs straight; Semispinalis capitis
picks up the barbell; and returns to a standing Longissimus capitis Spinalis capitis
position. In performing this type of Splenius capitis
Semispinalis
Spinalis cervicis
capitis (cut)
Iliocostalis cervicis
Iliocostalis
thoracis
Spinalis
Longissimus
thoracis
thoracis
Iliocostalis
lumborum
pter
2
FIG. 12.18 • Muscles of the back and the neck help move the
head (posterior view) and hold the
torso erect. The splenius capitis and semispinalis have been
cut on the left to show underlying muscles.

Quadratus lumborum muscle FIG. 12.19 Palpation

(kwad-ra ́tus lum-bo ́rum) With subject prone, just superior to iliac crest and lateral to lumbar Lumbar
erector spinae with isometric lateral flexion lateral

Origin flexion
Posterior inner lip of the iliac crest

Innervation
Insertion
Branches of T12, L1 nerves
Approximately one-half the length of the lower border of the twelfth
Application, strengthening, and flexibility Lumbar
rib and the transverse process of the upper four lumbar vertebrae extension
The quadratus lumborum is important in lumbar lateral flexion
and in elevating the pelvis on the same side in the standing
Action
position. Trunk rotation and lateral flexion movements against
Lateral flexion to the ipsilateral side Stabilizes resistance are good exercises for development of this muscle.
the pelvis and lumbar spine Extension of the The position of the body relative to gravity may be changed to
lumbar spine increase resistance on this and other trunk and abdominal
Anterior pelvic rotation muscles. Left lumbar lateral flexion while in lumbar flexion
Lateral pelvic rotation to contralateral side stretches the right quadratus lumborum, and vice versa.
Twelfth rib
Twelfth thoracic vertebra

Transverse processes First lumbar vertebra
Lateral
flexion I, Approximately one-half
length of lower border of the twelfth
Quadratus lumborum m.
rib and transverse process of the
upper four lumbar vertebrae
Iliac fossa
Pectineal line Fifth lumbar vertebra
Iliopectineal eminence
O, Posterior
inner lip of
the iliac crest
Inferior pubic ramus

Superior pubic ramus
Chapter
12
FIG. 12.19 • Quadratus lumborum muscle. O, Origin; I, Insertion.

Muscles of the abdominal wall

FIGS. 12.20, 12.21, 12.22
ar
n
Pectoralis major
Latissimus dorsi
Serratus
ar
anterior
n
Rectus abdominis
(covered by sheath)
Rectus abdominis
(sheath removed)
External oblique
Linea alba
abdominal FIG. 12.20 • Muscles of
ar Umbilicus
the abdomen: external
n Internal oblique
abdominal
oblique and rectus
erally
abdominis. The fibrous
Iliac crest sheath around the rectus has
Transversus
abdominis been removed on the right side
to show the muscle within.
Inguinal canal
and ligament
Pectoralis major
Latissimus dorsi
Serratus
anterior
FIG. 12.21 • Muscles of
the abdomen. The external oblique
has been removed on the right
Posterior wall of
side to reveal the internal oblique.
rectus sheath
Rectus The external and internal
(rectus abdominis
sheath (cut)
removed)
Linea obliques have been
semilunaris Transversus removed on the left side to
abdominis
reveal the transversus
Internal
oblique
Linea alba abdominis. The rectus
abdominal Umbilicus abdominis has been cut to reveal
the posterior rectus sheath.
Inguinal canal
and ligament
Subcutaneous fat Aponeurosis of external oblique abdominal External oblique abdominal FIG. •
12.22 Abdominal
wall above umbilicus.
Linea alba
The unique arrangement
of the four abdominal muscles
pter Internal with their fascial attachment in
oblique
2
and around the rectus abdominis
abdominal
Transversus muscle is shown. With no bones

abdominis for attachments,
Rectus abdominis
these muscles can be
Aponeurosis of internal
adequately maintained
Transverse fascia oblique abdominal
through exercise.
Aponeurosis of transversus abdominis

Rectus abdominis muscle FIG. 12.23 rectus abdominis flattens the lower back, making the erector
spinae muscle more effective as an extensor of the spine and
(rek´ ́tus ab-dom ́i-nis)
the hip flexors (the iliopsoas muscle, particularly) more effective Lumbar
Origin in raising the legs. flexion
Crest of the pubis

In a relatively lean person with well-developed abdominals,
Insertion
three distinct sets of lines or depressions may be noted. Each Lumbar
Cartilage of the fifth, sixth, and seventh ribs and the xiphoid represents an area of tendinous connective tissue connecting or lateral
process supporting the abdominal arrangement of muscles in lieu of flexion
Action bony attachments. Running vertically from the xiphoid process

through the umbilicus to the pubis is the linea alba . It divides
Both sides: lumbar flexion
each rectus abdominis and serves as its medial border. Lateral
Posterior pelvic rotation
to each rectus abdominis is the
Right side: weak lateral flexion to the right Left side:
weak lateral flexion to the left
Palpation linea semilunaris , a crescent, or moon-shaped, line running

Anteromedial surface of the abdomen, between the rib cage and vertically. This line represents the aponeurosis connecting the
the pubic bone with isometric trunk flexion lateral border of the rectus abdominis and the medial border of
the external and internal abdominal obliques. The
Innervation
tendinous inscriptions are horizontal indentations that transect
Intercostal nerves (T7–T12)
the rectus abdominis at three or more locations, giving the
Application, strengthening, and flexibility muscle its segmented appearance. Refer to Fig. 12.20.
The rectus abdominis muscle controls the tilt of the pelvis and
the consequent curvature of the lower spine. By rotating the There are several exercises for the abdominal muscles, such as
pelvis posteriorly, the bent-knee sit-ups, crunches, and isometric contractions. Bent-knee sit-ups
with the arms folded across the chest are considered by many to be a safe
and efficient exercise. Crunches are considered to be even more effective
I, Cartilage of for isolating the work to the abdominals. Both of these exercises shorten
fifth, sixth,
the iliopsoas muscle and other hip flexors, thereby reducing their ability to
and seventh
generate force. Twisting to the left and right brings the oblique muscles into
ribs, xiphoid
process more active contraction. In all the above exercises, it is important to use
proper technique, which involves gradually moving to the up position until
Lateral flexion the lumbar spine is actively flexed maximally and then slowly returning to
the beginning position. Jerking movements using momentum should be
avoided. Movement continued beyond full lumbar flexion exercises only the
hip flexors, which is not usually an objective. Even though all these
exercises may be helpful in strengthening the abdominals, careful analysis
should occur before deciding which are indicated in the presence of various
injuries and Chapter
Linea alba Flexion
Tendinous
inscription
Rectus abdominis m.
O, Crest of
problems of the lower back.
The rectus abdominis is stretched by simultaneously
12
pubis
hyperextending both the lumbar and the thoracic spine.
Extending the hips assists in this process by accentuating the
anterior rotation of the pelvis to hyperextend the lumbar spine.
FIG. 12.23 • Rectus abdominis muscle, anterior view. O,

External oblique abdominal Palpation
muscle FIG. 12.24 With subject supine, palpate lateral to the rectus abdominis
ar
between iliac crest and lower ribs with active rotation to the
n (ek-stur ́nel o-bleek ́ ab-dom ́i-nel)
contralateral side
Origin
Innervation
Borders of the lower eight ribs at the side of the chest, dovetailing
Intercostal nerves (T8–T12), iliohypogastric nerve (T12, L1),
ar with the serratus anterior muscle*
and ilioinguinal nerve (L1)
n Insertion
Anterior half of the crest of the ilium, the inguinal ligament, the
Working on each side of the abdomen, the external oblique
crest of the pubis, and the fascia of the rectus abdominis
abdominal muscles aid in rotating the trunk when working
muscle at the lower front
independently of each other. Working together, they aid the
Action rectus abdominis muscle in its described action. The left
ar Both sides: lumbar flexion external oblique abdominal muscle contracts strongly during
n Posterior pelvic rotation sit-ups when the trunk rotates to the right, as in touching the left
terally Right side: lumbar lateral flexion to the right and elbow to the right knee. Rotating to the left brings the right
rotation to the left, lateral pelvic rotation to the left Left side: external oblique into action.
lumbar lateral flexion to the left and rotation to the right, lateral
pelvic rotation to the right
Each side of the external oblique must be stretched
individually. The right side is stretched by moving into extreme
* Sometimes the origin and insertion are reversed in anatomy books. This is the result
of different interpretations of which bony structure is the more movable. The insertion
left lateral flexion combined with extension, or by extreme
is considered the most movable part of a muscle. lumbar rotation to the right combined with extension. The
opposite movements combined with extension stretch the left
side.
O, Borders of lower eight

ribs at side
of chest, dovetailing
with serratus anterior
muscle
Contralateral
rotation
External oblique
Lumbar flexion
abdominal m.
Lumbar lateral
flexion
I, Anterior half of crest of

ilium, inguinal
ligament, crest of
pubis, fascia of
pter Inguinal ligament
rectus abdominis
2 m. at lower front
FIG. 12.24 • External oblique abdominal muscle, lateral view. O, Origin; I, Insertion.

Internal oblique abdominal muscle Innervation
FIG. 12.25
Lumbar
(in-ter ́nel o-bleek ́ ab-dom ́i-nel) flexion
Origin
The internal oblique abdominal muscles run diagonally in the
Upper half of the inguinal ligament, anterior twothirds of the crest
direction opposite that of the external
of the ilium, and lumbar fascia Lumbar
obliques. The left internal oblique rotates to the left, lateral
Insertion and the right internal oblique rotates to the right. flexion
Costal cartilages of the eighth, ninth, and tenth ribs and the linea In touching the left elbow to the right knee in crunches, the left
alba external oblique and the right internal oblique abdominal muscles
contract at the same time, assisting the rectus abdominis muscle in
Action flexing the trunk to make completion of the movement possible. In rotary
Both sides: lumbar flexion movements, the Lumbar
Posterior pelvic rotation
Right side: lumbar lateral flexion to the right and rotation to the right, internal oblique and the external oblique on the rotation
unilaterally
lateral pelvic rotation to the left Left side: lumbar lateral flexion to opposite side always work together.
the left and rotation to the left, lateral pelvic rotation to the right Like the external oblique, each side of the internal oblique
must be stretched individually. The right side is stretched by
Palpation moving into extreme left lateral flexion and extreme left lumbar
rotation combined with extension. The same movements to the
With subject supine, palpate anterolateral abdomen between iliac
right combined with extension stretch the left side.
crest and lower ribs with active rotation to the ipsilateral side
Ipsilateral
rotation
I, Costal cartilages
8,9,10
of eighth, ninth,
and tenth ribs, linea alba
Lumbar flexion
Internal oblique
Lumbar lateral abdominal m.
flexion
O, Upper half of inguinal

ligament,
anterior two-
Inguinal ligament
thirds of crest Chapter
of ilium, lumbar
fascia
12
FIG. 12.25 • Internal oblique abdominal muscle, lateral view. O, Origin; I, Insertion.

Transversus abdominis muscle Innervation
FIG. 12.26
(trans-vurs ́us ab-dom ́i-nis)
Origin
The transversus abdominis is the chief muscle of forced
Lateral third of the inguinal ligament, inner rim of the iliac crest,
expiration and is effective—together with the rectus abdominis,
inner surface of the costal cartilages of the lower six ribs, and
the external oblique abdominal, and the internal oblique
lumbar fascia
abdominal muscles—in helping hold the abdomen flat. It, along
Insertion with the other abdominal muscles, is considered by many to be
Crest of the pubis and the iliopectineal line Abdominal key in providing and maintaining core stability. This abdominal
aponeurosis to the linea alba flattening and forced expulsion of the abdominal contents are
the only action of this muscle.
Action
Forced expiration by pulling the abdominal wall inward
Palpation The transversus abdominis muscle is exercised effectively

by attempting to draw the abdominal contents back toward the
With subject supine, palpate anterolateral abdomen between iliac
spine. This may be done isometrically in the supine position or
crest and lower ribs during forceful exhalation; very difficult to
while standing. A maximal inspiration held in the abdomen
distinguish from the abdominal obliques
applies stretch.
O, Lateral third of inguinal

ligament,
inner rim of iliac crest,
inner surface
of costal cartilages
of lower six ribs,
lumbar fascia I, Crest of pubis,
iliopectineal line,
and linea alba
Transversus joining its fellow
abdominis m. from other side
Inguinal ligament
pter
FIG. 12.26 • Transversus abdominis muscle, lateral view. O, Origin; I, Insertion.

REVIEW EXERCISES i. Capital flexion

j. Capital extension
2. Why is good abdominal muscular development so
important? Why is this area so frequently neglected?
plane.
3. Why are weak abdominal muscles frequently blamed for
a. Cervical flexion
lower back pain?
b. Cervical extension
4. Prepare an oral or a written report on abdominal or back
c. Cervical rotation
injuries found in the literature.
d. Cervical lateral flexion
5. Research common spinal disorders such as brachial plexus
e. Lumbar flexion
neuropraxia, cervical radiculopathy, lumbosacral herniated
f. Lumbar extension
nucleus pulposus, sciatica, spondylolysis, and
g. Lumbar rotation
spondylolisthesis. Report your findings in class.
h. Lumbar lateral flexion
6. Muscle analysis chart • Cervical and lumbar spine
Cervical spine
Flexion Extension
Lateral flexion right Rotation right
Lateral flexion left Rotation left
Lumbar spine
Flexion Extension
Lateral flexion right Rotation right
Chapter
Lateral flexion left Rotation left
12

7. Antagonistic muscle action chart • Cervical and lumbar spine
Complete the chart by listing the muscle(s) or parts of muscles that are antagonist in their actions to the muscles in the left
column.
Agonist Antagonist
Splenius capitis
Splenius cervicis
Sternocleidomastoid
Erector spinae
Rectus abdominis
External oblique abdominal
Internal oblique abdominal
Quadratus lumborum
LABORATORY EXERCISES g. Splenius capitis

h. Quadratus lumborum
1. Locate the following parts of the spine on a human skeleton
3. Contrast crunches, bent-knee sit-ups, and straight-leg
and on a human subject:
sit-ups. Does having a partner to hold the feet make a
a. Cervical vertebrae
difference in the ability to do the bent-knee and straight-leg
b. Thoracic vertebrae
sit-ups? If so, why?
c. Lumbar vertebrae
d. Spinous processes
4. Have a laboratory partner stand and assume a position
e. Transverse processes
exhibiting good posture. What motions in each region of the
f. Sacrum
spine does gravity attempt to produce? Which muscles are
g. Manubrium
responsible for counteracting these motions against the pull
h. Xiphoid process
of gravity?
i. Sternum
j. Rib cage (various ribs)
pter 5. Compare and contrast the spinal curves of a laboratory
2. How and where can the following muscles be palpated on a partner sitting erect with those of one sitting slouched in a
2 human subject? chair. Which muscles are responsible for maintaining good
a. Rectus abdominis sitting posture?
b. External oblique abdominal
c. Internal oblique abdominal 6. Which exercise is better for the development of the
d. Erector spinae abdominal muscles—leg lifts or sit-ups? Analyze each
e. Sternocleidomastoid exercise with regard to the activity of the abdominal
f. Splenius cervicis muscles. Defend your answer.

7. Trunk and spine exercise movement analysis chart
After analyzing each exercise in the chart, break each into two primary movement phases, such as a lifting phase and a lowering phase. For
each phase, determine what trunk and spine movements occur, and then list the trunk and spine muscles primarily responsible for
causing/controlling those movements. Beside each muscle in each movement, indicate the type of contraction as follows: I—isometric;
Initial movement phase Secondary movement phase

Exercise
Push-up
Squat
Dead lift
Sit-up, bent knee
Prone extension
Rowing exercise
Leg raises
Stair machine
8. Trunk and spine sport skill analysis chart
Analyze each skill in the chart, and list the movements of the trunk and spine in each phase of the skill. You may prefer to list the initial
positions that the trunk and spine are in for the stance phase. After each movement, list the trunk and spine muscle(s) primarily responsible
for causing/controlling the movement. Beside each muscle in each movement, indicate the type of contraction as follows: I—isometric;
C—concentric; E—eccentric. It may be desirable to review the concepts for analysis in Chapter 8 for the various phases. Assume right
hand/ leg dominant where applicable. Circle R or L to indicate the dominant extremity for the exercise, if appropriate.
(R)
Baseball
pitch
(L)
(R) Chapter
Football
punt
(L) 12
(R)
Walking
(L)

Trunk and spine sport skill analysis chart (continued)
(R)
Softball
pitch
(L)
(R)
Soccer
pass
(L)
(R)
Batting
(L)
(R)
Bowling
(L)
(R)
Basketball
jump shot
(L)
References National Strength and Conditioning Association; Baechle TR, Earle
RW: Essentials of strength training and conditioning, ed 2,

Champaign, IL, 2000, Human Kinetics.
Clarkson HM, Gilewich GB: Musculoskeletal assessment: joint range
Oatis CA: Kinesiology: the mechanics and pathomechanics of human
of motion and manual muscle strength, ed 2, Baltimore, 1999, Lippincott
Williams & Wilkins.
Perry JF, Rohe DA, Garcia AO: The kinesiology workbook,
Day AL: Observation on the treatment of lumbar disc disease in
Philadelphia, 1992, Davis.
college football players, American Journal of Sports Medicine
15:275, January–February 1987. Prentice WE: Principles of athletic training: a competency-based
approach, ed 15, New York, 2014, McGraw-Hill.
Field D: Anatomy: palpation and surface markings, ed 3, Oxford,
2001, Butterworth-Heinemann. Rasch PJ: Kinesiology and applied anatomy, ed 7, Philadelphia, 1989,
Lea & Febiger.
Gench BE, Hinson MM, Harvey PT: Anatomical kinesiology,
Dubuque, IA, 1995, Eddie Bowers. Saladin KS: Anatomy & physiology: the unity of form and function,
ed 5, New York, 2010, McGraw-Hill.
human motion, ed 12, New York, 2012, McGraw-Hill. Seeley RR, Stephens TD, Tate P: Anatomy & physiology, ed 8,
New York, 2008, McGraw-Hill.
Hislop HJ, Montgomery J: Daniels and Worthingham’s muscle testing:
techniques of manual examination, ed 8, Philadelphia, 2007, Saunders. Sieg KW, Adams SP: Illustrated essentials of musculoskeletal anatomy,
Lindsay DT: Functional human anatomy, St. Louis, 1996, Mosby. Stone RJ, Stone JA: Atlas of the skeletal muscles, ed 6, New York,
2009, McGraw-Hill.
ter Magee DJ: Orthopedic physical assessment, ed 5, Philadelphia, 2008,
Thibodeau GA, Patton KT: Anatomy & physiology, ed 9, St. Louis,
2
1993, Mosby.
Martens MA, et al: Adductor tendonitis and muscular abdominis
Saunders.
tendopathy, American Journal of Sports Medicine 15:353, Van De Graaff KM: Human anatomy, ed 6, Dubuque, IA, 2002,
July–August 1987. McGraw-Hill.
Marymont JV: Exercise-related stress reaction of the sacroiliac joint,

an unusual cause of low back pain in athletes, American Journal of Sports Medicine
14:320, July–August 1986. For additional resources and a list of related websites,
Muscolino JE: The muscular system manual: the skeletal muscles of visit www.mhhe.com/floyd19e.

Worksheet Exercises
Worksheet 1
with an “O” and an “I,” respectively, and draw in the origin and insertion on the anterior view as applicable.
a. Rectus abdominis
b. External oblique abdominal
c. Internal oblique abdominal
d. Sternocleidomastoid
Chapter
12

Worksheet Exercises
Worksheet 2
with an “O” and an “I,” respectively, and draw in the origin and insertion on the posterior view as applicable.
a. Erector spinae
b. Quadratus lumborum
c. Splenius—cervicis and capitis
pter

C HAPTER 13
M USCULAR A NALYSIS
OF T RUNK AND L OWER
E XTREMITY E XERCISES
Objectives
To analyze an exercise to determine the joint movements
C analysis
hapter 8 of exercisean
presented and activities. That
introduction to thechap-
j ter included only analysis of the muscles previously studied in
and the types of contractions occurring in the specific the upper-extremity region.
muscles involved in those movements Since that chapter, all the other joints and large muscle
groups of the human body have been considered. The
exercises and activities in this chapter concentrate more on the
j To learn to group individual muscles into units that
muscles in the trunk and lower extremity.
produce certain joint movements
j To begin to think of exercises that increase the Strength, endurance, and flexibility of the muscles of the
strength and endurance of individual muscle groups lower extremity, trunk, and abdominal sections are also very
important in skillful physical performance and body
maintenance.
j To learn to analyze and prescribe exercises to strengthen
The type of contraction is determined by whether the muscle
major muscle groups
is lengthening or shortening during the movement. However,
j To apply the concept of the kinetic chain to the lower muscles may shorten or lengthen in the absence of a
extremity contraction through passive movement caused by other
contracting muscles, momentum, gravity, or external forces
such as manual assistance and exercise machines.
A concentric contraction is a shortening contraction of the

muscles against gravity or resistance, whereas an eccentric
Online Learning Center Resources contraction is a contraction in which the muscle lengthens under
tension to control the joints moving with gravity or resistance.
Contraction against gravity is also quite evident in the lower
j Self-grading quizzes extremities. To simply stand still, isometric contractions are
j Anatomy flashcards utilized in the hip extensors, knee extensors, and plantar flexors
j Animations to prevent hip flexion, knee flexion, and dorsiflexion,
j Related websites respectively.
Chapter
13

The quadriceps muscle group contracts eccentrically when our muscle mass, we burn more calories and are less likely to
the body slowly lowers in a weightbearing movement through gain excessive fat.
lower-extremity action. The quadriceps functions as a Sports participation does not ensure sufficient development
decelerator to knee joint flexion in weight-bearing movements of muscle groups. Also, more and more emphasis has been
by contracting eccentrically to prevent too rapid a downward placed on mechanical kinesiology in physical education and
movement. One can easily demonstrate this fact by palpating athletic skill teaching. This is desirable and can help bring about
this muscle group while slowly moving from a standing position more skillful performance. However, it is important to remember
to a half squat. This type of contraction involves almost as much that mechanical principles will be of little or no value to
effort as concentric contractions. performers without adequate strength and endurance of the
muscular system, which is developed through planned
exercises and activities. In the fitness and health revolution of
In this example involving the quadriceps, the slow descent is recent decades, a much greater emphasis has been placed on
eccentric, and the ascent from the squatted position is exercises and activities that improve the physical fitness,
concentric. If the descent were under no muscular control, it strength, endurance, and flexibility of participants. This chapter
would be at the same speed as gravity, and the muscle continues the practice of analyzing the muscles through simple
lengthening would be passive. That is, the movement and exercises, the approach begun in Chapter 8. When these
change in length of the muscle would be both caused and techniques are practiced extensively and mastered, the
controlled by gravity and not by active muscular contractions. individual is ready to analyze and prescribe exercises and
activities for the muscular strength and endurance needed in
sports activities and for healthful living.
More and more medical and allied health professionals have
been emphasizing the development of muscle groups through
resistance training and circuit-training activities. Athletes and
nonathletes, both male and female, need overall muscular
development. Even those who do not necessarily desire To further assist in analyzing the muscles primarily involved
significant muscle mass are advised to develop and maintain in exercises, review the “Concepts for Analysis” section in
their muscle mass through resistance training. As we age, we Chapter 8. It would also be beneficial to utilize Appendix 5 and
normally tend to lose muscle mass, and as a result our determine the muscles involved in the different phases using
metabolism decreases. This factor, combined with improper the Skill Analysis Worksheet found in the Worksheet Exercises
eating habits, results in unhealthful fat accumulation and at the end of this chapter. The worksheets together provide for
excessive weight gain. Through increasing analysis of up to six different phases.
pter

Abdominal curl-up FIG. 13.1
Description
The participant lies on the back, forearms crossed and lying
across the chest, with the knees flexed approximately 90
degrees and the feet about hip width apart. The hips and knees A
are flexed in this manner to reduce the length of the hip flexors,
thereby reducing their contribution to the curl-up.
The participant performs trunk flexion up to a curl-up

position, rotates the trunk to the right and points the left elbow
toward the anterior right pelvis (anterior superior iliac spine),
and then returns to the starting position. On the next repetition,
the participant should rotate to the left instead of to the right for B
balanced muscular development.
Analysis
This open kinetic chain exercise is divided into four phases for
analysis: (1) trunk flexion phase to curl-up position, (2) rotating
to right/left phase, (3) return phase to curl-up position, and (4)
return phase to starting position (Table 13.1). C
FIG. 13.1 • Abdominal curl-up. A, Beginning relaxed position; B, Trunk

flexion to curl-up position;
C, Trunk flexion and right rotation curl-up position.
TABLE 13.1 • Abdominal curl-up
Trunk flexion phase to Return phase to Return phase to

curl-up position Rotating to right/left phase Action curl-up position starting position
Joint Action Agonists Agonists Action Agonists Action Agonists
Cervical Mainte- Cervical spine Mainte- Cervical spine Cervical spine

spine nance flexors (isometric nance flexors (isometric flexors (eccentric
Cervical
Flexion flexors of contraction) of contraction) Extension contraction)
spine
Sternocleido- cervical Sternocleido- cervical Sternocleido- Sternocleido-
mastoid flexion mastoid flexion mastoid mastoid
Right lumbar Trunk flexors

Trunk flexors rotators Right lumbar (eccentric
Rectus (R) Rectus rotators (eccentric contraction)
Left
abdominis abdominis contraction) Rectus
lumbar
External Right (L) External (R) Rectus abdominis abdominis
rotation
Trunk Flexion oblique lumbar oblique (L) External oblique Extension External
to
abdominal rotation abdominal abdominal oblique
neutral
Internal (R) Internal (R) Internal oblique abdominal
position
oblique oblique abdominal Internal
abdominal abdominal (R) Erector spinae oblique
(R) Erector spinae abdominal
Hip flexors Hip flexors Hip flexors

Hip flexors (isometric (isometric (eccentric
Mainte- Mainte-
Iliopsoas contraction) contraction) contraction)
nance nance
Hip Flexion Rectus Iliopsoas Iliopsoas Extension Iliopsoas Chapter
of hip of hip
13
femoris Rectus Rectus Rectus
flexion flexion
Pectineus femoris femoris femoris
Pectineus Pectineus Pectineus

Alternating prone extensions FIG. 13.2 the head, upper trunk, left upper extremity, and right lower
extremity are raised from the floor.
Description
Analysis
The participant lies in a prone position, facedown, with the
shoulders fully flexed in a relaxed position lying in front of the This open kinetic chain exercise is separated into two phases
body. The head, upper trunk, right upper extremity, and left for analysis: (1) lifting phase to raise the right upper extremity
lower extremity are raised from the floor. The knees are kept in off the surface and raise the left lower extremity off the floor and
full extension. Then the participant returns to the starting (2) lowering phase to relaxed position (Table 13.2).
position. On the next repetition,
FIG. 13.2 • Alternating prone extensions. A,

Beginning relaxed
position; B, Raised position.
B
TABLE 13.2 • Alternating prone extensions (Superman exercise)
Lifting phase to raise upper and lower extremities Action Lowering phase to relaxed position Action
Joint Agonists Agonists
Shoulder joint flexors (eccentric

Shoulder joint flexors
contraction)
Pectoralis major (clavicular head or
Pectoralis major (clavicular
upper fibers)
Shoulder Flexion Extension head or upper fibers)
Deltoid
Deltoid
Coracobrachialis
Coracobrachialis
Biceps brachii
Biceps brachii
Shoulder girdle adductors

Shoulder girdle adductors
Shoulder (eccentric contraction)
Adduction Trapezius Abduction
girdle Trapezius
Rhomboids
Rhomboids
Trunk and cervical spine extensors

Trunk extensors
Flexion (return to (eccentric contraction)
Erector spinae
Trunk Extension neutral relaxed Erector spinae
Splenius
position) Splenius
Quadratus lumborum
Quadratus lumborum
Hip extensors Hip extensors (eccentric contraction) Gluteus

pter Gluteus maximus Flexion (return to maximus
3
Hip Extension Semitendinosus neutral relaxed Semitendinosus
Semimembranosus position) Semimembranosus
Biceps femoris Biceps femoris

Squat FIG. 13.3 The feet should be parallel, with slight external rotation of
the lower extremity. The knees should point over the ankles and
Description feet without going in front of, between, or outside of the vertical
plane of the feet.
The participant places a barbell on the shoulders behind the
neck and grasps it with the palmsforward position of the hands.
The participant squats down, flexing at the hips while keeping
Analysis
the spine in normal alignment, until the thighs are parallel to the
floor. The participant then returns to the starting position. This This closed kinetic chain exercise is separated into two phases
exercise is commonly performed improperly by allowing the for analysis: (1) lowering phase to the squatted position and (2)
knees to move forward beyond the plane of the feet, which lifting phase to the starting position (Table 13.3). Note: It is
greatly increases the risk of injury. Care should be taken to assumed that no movement will take place in the shoulder joint,
ensure that the shins remain as vertical as possible during this shoulder girdle, wrists, hands, or back, although isometric
exercise. muscle activity is required in these areas to maintain proper
positioning.
FIG. 13.3 • Squat. A, Starting position; B, Squatted position.

A B
TABLE 13.3 • Squat
Lowering phase to squatted position Lifting phase to starting position Action
Joint Action Agonists Agonists
Hip extensors (eccentric contraction) Gluteus Hip extensors

maximus Gluteus maximus
Hip Flexion Semimembranosus Extension Semimembranosus
Semitendinosus Semitendinosus
Knee extensors (eccentric contraction) Rectus Knee extensors

femoris Rectus femoris
Knee Flexion Vastus medialis Extension Vastus medialis
Vastus intermedius Vastus intermedius
Vastus lateralis Vastus lateralis
Chapter
13
Plantar flexors (eccentric contraction) Plantar flexors
Ankle Dorsiflexion Gastrocnemius Plantar flexion Gastrocnemius
Soleus Soleus

Dead lift FIG. 13.4 Analysis

This closed kinetic chain exercise is divided into two phases for
Description analysis: (1) lifting phase to the hip extended/knee extended
The participant begins in hip/knee flexed position, keeping the position and (2) lowering phase to the hip flexed/knee flexed
arms, legs, and back straight, and grasps the barbell on the starting position (Table 13.4).
floor. Then a movement to the standing position is made by
extending the hips. This exercise, when done improperly by
allowing lumbar flexion, may contribute to low back problems. It
is essential that the lumbar extensors be used more as
isometric stabilizers of the low back while the hip extensors
perform the majority of the lift in this exercise.
FIG. 13.4 • Dead lift. A, Beginning hip flexed/knee flexed position; B, Ending
hip extended/knee extended
position.
A B
TABLE 13.4 • Dead lift
Lifting phase to hip/knee extended position Action Lowering phase to hip/knee flexed position Action
Joint Agonists Agonists
Wrist and hand flexors (isometric Wrist and hand flexors (isometric
contraction) contraction)
Wrist
and Flexion Flexion
hand
Trunk extensors (isometric contraction) Erector Trunk extensors (isometric contraction) Erector
Maintenance Maintenance
Trunk spinae (sacrospinalis) spinae (sacrospinalis)
of extension of extension
Quadratus lumborum Quadratus lumborum
Hip extensors Hip extensors (eccentric contraction) Gluteus

Gluteus maximus maximus
Hip Extension Semimembranosus Flexion Semimembranosus
Semitendinosus Semitendinosus
Knee extensors (quadriceps)

Knee extensors (quadriceps)
(eccentric contraction)
Rectus femoris
Rectus femoris
Knee Extension Vastus medialis Flexion
pter Vastus medialis
Vastus intermedius
Vastus intermedius
3 Vastus lateralis
Vastus lateralis
Note: Slight movement of the shoulder joint and shoulder girdle is not being analyzed.

Isometric exercises Abdominal contraction FIG. 13.5

An exercise technique called isometrics is a type of muscular Description
activity in which there is contraction of muscle groups with little
The participant contracts the muscles in the anterior abdominal
or no muscle shortening. Though not as productive as isotonics
region as strongly as possible, with no movement of the trunk or
in terms of overall strength gains, isometrics are an effective
hips. This exercise can be performed in the sitting, standing, or
way to build and maintain muscular strength in a limited range
supine position. The longer the contraction in seconds, the more
of motion.
valuable the exercise will be, to a degree.
A few selected isometric exercises are analyzed muscularly

to show how they are designed to develop specific muscle
groups. Although there are varying approaches to isometrics,
Analysis
most authorities agree that isometric contractions should be
Abdomen
held approximately 7 to 10 seconds for a training effect.
Contraction
Rectus abdominis
Internal oblique abdominal
Transversus abdominis
A B
FIG. 13.5 • Abdominal contraction. A, Beginning position; B, Contracted position.
Chapter
13

Rowing exercise FIG. 13.6 Analysis

This closed kinetic chain exercise is divided into two
Description movements for analysis: (1) arm pull to chest/ leg push to
The participant sits on a movable seat with the knees and hips extend knees and hip phase and (2) return phase to the starting
flexed close to the chest. The arms are reaching forward to position (Table 13.5).
grasp a horizontal bar. The legs are extended forcibly as the
arms are pulled toward the chest. Then the legs and arms are
returned to the starting position.
A B
FIG. 13.6 • Rowing exercise machine. A, Starting position; B, Movement.
TABLE 13.5 • Rowing exercise
Arm pull/leg push phase Return phase to starting position
Ankle dorsiflexors
Foot Ankle plantar flexors Tibialis anterior
Plantar
and Gastrocnemius Dorsiflexion Extensor hallucis longus
flexion
ankle Soleus Extensor digitorum longus
Peroneus tertius
Quadriceps (knee extensors)

Knee flexors (hamstrings)
Rectus femoris
Biceps femoris
Knee Extension Vastus medialis Flexion
Semitendinosus
Vastus intermedius
Semimembranosus
Vastus lateralis
Hip extensors
Hip flexors
Gluteus maximus
Iliopsoas
Hip Extension Biceps femoris Flexion
Rectus femoris
Semimembranosus
Pectineus
Semitendinosus
pter Trunk flexors
3
Trunk extensors Rectus abdominis
Trunk Extension Flexion
Erector spinae Internal oblique abdominal

TABLE 13.5 (continued) • Rowing exercise
Arm pull/leg push phase Return phase to starting position
Shoulder girdle adductors, Shoulder girdle adductors, downward rotators,

Adduction, downward rotators, and Abduction, and depressors (eccentric contraction)
Shoulder downward depressors upward
girdle rotation, and Trapezius (lower) rotation, and Trapezius (lower)
depression Rhomboid elevation Rhomboid
Pectoralis minor Pectoralis minor
Shoulder joint extensors

Shoulder joint extensors
Latissimus dorsi
Latissimus dorsi
Shoulder Teres major
Extension Flexion Teres major
joint Posterior deltoid
Posterior deltoid
Teres minor
Teres minor
Infraspinatus
Infraspinatus
Elbow joint flexors

Elbow joint flexors
Elbow Biceps brachii
Flexion Extension Biceps brachii
joint Brachialis
Brachialis
Brachioradialis
Brachioradialis
Wrist and hand flexors Wrist and hand flexors (isometric

(isometric contraction) contraction)
Wrist and Flexor carpi ulnaris Flexor carpi ulnaris
Flexion Flexion
hand Palmaris longus Palmaris longus
REVIEW EXERCISES muscles. Separate the list into open versus closed kinetic chain
exercises.
1. Select, describe, and completely analyze five conditioning

exercises.
2. Collect, analyze, and evaluate exercises that are found in LABORATORY EXERCISES
newspapers, in magazines, and on the Internet or are
observed on television. 1. Observe children using playground equipment. Analyze
3. Prepare a set of exercises that will ensure development of muscularly the activities they are performing.
all large muscle groups in the body. Select exercises from
4. exercise books for analysis. Bring to class other typical 2. Visit the facility on your campus where the free weights and
5. exercises for members to analyze. specific or multifunction exercise machines are located.
Analyze exercises that can be done with each machine.
6. Analyze the conditioning exercises given by your physical Compare and contrast similar exercises using different
education teachers, coaches, and athletic trainers. exercise machines and free weights. Note: Manufacturers
of all types of exercise apparatus have a complete list of
7. Consider a sport (basketball or any other sport) and exercises that can be performed with
develop exercises applying the overload principle that
would develop all the large muscle groups used in that their machines. Secure a copy of recommended Chapter
8.
sport.
Prepare a list of exercises not found in this chapter to 3.
with the knees flexed and 13
exercises and muscularly analyze each exercise. Lie supine on a table
develop the lower-extremity and spinal hips flexed 90 degrees and the ankles in the

neutral 90-degree position. Extend each joint until your between your heels and the wall. Maintain your feet in
knee is fully extended, your hip is flexed only 10 degrees, position, with hips and knees each flexed approximately 90
and your ankle is plantarflexed 10 degrees by performing degrees so that your thighs are parallel to the floor.
each of the following movements in the order given: Keeping your feet in place, slowly slide your back and
buttocks up the wall until your buttocks are as far away
• Full knee extension from the floor as possible without moving your feet. Analyze
• Hip extension to within 10 degrees of neutral the movements and the muscles responsible for each
• Plantar flexion to 10 degrees movement at the hip, knee, and ankle.
Analyze the movements and the muscles responsible for
each movement at the hip, knee, and ankle.
5. What is the difference between the two exercises in
4. Stand with your back and buttocks against a smooth wall and Questions 3 and 4? Can you perform the movement in
place your feet (shoulder width apart) with approximately Question 4 one step at a time, as you did in Question 3?
12 inches
6. Exercise analysis chart
Analyze each exercise in the chart. Use one row for each joint involved that actively moves during the exercise. Do not include joints for
which there is no active movement or joints maintained in one position isometrically.

Trunk flexion
phase to curl-up
position
Rotating to
right phase
Abdominal
curl-up
Return phase
to curl-up
position
Return phase
to starting
position
Lifting phase
Alternating
prone
extensions
Lowering
phase
pter


Lowering
phase
Squat
Lifting phase
Lifting phase
Dead lift
Lowering phase
Arm pull/leg
push phase
Rowing
exercise
Return phase to
starting position
Chapter
13

References Northrip JW, Logan GA, McKinney WC: Analysis of sport motion:
anatomic and biomechanic perspectives, ed 3, New York, 1983, McGraw-Hill.
Adrian M: Isokinetic exercise, Training and Conditioning 1:1, June 1991. Powers SK, Howley ET: Exercise physiology: theory and application
Altug Z, Hoffman JL, Martin JL: Manual of clinical exercise testing, of fitness and performance, ed 7, New York, 2009, McGraw-Hill.
prescription and rehabilitation, Norwalk, CT, 1993, Appleton & Lange. Prentice WE: Rehabilitation techniques in sports medicine, ed 5, New
Andrews JR, Wilk KE, Harrelson GL: Physical rehabilitation of the Steindler A: Kinesiology of the human body, Springfield, IL, 1970,
injured athlete, ed 3, Philadelphia, 2004, Saunders. Charles C Thomas.
Ellenbecker TS, Davies GJ: Closed kinetic chain exercise: a Torg JS, Vegso JJ, Torg E: Rehabilitation of athletic injuries: an atlas
comprehensive guide to multiple-joint exercise, Champaign, IL, of therapeutic exercise, Chicago, 1987, Year Book.
Wirhed R: Athletic ability and the anatomy of motion, ed 3, St. Louis,
Fahey TD: Athletic training: principles and practices, Mountain View, 2006, Mosby Elsevier.
CA, 1986, Mayfield.
Logan GA, McKinney WC: Anatomic kinesiology, ed 3, New York,

1982, McGraw-Hill.
Matheson O, et al: Stress fractures in athletes, American Journal of

Sports Medicine 15:46, January–February 1987.
National Strength and Conditioning Association; Baechle TR, Earle For additional resources and a list of related websites,
RW: Essentials of strength training and conditioning, ed 2, Champaign, IL, visit www.mhhe.com/floyd19e.
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A ppendix
Appendix 1
Range of motion for diarthrodial joints of the upper extremity
Joint Type Motion Range
Protraction Moves anteriorly 15°
Retraction Moves posteriorly 15°
Elevation Moves superiorly 45°

Sternoclavicular Arthrodial
Depression Moves inferiorly 5°
Upward rotation 45°
Downward rotation 5°
Protraction-retraction 20°–30° rotational and gliding motion 20°–30°
Elevation-depression rotational and gliding motion 20°–30° rotational

Acromioclavicular Arthrodial
Upward rotation– and gliding motion
downward rotation
Not a true synovial joint; Abduction-adduction 25° total range
all movement
Upward rotation– 60° total range
Scapulothoracic totally dependent
downward rotation
on AC and SC
Elevation-depression 55° total range
joints
Flexion 90°–100°
Extension 40°–60°
Abduction 90°–95°
Adduction 0° prevented by trunk, 75° anterior to trunk

Glenohumeral Enarthrodial
Internal rotation 70°–90°
External rotation 70°–90°
Horizontal abduction 45°
Horizontal adduction 135°
Extension 0°
Elbow Ginglymus
Flexion 145°–150°
Supination 80°–90°
Radioulnar Trochoid
Pronation 70°–90°

Range of motion for diarthrodial joints of the upper extremity ( continued)
Flexion 70°–90°
Wrist Condyloid
Adduction 25°–40°
Flexion 15°–45°
Thumb Extension 0°–20°

Sellar
carpometacarpal Adduction 0°
Thumb Extension 0°
Ginglymus
metacarpophalangeal Flexion 40°–90°
Flexion 80°–90°
Thumb interphalangeal Ginglymus
Extension 0°
2nd, 3rd, 4th, and 5th Flexion 85°–100°
metacarpophalangeal Condyloid
Abduction Variable 10°–40°
joints
Adduction Variable 10°–40°
2nd, 3rd, 4th, and 5th Flexion 90°–120°

proximal interphalan- Ginglymus
Extension 0°
geal joints
2nd, 3rd, 4th, and 5th distal Flexion 80°–90°

interphalangeal Ginglymus
Extension 0°
joints

Appendix 2
Range of motion for diarthrodial joints of the spine and lower extremity
Flexion 80°
Arthrodial except atlan- Extension 20°–30°
Cervical toaxial joint, which is Lateral flexion 35°

trochoid
Rotation 45°
unilaterally
Flexion 45°
Extension 45°
Lumbar Arthrodial Lateral flexion 45°
Rotation 60°
unilaterally
Flexion 130°
Extension 30°
Abduction 35°
Hip Enarthrodial
Adduction 0°–30°
External rotation 50°
Internal rotation 45°
Extension 0°
Knee Flexion 140°
Ginglymus
For internal and external rotation to occur, the knee must
(trochoginglymus) Internal rotation 30°
be flexed approximately 30° or more.
External rotation 45°
Plantar flexion 50°

Ankle (talocrural) Ginglymus
Dorsal flexion 15°–20°
Inversion 20°–30°
Transverse tarsal and subtalar Arthrodial
Eversion 5°–15°
Flexion 45°
Extension 70°
Great toe metatarsophalangeal Condyloid
Flexion 90°
Great toe interphalangeal Ginglymus
Extension 0°
Flexion 40°
2nd, 3rd, 4th, and 5th metatarsophalangeal joints Extension 40°

Condyloid
2nd, 3rd, 4th, and 5th proximal interphalangeal joints Flexion 35°
Ginglymus
Extension 0°
2nd, 3rd, 4th, and 5th distal interphalangeal joints Flexion 60°
Ginglymus
Extension 30°

Appendix 3
Commonly used exercises for strengthening selected muscles

Some exercises may be more or less specific for certain muscles. In some cases, certain exercises are designed to emphasize specific portions of a
particular muscle more than other portions. Some exercises may be modified slightly to further emphasize or deemphasize certain muscles or portions
of muscles. In addition to the muscles listed, numerous other muscles in surrounding joints or other parts of the body may be involved by contracting
isometrically to maintain appropriate position of the body for the muscles listed to carry out the exercise movement. Appropriate strength and
endurance of these stabilizing muscles is essential for correct position and execution of the listed exercises. Finally, these exercises may be
documented by different names by different authorities. Illustration and documentation of the proper techniques and indications for these exercises is
beyond the scope of this text. Please consult several strength and conditioning texts for further details.
Upper extremity Upper extremity
Muscle groups Muscles Exercise Muscle groups Muscles Exercise
Front press Arm curls

Dumbbell flys Deltoid, anterior Triceps dips
Dumbbell press fibers One-arm dumbbell
Bench press Deltoid, middle press
Shoulder
Scapula Serratus anterior Close-grip bench press fibers Front raises
flexors
abductors Pectoralis minor Incline press Pectoralis major, Low pulley front raises
Push-ups clavicular fibers One-dumbbell front
Incline dumbbell press Coracobrachialis raises
Pec deck flys Barbell front raises
Cable crossover flys
Latissimus dorsi
Dumbbell pullovers
Bent-over lateral raises Teres major
Barbell pullovers
Rhomboid Pec deck rear delt laterals Triceps brachii,
Reverse chin-ups
Trapezius, lower Seated rows long head
Scapula Close-grip lat
fibers Bent rows Shoulder Pectoralis major,
adductors pulldowns
Trapezius, middle T-bar rows extensors sternal fibers
Straight-arm lat
fibers Dead lifts Deltoid,
pulldowns
Sumo dead lifts posterior fibers
One-arm dumbbell
Infraspinatus
Serratus anterior Dumbbell press rows
Teres minor
Scapula Trapezius, lower Dumbbell flys
upward fibers One-arm dumbbell press Deltoid, anterior Back press
rotators Trapezius, middle Lateral raises fibers Front press
fibers Upright rows Deltoid, posterior Dumbbell press
fibers One-arm dumbbell press
Parallel bar dips
Shoulder Deltoid, middle Lateral raises
Dumbbell pullovers
abductors fibers Side-lying lateral raises
Barbell pullovers
Pectoralis major, Low pulley lateral raises
Chin-ups
clavicular fibers Upright rows
Scapula Reverse chin-ups
Pectoralis minor Supraspinatus Nautilus lateral raises
downward Lat pulldowns
Rhomboid Upright rows
rotators Back lat pulldowns
Close-grip lat pulldowns Pectoralis major Triceps dips
Straight-arm lat Latissimus dorsi Parallel bar dips
Shoulder
pulldowns Teres major Chin-ups
adductors
One-arm dumbbell rows Subscapularis Lat pulldowns
Coracobrachialis Back lat pulldowns
Rhomboid
Upright rows
Levator scapulae Triceps dips
Barbell shrugs
Scapula Trapezius, upper Pectoralis major Side-lying internal
Dumbbell shrugs Shoulder
elevators fibers Latissimus dorsi rotations
Machine shrugs internal
Trapezius, middle Teres major Standing internal
Dead lifts rotators
fibers Subscapularis rotations at 90
degrees abduction
Pectoralis minor
Scapula Parallel bar dips
Trapezius, lower Side-lying external
depressors Body dips
fibers Shoulder rotations
Infraspinatus
external Standing external
Teres minor
rotators rotations at
90 degrees abduction

Upper extremity Upper extremity
Muscle Muscle
Muscles Exercise Muscles Exercise
groups groups
Latissimus dorsi Flexor carpi radialis

Bent-over lateral raises
Infraspinatus Palmaris longus
Low pulley bent-over
Shoulder Teres minor Flexor carpi ulnaris
lateral raises Wrist
horizontal Deltoid, middle Flexor digitorum Wrist curls
Pec deck rear delt laterals Bent flexors
abductors fibers superficialis
rows
Deltoid, posterior Flexor digitorum
T-bar rows
fibers profundus
Dumbbell flys Extensor carpi

Triceps dips radialis longus
Reverse barbell curls
Dumbbell press Wrist Extensor carpi
Reverse wrist curls
Bench press extensors radialis brevis
Reverse pushdowns
Close-grip bench press Extensor carpi
Shoulder Incline press ulnaris
Pectoralis major
horizontal Decline press
Coracobrachialis Hand intrinsics
adductors Push-ups Ball squeezes
Flexor digitorum
Incline dumbbell press Putty squeezes
Finger profundus
Incline dumbbell flys Rice bucket grips
flexors Flexor digitorum
Pec deck flys Wrist curls
superficialis
Cable crossover flys Dead lifts
Flexor pollicis longus
Seated rows
Arm curls concentration Extensor digitorum

Reverse barbell curls
curls Finger Extensor digiti
Reverse wrist curls
Hammer curls extensors minimi
Rubber band stretches
Low pulley curls Extensor indicis
High pulley curls

Barbell curls
Machine curls
Preacher curls
Biceps brachii Reverse barbell curls
Elbow
Brachialis Chin-ups Lower extremity
flexors
Brachioradialis Reverse chin-ups
Lat pulldowns Muscle
Muscles Exercise
Back lat pulldowns groups
Close-grip lat pulldowns Crunches
Seated rows Sit-ups
One-arm dumbbell rows Gym ladder sit-ups
Bent rows Rectus femoris Calves over bench sit-ups
T-bar rows Iliopsoas Incline bench sit-ups
Upright rows Hip flexors
Pectineus Specific bench sit-ups
Barbell pullovers Tensor fasciae latae Machine crunches
Bench press Incline leg raises
Close-grip bench press Leg raises
Decline press Hanging leg raises
Dumbbell press
Stiff-legged dead lifts
Dumbbell pullovers
Dead lifts
Dumbbell triceps
Back extensions
extensions
Dumbbell squats
Front press
Squats
Triceps brachii Incline dumbbell press
Gluteus maximus Front squats
Triceps brachii, Incline press
Biceps femoris, Power squats
lateral head One-arm dumbbell Hip
long head Angled leg press
Elbow Triceps brachii, triceps extensions extensors
Semitendinosus Good mornings
extensors long head One-arm reverse
Semimembranosus Lunges
Triceps brachii, pushdowns
Cable back kicks
medial head Parallel bar dips
Machine hip extensions
Anconeus Pushdowns
Floor hip extensions
Push-ups
Bridging
Reverse pushdowns
Prone arches
Seated dumbbell
triceps extensions Cable hip abductions
Seated ez-bar triceps Standing machine
Gluteus medius
extensions Hip hip abductions
Gluteus maximus
Triceps dips abductors Floor hip abductions
Tensor fascia latae
Triceps extensions Seated machine hip
Triceps kickbacks abductions

Lower extremity Cervical spine and trunk
Muscle Muscle
Muscles Exercise Muscles Exercise
groups groups
Adductor magnus Sumo dead lifts Splenius cervicis

Hip Adductor longus Power squats Cervical Splenius capitus Dead lifts
adductors Adductor brevis Cable adductions extensors Trapezius, upper Neck extensions
Gracilis Machine adductions fibers
Gluteus maximus Cervical Chin tucks

Sternocleidomastoid
Piriformis flexors Sit-ups
Hip Gemellus superior
Hip turn-outs Sternocleidomastoid
external Gemellus inferior Cervical
Body turn-aways Splenius cervicis Machine neck rotations
rotators Obturator externus rotators
Splenius capitus
Obturator internus
Quadratus femoris Back extensions
Leg extensions Trunk Alternating prone
Erector spinae
Dead lifts extensors extensions
Sumo dead lifts Prone arches
Vastus medialis Dumbbell squats
Dead lifts
Knee Vastus intermedius Squats
Crunches
extensors Rectus femoris Front squats
Crunch twists
Vastus lateralis Angled leg press
Sit-ups
Power squats
Rectus abdominis Gym ladder sit-ups
Hack squats
External oblique Calves over bench sit-ups
Lunges Trunk
abdominal Incline bench sit-ups
flexors
Semitendinosus Internal oblique Specific bench sit-ups
Biceps femoris, abdominal High pulley crunches
long head Machine crunches
Biceps femoris, Incline leg raises
Standing leg curls
Knee short head Leg raises
Seated leg curls
flexors Semimembranosus Hanging leg raises
Lying leg curls
Gastrocnemius,
lateral head Crunches
Gastrocnemius, Crunch twists
medial head Sit-up twists
Gym ladder sit-ups
Tibialis anterior
Calves over bench sit-ups
Extensor hallucis
External oblique Incline bench sit-ups
Ankle longus Towel pulls
Trunk abdominal Specific bench sit-ups
dorsiflexors Extensor digitorum Elastic band pulls
rotators Internal oblique High pulley crunches
longus
abdominal Machine crunches
Peroneous tertius
Incline leg raises
Gastrocnemius, Standing calf raises Leg raises
Ankle lateral head One-leg toe raises Hanging leg raises
plantar Soleus Donkey calf raises Broomstick twists
flexors Gastrocnemius, Seated calf raises Machine trunk rotations
medial head Seated barbell calf raises
Crunches
Tibialis anterior Crunch twists
Transverse Tibialis posterior Sit-ups
tarsal/ Flexor digitorum Towel drags Gym ladder sit-ups
subtalar longus Elastic band turn-ins External oblique Calves over bench sit-ups
inversion Flexor hallucis abdominal Incline bench sit-ups
longus Trunk Internal oblique Specific bench sit-ups
lateral abdominal High pulley crunches
Extensor
Transverse flexors Quadratus Machine crunches
digitorum longus
tarsal/ Towel drags lumborum Incline leg raises
Peroneus longus
subtalar Elastic band turn-outs Rectus abdominis Leg raises
Peroneus brevis
eversion Hanging leg raises
Peroneus tertius
Broomstick twists
Extensor Dumbbell side bends
Toe hallucis longus Towel pulls Roman chair side bends
extensors Extensor digitorum Elastic band pulls
longus
Flexor digitorum
Towel curls
Toe longus
Marble pickups
flexors Flexor hallucis longus
Pencil pickups
Foot intrinsics

Appendix 4
Etymology of commonly used terms in kinesiology

Below are some of the most commonly used terms in naming the muscles, bones, and joints as well as some additional terms utilized in explaining
their function. This etymology is provided in order to better understand the origin and historical development of these terms and to provide a more
meaningful background as to how these terms came to be used in the study of the body and its movement today.
abdominis Latin: belly coronoid Greek: korone, something curved, kind of

abductor Latin: abducere crown 1 eidos, form, shape
acromion Greek: akron, extremity 1 omus, shoulder cortical Latin: rind
adductor Latin: adducere, adduct-, to bring to, contract costal Latin: costa, rib
amphiarthrodial Greek: ampho, both 1 arthron, coxal Latin: coxa, hip
joint 1 eidos, form, shape cranial Latin: cranialis, cranium; Greek: kranion Latin:
anconeus Greek: agkon, elbow crest crista, crest
antebrachial Latin: ante, before 1 brachium, arm crural Latin: cruralis, pertaining to leg or thigh Latin:
antecubital Latin: ante, before 1 cubitum, elbow cubital cubitum, elbow
anterior Latin: comparative of ante, before cuboid Greek: kybos, cube
appendicular Latin: appendere, to hang to cuneiforms Latin: cuneus, wedge 1 forma, form
arthrodial Greek: arthron, joint 1 eidos, form, shape deltoid, deltoidius Latin: deltoides: Greek deltoeides,
axillary Latin: axilla triangular: delta, delta 1 - oeides, -oid
axon Greek: axon, axis dendrite Greek: dendrites, pertaining to a tree
biceps Latin: two-headed, bi-, two; caput, head derma Greek: derma, skin
brachialis Latin: brachialis, brachial, arm dermatome Greek: derma, skin 1 tome, incision
brachii Latin: bracchium, arm diaphysis Greek: diaphysis, a growing through
brachioradialis Latin: bracchium, arm 1 radialis, radius diarthrodial Greek: dis, two 1 arthron, joint 1 eidos,
brevis Latin: (adj.) short, low, little, shallow form, shape
buccal Latin: cheek digital, digitorum Latin: digitus, finger or toe
bursa Greek: a leather sack distal Latin: distare, to be distant
calcaneus Latin: calcaneus, heel, from Latin calcaneum, dorsal Latin: dorsalis, dorsualis, of the back, from
from calx, calc dorsum, back
cancellous Latin: cancellus, lattice dorsi Latin: dorsi, genitive of dorsum, back
capitate, capitis Latin: caput, head eccentric Greek: ek, out 1 kentron, center
carpal Latin: carpalis, from carpus, wrist enarthrodial Greek: en, in 1 arthron, joint 1 eidos,
carpus, carpi Latin: from Greek karpos, wrist form, shape
caudal Latin: caudalis, tail endosteum Greek: endon, within 1 osteon, bone
celiac Greek: koilia, belly epiphyseal Greek: epi, above 1 phyein, to grow
cephalic Greek: kephale, head epiphysis Greek: a growing upon
cerebellum Latin: little brain erector Latin: erigere, to erect
cerebrum Latin: cerebrum, brain extensor Latin: extendere, to stretch out
cervicis Latin: cervix, neck external, externus Latin: externus, outside, outward
clavicle French: clavicule, collarbone; Latin: clavicula, key fabella Latin: faba, little bean
little facet French: facette, small face
coccyx Greek: kokkyz, cuckoo fasciae Latin: fascia, band
colli Latin: collare, necklace, band or chain for the neck, femoris Latin: femur, thigh, genitive of femur, thigh
from collum, the neck femur Latin: thigh
concentric Latin: con, together with 1 centrum, center fibers Latin: fibra, a fiber, filament, of uncertain origin,
condyle Greek: kondylos, knuckle perhaps related to Latin: filum, thread
condyloidal Greek: kondylos, knuckle 1 eidos, form, fibrous Latin: fibra, fiber
shape fibula Latin: clasp, brooch
coracobrachialis Greek: from coracoid korax, crow; flexor Latin: bender
eidos, form; Greek: brachion 1 Latin, radial foramen Latin: hole
coracoid Greek: korax, raven 1 eidos, form, shape fossa Latin: ditch
coronal Greek: korone, crown fovea Latin: pit

frontal Latin: frontem (nom, frons), forehead, literally longus Latin: long
that which projects lordosis Greek: lordosis, bending
fusiform Latin: fusus, spindle 1 forma, shape lumbar, lumborum Latin: lumbus, loin
gaster Greek: gaster, belly lumbricals Latin: lumbus, loin; referred to vermiform;
gastrocnemius Greek: gaster, belly 1 kneme, leg Latin: vermis, worm 1 forma, form
gemellus Latin: twin lunate Latin: lunatus, past participle of lunare, to bend
ginglymus Greek: ginglymos, hinge like a crescent, from luna, moon
gluteus Greek: gloutos, buttock magnus Latin: great
gomphosis Greek: bolting together major Middle English: majour; Latin: major
goniometer Greek: gonia, angle 1 metron, measure malleolus Latin: malleolus, little hammer Latin:
gracilis Latin: graceful mammary mamma, breast
greater Middle English: grete; Old English: great, thick, mandible Latin: mandibula, jaw; Latin: mandere, to
coarse; French: grand, which is from Latin: magnus chew
hallucis Latin: hallex, large toe manubrium Latin: handle, from manus, hand
hamate Latin: hamatus, hooked margin Latin: marginalis, border
head Latin: from caput maxilla Latin: upper jaw, of mala, jaw, cheekbone
humerus Latin: a misspelling borrowing umerus, maximus Latin: greatest
shoulder meatus Latin: meatus, passage
hyaline Greek: hyalos, glass medial, medialis Latin: medialis, of the middle; Latin:
iliacus Latin: ilium, flank medius, middle
iliocostalis Latin: ilium, flank 1 costa, rib medius Latin: middle
ilium Latin: ilium, groin, flank, variant of Latin: ilia mental Latin: mentum, chin
indicis Latin: forefinger, pointer, sign, list metacarpal Greek: meta, after, beyond, over 1 Latin:
inferior Latin: inferior, lower carpalis, from carpus, wrist
infraspinatus, infraspinous Latin: infra, below 1 spina, metatarsals Greek: meta, after, beyond, over 1 tarsos,
spine flat surface
inguinal Latin: inguinalis, groin middle Old English: middle; Latin: medium
insertion Latin: in, into 1 serere, to join minimus, minimi Latin: minimum, smallest
intermediate Latin: intermediates, lying between; Latin: minor Latin: lesser, smaller, junior
intermedius, that which is between; from inter, between 1 medius, multifidus Latin: multus, many 1 clefts or segments
in the middle muscle Latin: musculus
intermedius Latin: inter, between, mediare, to divide myo Greek: mys, muscle
that which is between myotome Greek: mys, muscle 1 tome, incision
internal, internus Latin: internus, within nasal Latin: nasus, nose
interossei Latin: inter, between 1 os, bone navicular Latin: navicula, boat, diminutive of navis, ship
interspinalis Latin: inter, between 1 spina, spine neural Latin: neuralis, nerve
intertransversarii Latin: inter, between 1 transverses, neuron Greek: neuron, nerve, sinew
cross-direction notch French: noche, indention, depression Latin:
ischium Greek: ischion, hip joint nuchal nape (back) of the neck
isokinetic Greek: isos, equal 1 kinesis, motion oblique, obliquus Latin: obliquus, slanted
isometric Greek: isos, equal 1 metron, measure obturator Latin: obturare, to close
isotonic Greek: isos, equal 1 tonus, tone occiput Latin: occiput (gen. occipitis), back of the skull,
kinematic Greek: kinematos, movement from ob, against, behind 1 caput, head
kinesiology Greek: kinematos, movement 1 logos, olecranon Greek: elbow
word, reason omos Greek: omos, shoulder
kinesthesia Greek: kinematos, movement 1 aesthesis, opponens Latin: opponentem (nom. opponens), prp. of
sensation opponere, oppose, object to, set against
kyphosis Greek: humpback oral Latin: oralis, mouth
latae Latin: latus, side orbital Latin: orbita, track
lateral, lateralis Latin: lateralis, belonging to the side origin Latin: origo, beginning
latissimus Latin: latissimus, superlative of latus, wide osseous Latin: osseus, bony
lesser Middle English: lesse; Latin: minor otic Greek: otikos, ear
levator Latin: levator, lifter palmar Latin: palma, palm of the hand
lever Latin: levare, to raise palmaris Latin: palma, palm
linea Latin: linea, line patella Latin: pan, kneecap
longissimus Latin: longest, very long pectineus Latin: pectin, comb

pectoralis Latin: pectoralis, from pectus, pector-, breast; splenius Greek: splenion, bandage
Middle English, French, Latin: pectorale, breastplate, from neuter of sternocleidomastoid Greek: sternon, chest 1 kleis,
pectoralis key 1 mastos, breast 1 eidos, form
pedal Latin: pedalis, foot sternum Greek: sternon, chest, breast, breastbone
pennate Latin: penna, feather styloid Anglo-Saxon: stigan, to rise 1 eidos, form
perineal Greek: perinaion, perineum subscapularis Latin: sub, beneath 1 scapulae, shoulder
periosteum Greek: peri, around 1 osteon, bone blades
peroneus Greek: perone, brooch sulcus Latin: groove
phalanges A plural of phalanx Greek: phalangos, finger superficialis Latin: superficies, of or pertaining to the
or toe bone surface
phalanx Greek: phalangos, finger or toe bone superior Latin: superiorem, higher
piriformis Latin: piriformis, pear shaped supinator Latin: reflectere, to bend back
pisiform Latin: pisa, pea 1 forma, form supraspinatus, supraspinous Latin: supra,
plantae Latin: planta, sole of the foot above 1 spina, spine
pollicis Latin: from pollex, thumb, big toe sural Latin: sura, calf
popliteus Latin: poples, ham of the knee suture Latin: sutura, a seam
posterior Latin: comparative of posterus, coming after, symphysis Greek: symphysis, growing together
from post, afterward synarthrodial Greek: syn,
process Latin: processus, going before together 1 arthron, joint 1 eidos, form, shape
profundus Latin: deep, bottomless, vast synchondrosis Greek: syn,
pronator Latin: pronare, to bend forward together 1 chondros, cartilage 1 osis, condition
proximal Latin: proximitatem (nom. proximitas), syndesmosis Greek: syndesmos, ligament 1 osis,
nearness, vicinity, from proximus, nearest condition
psoas Greek: psoa, muscle of the loin synovial Latin: synovia, joint fluid
pubis Latin: (os) pubis, bone of the groin talus Latin: ankle, anklebone, knucklebone
quadratus Latin: quadratus, square tarsal Greek: tarsalis, ankle
quinti Latin: quintus, fifth temporal Latin: temporalis, of time, temporary, from
radialis Latin: radialis, radius, beam of light Latin: tempus (temporis), time, season, proper time or season
radiate radiatre, to emit rays tendon Latin: tendo, tendon
radius Latin: beam of light Latin: tensor Latin: tendere, to stretch
ramus branch teres Latin: rounded
rectus Latin: rectus, straight tertius Latin: third
rhomboids, rhomboidus From the word rhombus; thoracic Greek: thorax, chest
Latin: flatfish, magician’s circle; from Greek: rhombos, rhombus tibia Latin: shinbone
tibialis Latin: tibia, pipe, shinbone
rotatores Latin: rotare, to rotate transverse Latin: transverses, oblique
sacrum Latin: os sacrum, sacred bone trapezium Greek: trapezion, a little table
sartorius Latin: sartor, tailor trapezius Latin: trapezium, trapezium, from the shape of
scaphoid Latin: skiff, boat shaped 1 eidos, form the muslces paired
scapulae, scapula Latin: shoulder; Latin: scapulae, the trapezoid Greek: trapezoeides, table shaped
shoulder blades triceps Latin: three-headed; tri-, tri- 1 caput, head
scoliosis Greek: scoliosis, crookedness triquetrum Latin: neuter of triquetrus, three-cornered
sellar Latin: Turkish saddle trochanter Greek: trokhanter, to run
semimembranosus Latin: semi, half 1 membrane, trochlear Greek: trokhileia, system of pulleys
membrane tubercle Latin: turberculum, a little swelling
semispinalis Latin: semi, half 1 spina, spine tuberosity Latin: tuberositas, tuberosity
semitendinosus Latin: semi, half 1 tendere, to stretch ulna Latin: elbow
serratus Latin: serratus, saw-shaped, from serra, saw ulnaris Latin: ulna, elbow
sesamoid Latin: sesamoides, resembling a grain of umbilical Latin: umbilicus, naval
sesame in size or shape vastus Latin: immense, extensive, huge
sinus Latin: curve, hollow vertical Latin: verticalis, overhead, vertex, highest point
soleus Latin: solea, sandal visceral Latin: viscera, body organs
somatic Greek: soma, body volar Latin: vola, sole, palm
sphincter Greek: sphincter, hand xiphoid Greek: xiphos, sword 1 eidos, form, shape
spinae Latin: thorn zygoma Latin: zygoma, zygomat-, from Greek zugoma,
spinal Latin: spinalis, spine bolt, from zugoun, to join

Appendix 5
Determining if a muscle (or muscle group) is contracting and, if so, the contraction type (isometric, concentric, or
eccentric)
Is Joint Movement Occurring?
Yes
No
Then is an external force (gravity, machine, inertia, etc.) causing the movement?
No Is the joint fully supported in its current

Yes
Then internal force (muscle contraction) must be causing position by external means?
Is the joint moving Faster, Slower,
the movement which means the
or at the Same Speed that the
agonist muscle group is performing a
external force would normally cause it
concentric contraction to cause movement in the
to move?
direction in which it is occurring.
No Yes
Then there must be Then no contraction
Shortening Shortening
internal force generated is needed in any of the
by an isometric muscles to maintain
muscle contraction to the position, but muscle could
maintain the current be unnecessarily
position of the joint. contracting isometrically.
Faster Slower Same Speed

Then the contraction is Then the contraction is Then there is no
concentric because eccentric because the appreciable active
the movement is being movement is being contraction in either If the sum of If the sum of
accelerated ( caused decelerated ( controlled) the shortening or gravity & external gravity & external
or enhanced) by the by the muscles that lengthening muscle forces were to cause the forces were to cause the
muscles that cause oppose movement groups. All movement joint to move into joint to move into
movement (agonists) in (antagonists) in the is passive and flexion then the extension then the
the same direction as the direction of the caused by the extensors must be flexors must be
occurring movement. occurring movement. external force(s). contracting contracting
isometrically to isometrically to
maintain the position. maintain the position.
Contracting muscle Contracting muscle

is shortening is lengthening
Respectively Respectively
substitute adduction substitute abduction
& abductors or & adductors or
internal rotation & external rotation &
external rotators internal rotators
Contracting muscle is neither

shortening nor lengthening

G lossary
abduction Lateral movement away from the midline angular displacement The change in location of a rotat-
of the trunk, as in raising the arms or legs to the side horizontally. ing body.
angular motion Motion involving rotation around an axis.
acceleration The rate of change in velocity. antagonist A muscle or muscle group that counteracts or
accessory motion The actual change in relationship opposes the contraction of another muscle or muscle group.
between the articular surface of one bone relative to another, anterior axillary line A line parallel to the mid-axillary
characterized as roll, spin, and glide. line which passes through the anterior axillary skinfold.
action potential Electrical signal transmitted from the brain anteroposterior axis The axis that has the same direc-
and spinal cord through axons to the muscle fibers in a particular tional orientation as the sagittal plane of motion and runs from front to
motor unit providing the stimulus to contract. back at a right angle to the frontal plane of motion. Also known as the
active insufficiency Point reached when a muscle sagittal or AP axis.
becomes shortened to the point that it cannot generate or maintain anteversion Abnormal or excessive rotation forward of a
active tension. structure, such as femoral anteversion.
active tension Tension in muscles that is generated via an aponeurosis A tendinous expansion of dense fibrous con-
active contraction of the respective muscle fibers in that muscle. nective tissue, sheet- or ribbonlike in appearance and resembling a
flattened tendon, which serves as a fascia to bind muscles together or
adduction Movement medially toward the midline of the as a means of connecting muscle to bone.
trunk, as in lowering the arms to the side or legs back to the anatomical
position. appendicular skeleton The appendages, or the upper and
afferent nerves Nerves that bring impulses from receptors lower extremities, and the shoulder and pelvic girdles.
in the skin, joints, muscles, and other peripheral aspects of the body to arthrodial joints Joints in which bones glide on each
the central nervous system. other in limited movement, as in the bones of the wrist (carpal) or the
aggregate muscle action Muscles working together in bones of the foot (tarsal).
groups rather than independently to achieve given joint motions. arthrokinematics Motion between the actual articular sur-
faces of the bones at a joint.
agonist A muscle or muscle group that is described as arthrosis Joint or articulation between two or more bones.
being primarily responsible for a specific joint movement when axial skeleton The skull, vertebral column, ribs, and
contracting. sternum.
all or none principle States that regardless of the number axis of rotation The point in a joint about which a bone
involved, the individual muscle fibers within a given motor unit will fire moves or turns to accomplish joint motion.
and contract either maximally or not at all. axon An elongated projection that transmits impulses away
amphiarthrodial (amphiarthrosis) joints Joints that from the neuron cell body.
functionally allow only a very slight amount of movement such as balance The ability to control equilibrium, either static or
synchondrosis (e.g., costochondral joint of the ribs with sternum), dynamic.
syndesmosis (e.g., distal tibiofibular), and symphysis (e.g., symphysis biarticular muscles Those muscles that, from origin to
pubis) joints. insertion, cross two different joints, allowing them to perform actions at
amplitude Range of muscle fiber length between maximal each joint.
and minimal lengthening. bilateral Relating to the right and left sides of the body or
anatomical position The position of reference in which of a body structure such as the right and left extremities.
the subject is in the standing position, with feet together and palms of biomechanics The study of mechanics as it relates to the
hands facing forward. functional and anatomical analysis of biological systems, especially
angle Bend or protruding angular projection of a bone humans.
such as superior and inferior angle of scapula. bipennate A type of pennate muscle with fibers running
angle of pull The angle between the muscle insertion and obliquely on both sides from a central tendon, such as the rectus
the bone on which it inserts. femoris and flexor hallucis longus.

border or margin Edge or boundary line of a bone such concurrent Movement pattern allowing the involved biar-
as lateral and medial border of scapula. ticular muscle to maintain a relatively consistent length because of the
brachial plexus Group of spinal nerves composed of same action at both of its joints.
cervical nerves 5 through 8, along with thoracic nerve 1; supplies motor condyle Large, rounded projection that usually articulates
and sensory function to the upper extremity and most of the scapula. with another bone, such as the medial or lateral condyle of the femur.
cancellous bone Spongy, porous bone that lies under cor- condyloid joint Type of joint in which the bones permit
tical bone. movement in two planes without rotation, as in the wrist between the
cardinal plane Specific planes that divide the body exactly radius and the proximal row of the carpal bones or the second, third,
into two halves. fourth, and fifth metacarpophalangeal joints.
carpal tunnel A three-sided arch, concave on the palmar
side and formed by the trapezium, trapezoid, capitate, and hamate. It contractility The ability of muscle to contract and
is spanned by the transverse carpal and volar carpal ligaments develop tension or internal force against resistance when stimulated.
creating a tunnel.
carpal tunnel syndrome A condition characterized by contraction phase In a single muscle fiber contraction,
swelling and inflammation with resultant increased pressure in the it is the phase following the latent perion in which the muscle fiber
carpal tunnel, which interferes with normal function of the median actually begins shortening; lasts about 40 milliseconds.
nerve, leading to reduced motor and sensory function of its
distribution; particularly common with repetitive use of the hand and core training Strengthening and conditioning that focuses
wrist in manual labor and clerical work such as typing and on the diaphragm, transversus abdominis, lumbar multifidus, and the
keyboarding. muscles of the pelvic floor as well as the rectus abdominis, external
obliques, internal obliques, and erector spinae.
carrying angle In the anatomical position, the angle
formed by the forearm deviating laterally from the arm, typically 5 to coronal axis Runs from side to side through the body and
15 degrees. is at a right angle to the sagittal plane of motion. Also known as the
cartilaginous joints Joints joined together by hyaline car- frontal or lateral axis.
tilage or fibrocartilage, allowing very slight movement, such as cortex Diaphyseal wall of long bones, formed from hard,
synchondrosis and symphysis. dense compact bone.
center of gravity The point at which all of the body’s mass cortical bone Harder, more compact bone that forms the
and weight are equally balanced or equally distributed in all directions. outer bony surface of the diaphysis.
countercurrent Movement pattern resulting from opposite
center of rotation The point or line around which all actions occurring simultaneously at both joints of a biarticular muscle
other points in the body move. resulting in substantial shortening of the biarticular muscle.
central nervous system (CNS) The cerebral cortex, basal
ganglia, cerebellum, brain stem, and spinal cord. cranial nerves The group of 12 pairs of nerves originating
cervical plexus Group of spinal nerves composed of from the undersurface of the brain and exiting from the cranial cavity
cervical nerves 1 through 4; generally responsible for sensory and through skull openings; they supply specific motor and sensory
motor function from the upper part of the shoulders to the back of the function to the head and face.
head and front of the neck. crest Prominent, narrow, ridgelike projection of bone, such
as the iliac crest of the pelvis.
circumduction Circular movement of a bone at the joint, curvilinear motion Motion along a curved line.
as in movement of the hip, shoulder, or trunk around a fixed point. Davis’s law States that ligaments, muscle, and other soft
Combination of flexion, extension, abduction, and adduction. tissue when placed under appropriate tension will adapt over time by
lengthening and conversely when maintained in a loose or shortened
closed kinetic chain When the distal end of an extremity state over a period of time will gradually shorten.
is fixed, preventing movement of any one joint unless predictable
movements of the other joints in the extremity occur. dendrite One or more branching projections from the neu-
ron cell body that transmit impulses to the neuron and cell body.
coefficient of friction The ratio between the force needed
to overcome friction over the force holding the surfaces together. depression Inferior movement of the shoulder girdle, as in
returning to the normal position from a shoulder shrug.
collagen A protein in the body that forms fibrous con- dermatome A defined area of skin supplied by a specific
nective tissues such as ligaments, tendons, cartilage, bone, and skin. spinal nerve.
Its elongated fibrils provide strength and flexibility to these tissues. dexter Relating to, or situated to the right or on the right
side of something.
concentric contraction A contraction in which there is a diagonal abduction Movement by a limb through a diago-
shortening of the muscle that causes motion to occur at the joints it nal plane away from the midline of the body such as in the hip or
crosses. glenohumeral joint.

diagonal adduction Movement by a limb through a diago- the action potentials of muscles and provide an electronic readout of
nal plane toward and across the midline of the body such as in the hip the contraction intensity and duration.
or glenohumeral joint. elevation Superior movement of the shoulder girdle, as in
diagonal or oblique axis Axis that runs at a right angle shrugging the shoulders.
to the diagonal plane. As the glenohumeral joint moves from diagonal enarthrodial joint Type of joint that permits movement
abduction to diagonal adduction in overhand throwing, its axis runs in all planes, as in the shoulder (glenohumeral) and hip joints.
perpendicular to the plane through the humeral head.
endochondral bones Long bones that develop from hya-
diagonal plane A combination of more than one plane. line cartilage masses after the embryonic stage.
Less than parallel or perpendicular to the sagittal, frontal, or transverse endosteum Dense, fibrous membrane covering the inside
plane. Also known as oblique plane. of the cortex of long bones.
diaphysis The long cylindrical portion or shaft of long epicondyle Projection located above a condyle, such as the
bones. medial or lateral epicondyle of the humerus.
diarthrodial (diarthrosis) joints Freely movable synovial epiphyseal plate Thin cartilage plate separating the
joints containing a joint capsule and hyaline cartilage and lubricated by diaphysis and epiphysis during bony growth; commonly referred to as
synovial fluid. growth plate.
displacement A change in position or location of an object epiphysis The end of a long bone, usually enlarged and
from its original point of reference. shaped to join the epiphysis of an adjacent bone, formed from
distal Farthest from the midline or point or reference; the cancellous or trabecular bone.
fingertips are the most distal part of the upper extremity. equilibrium State of zero acceleration in which there is no
distance The path of movement; refers to the actual sum change in the speed or direction of the body.
length of units of measurement traveled. eversion Turning of the sole of the foot outward or later-
dislocating component When the angle of pull is greater ally, as in standing with the weight on the inner edge of the foot.
than 90 degrees, the force pulls the bone away from its joint axis,
thereby increasing joint distraction forces. extensibility The ability of muscle to be stretched back to
dorsal (dorsum) Relating to the back, being or located its original length following contraction.
near, on, or toward the back, posterior part, or upper surface of; also extension Straightening movement resulting in an increase
relating to the top of the foot. of the angle in a joint by moving bones apart, as when the hand
dorsiflexion (dorsal flexion) Flexion movement of the moves away from shoulder during extension of the elbow joint.
ankle resulting in the top of foot moving toward the anterior tibia.
external rotation Rotary movement around the longitudi-
duration An exercise variable usually referring to the num- nal axis of a bone away from the midline of the body. Also known as
ber of minutes per exercise bout. rotation laterally, outward rotation, and lateral rotation.
dynamic equilibrium Occurs when all of the applied
and inertial forces acting on the moving body are in balance, resulting extrinsic muscles Muscles that arise or originate outside
in movement with unchanging speed or direction. of (proximal to) the body part on which they act.
facet Small flat or shallow bony articular surface such as
dynamics The study of mechanics involving systems in the articular facet of a vertebra.
motion with acceleration. fascia Sheet or band of fibrous connective tissue that envel-
eccentric contraction A contraction in which the muscle ops, separates, or binds together parts of the body such as muscles,
lengthens in an attempt to control the motion occurring at the joints organs, and other soft tissue structures of the body.
that it crosses, characterized by the force of gravity or applied fibrous joints Joints joined together by connective tis-
resistance being greater than the contractile force. sue fibers and generally immovable, such as gomphosis, sutures, and
syndesmosis.
eccentric force Force that is applied in a direction not fibular Relating to the fibular (lateral) side of the lower
in line with the center of rotation of an object with a fixed axis. In extremity.
objects without a fixed axis, it is an applied force that is not in line with first-class lever A lever in which the axis (fulcrum) is
the object’s center of gravity. between the force and the resistance, as in the extension of the elbow
joint.
efferent nerves Nerves that carry impulses to the outlying flat muscles A type of parallel muscle that is usually thin
regions of the body from the central nervous system. and broad, with fibers originating from broad, fibrous, sheetlike
elasticity The ability of muscle to return to its original aponeuroses such as the rectus abdominus and external oblique.
length following stretching.
elastin A protein in the body that forms connective tissue. flexion Movement of the bones toward each other at a joint
It has a highly elastic quality and will return to its original state after by decreasing the angle, as in moving the hand toward the shoulder
stress, whether compressed or stretched. during elbow flexion.
electromyography (EMG) A method utilizing either sur- follow-through phase Phase that begins immediately after
face electrodes or fine wire/needle electrodes to detect the climax of the movement phase, in order to bring

about negative acceleration of the involved limb or body segment; head Prominent, rounded projection of the proximal end
often referred to as the deceleration phase. The velocity of the body of a bone, usually articulating, such as the humeral or femoral head.
segment progressively decreases, usually over a wide range of motion.
heel-strike First portion of the walking or running stance
foramen Rounded hole or opening in bone, such as the phase characterized by landing on the heel with the foot in supination
foramen magnum in the base of the skull. and the leg in external rotation.
force The product of mass times acceleration. horizontal abduction Movement of the humerus in the
force arm The perpendicular distance between the loca- horizontal plane away from the midline of the body.
tion of force application and the axis. The shortest distance from the horizontal adduction Movement of the humerus in the
axis of rotation to the line of action of the force. Also known as the horizontal plane toward the midline of the body.
moment arm or torque arm. hyaline cartilage Articular cartilage; covers the end of
force couple Occurs when two or more forces are pulling bones at diarthrodial joints to provide a cushioning effect and reduce
in different directions on an object, causing the object to rotate about its friction during movement.
axis. hyperextension Extension beyond the normal range of
force magnitude Amount of force usually expressed in extension.
newtons. impingement syndrome Occurs when the tendons of the
fossa Hollow, depressed, or flattened surface of bone, such rotator cuff muscles, particularly the supraspinatus and infraspinatus,
as the supraspinous fossa or iliac fossa. become irritated and inflamed as they pass through the subacromial
fovea Very small pit or depression in bone, such as the space between the acromion process of the scapula and the head of
fovea capitis of the femur. the humerus, typically resulting in pain, weakness, and loss of
frequency An exercise variable usually referring to the movement.
number of times exercise is conducted per week. impulse The product of force and time.
friction Force that results from the resistance between the inertia Resistance to action or change; resistance to accel-
surfaces of two objects moving upon one another. eration or deceleration. Inertia is the tendency for the current state of
frontal plane Plane that bisects the body laterally from motion to be maintained, regardless of whether the body segment is
side to side, dividing it into front and back halves. Also known as the moving at a particular velocity or is motionless.
lateral or coronal plane.
fundamental position Reference position essentially the innervation The supplying of a muscle, organ, or body
same as the anatomical position, except that the arms are at the sides part with nerves.
and the palms are facing the body. insertion The distal attachment or point of attachment of
fusiform muscles A type of parallel muscle with fibers a muscle farthest from the midline or center of the body, generally
shaped together like a spindle with a central belly that tapers to considered the most movable part.
tendons on each end, such as the brachialis and the biceps brachii. instantaneous center of rotation The center of rotation
at a specific instant in time during movement.
gaster The central, fleshy, contractile portion of the muscle intensity An exercise variable usually referring to a certain
that generally increases in diameter as the muscle contracts. percentage of the absolute maximum that a person can sustain.
ginglymus joint Type of joint that permits a wide range of
movement in only one plane, as in the elbow, ankle, and knee joints. internal rotation Rotary movement around the longitudi-
nal axis of a bone toward the midline of the body. Also known as
glide (slide) (translation) A type of accessory motion rotation medially, inward rotation, and medial rotation.
characterized by a specific point on one articulating surface coming in
contact with a series of points on another surface. interneurons Central or connecting neurons that conduct
impulses from sensory neurons to motor neurons.
Golgi tendon organ (GTO) A proprioceptor, sensitive to intrinsic muscles Muscles that are entirely contained
both muscle tension and active contraction, found in the tendon close within a specified body part; usually refers to the small, deep muscles
to the muscle tendon junction. found in the foot and hand.
gomphosis A type of immovable articulation, as of a tooth inversion Turning of the sole of the foot inward or medially,
inserted into its bony socket. as in standing with the weight on the outer edge of the foot.
goniometer Instrument used to measure joint angles or irritability The property of muscle being sensitive or
compare the changes in joint angles. responsive to chemical, electrical, or mechanical stimuli.
goniometry Measuring the available range of motion in a isokinetic Type of dynamic exercise usually using concen-
joint or the angles created by the bones of a joint. tric and/or eccentric muscle contractions in which the speed (or
ground reaction force The force of the surface reacting to velocity) of movement is constant and muscular contraction (usually
the force placed on it, as in the reaction force between the body and maximal contraction) occurs throughout the movement.
the ground when running across a surface.
hamstrings A common name given to the group of poste- isometric contraction A type of contraction with little or
rior thigh muscles: biceps femoris, semitendinosus, and no shortening of the muscle resulting in no appreciable change in the
semimembranosus. joint angle.

isotonic Contraction occurring in which there is either linea semilunaris Lateral to the rectus abdominis, a cres-
shortening or lengthening in the muscle under tension; also known as cent, or moon-shaped, line running vertically that represents the
a dynamic contraction, and classified as being either concentric or aponeurosis connecting the lateral border of the rectus abdominis and
eccentric. medial border of the external and internal abdominal obliques.
joint capsule Sleevelike covering of ligamentous tissue
surrounding diarthrodial joints. lordosis Increased curving of the spine inward or forward
joint cavity The area inside the joint capsule of diarthrodial in the sagittal plane.
or synovial joints. lumbar kyphosis A reduction of its normal lordotic curve,
kinematics The description of motion, including consid- resulting in a flat-back appearance.
eration of time, displacement, velocity, acceleration, and space factors lumbar plexus Group of spinal nerves composed of L1
of a system’s motion. through L4 and some fibers from T12, generally responsible for motor
kinesiology The science of movement, which includes and sensory function of the lower abdomen and the anterior and
anatomical (structural) and biomechanical (mechanical) aspects of medial portions of the lower extremity.
movement.
kinesthesis The awareness of the position and movement mass The amount of matter in a body.
of the body in space; sense that provides awareness of bodily position, maximal stimulus A stimulus strong enough to produce
weight, or movement of the muscles, tendons, and joints. action potentials in all of the motor units of a particular muscle.
kinetic friction The amount of friction occurring between meatus Tubelike passage within a bone, such as the exter-
two objects that are sliding upon one another. nal auditory meatus of the temporal bone.
kinetics The study of forces associated with the motion of mechanical advantage The advantage gained through the
a body. use of machines to increase or multiply the applied force in performing
Krause’s end bulbs A proprioceptor sensitive to touch a task; enables a relatively small force to be applied to move a much
and thermal changes found in the skin, subcutaneous tissue, lip and greater resistance; determined by dividing the load by the effort.
eyelid mucosa, and external genitals.
kyphosis Increased curving of the spine outward or back- mechanics The study of physical actions of forces; can be
ward in the sagittal plane. subdivided into statics and dynamics.
latent period In a single muscle fiber contraction, it is the medial epicondylitis An elbow problem associated with
brief period of a few milliseconds following the stimulus before the the medial wrist flexor and pronator group near their origin on the
contraction phase begins. medial epicondyle; frequently referred to as golfer’s elbow.
lateral axis Axis that has the same directional orienta-
tion as the frontal plane of motion and runs from side to side at a right median Relating to, located in, or extending toward the
angle to the sagittal plane of motion. Also known as the frontal or middle, situated in the middle, mesial.
coronal axis. medullary cavity Marrow cavity between the walls of the
lateral epicondylitis A common problem quite frequently diaphysis, containing yellow or fatty marrow.
associated with gripping and lifting activities that usually involves the Meissner’s corpuscles A proprioceptor sensitive to fine
extensor digitorum muscle near its origin on the lateral epicondyle; touch and vibration found in the skin.
commonly known as tennis elbow. mid-axillary line A line running vertically down the sur-
lateral flexion Movement of the head and/or trunk later- face of the body passing through the apex of the axilla (armpit).
ally away from the midline; abduction of spine.
law of acceleration A change in the acceleration of a body mid-clavicular line A line running vertically down the sur-
occurs in the same direction as the force that caused it and is directly face of the body passing through the midpoint of the clavicle.
proportional to the force causing it and inversely proportional to the
mass of the body. mid-inguinal point A point midway between the anterior
law of reaction For every action there is an opposite and superior iliac spine and the public symphysis.
equal reaction. midsagittal (median) plane Cardinal plane that bisects
lever A rigid bar (bone) that moves about an axis. the body from front to back, dividing it into right and left symmetrical
ligament A type of tough connective tissue that attaches halves.
bone to bone to provide static stability to joints. midstance Middle portion of the walking or running stance
line Ridge of bone less prominent than a crest, such as the phase characterized by pronation and internal rotation of the foot and
linea aspera of the femur. leg; may be divided into loading response, midstance, and terminal
linea alba Tendinous division and medial border of the stance.
rectus abdominis running vertically from the xiphoid process through mid-sternal line A line running vertically down the surface
the umbilicus to the pubis. of the body passing through the middle of the sternum.
linear displacement The distance that a system moves in momentum The quality of motion, which is equal to mass
a straight line. times velocity.
linear motion Motion along a line; also referred to as motor neurons Neurons that transmit impulses away from
translatory motion. the brain and spinal cord to muscle and glandular tissue.

motor unit Consists of a single motor neuron and all of the subserous tissues around joints, external genitals, and mammary
muscle fibers it innervates. glands.
movement phase The action part of a skill, sometimes palmar flexion Flexion movement of the wrist in the sagit-
known as the acceleration, action, motion, or contact phase. Phase in tal plane with the volar or anterior side of the hand moving toward the
which the summation of force is generated directly to the ball, sport anterior side of the forearm.
object, or opponent, and is usually characterized by near-maximal palpation Using the sense of touch to feel or examine a
concentric activity in the involved muscles. muscle or other tissue.
parallel muscles Muscles that have their fibers arranged
multiarticular muscles Those muscles that, from origin to parallel to the length of the muscle, such as flat, fusiform, strap, radiate,
insertion, cross three or more different joints, allowing them to perform or sphincter muscles.
actions at each joint. parasagittal plane Planes parallel to the midsagittal plane.
multipennate muscle A type of pennate muscle that has passive insufficiency State reached when an opposing
several tendons with fibers running diagonally between them, such as muscle becomes stretched to the point where it can no longer
the deltoid. lengthen and allow movement.
muscle spindle A proprioceptor sensitive to stretch and passive tension Tension in muscles that is due to exter-
the rate of stretch that is concentrated primarily in the muscle belly nally applied forces and is developed as a muscle is stretched beyond
between the fibers. its normal resting length.
myotatic or stretch reflex The reflexive contraction that pennate muscles Muscles that have their fibers arranged
occurs as a result of the motor neurons of a muscle being activated obliquely to their tendons in a manner similar to a feather, such as
from the CNS secondarily to a rapid stretch occurring in the same unipennate, bipennate, and multipennate muscles.
muscle; the knee jerk or patella tendon reflex is an example.
periodization The intentional variance of overload through
myotome A muscle or group of muscles supplied by a spe- a prescriptive reduction or increase in a training program to bring about
cific spinal nerve. optimal gains in physical performance.
neuromuscular junction Connection between the ner- periosteum The dense, fibrous membrane covering the
vous system and the muscular system via synapses between efferent outer surface of the diaphysis.
nerve fibers and muscle fibers. peripheral nervous system (PNS) Portion of the nervous
neuron Nerve cell that is the basic functional unit of the system containing the sensory and motor divisions of all the nerves
nervous system responsible for generating and transmitting impulses. throughout the body except those found in the central nervous
system.
neuron cell body Portion of a neuron containing the pes anserinus Distal tendinous expansion formed by the
nucleus but not including the axon and dendrites. sartorius, gracilis, and semitendinosus and attaching to the
neutralizers Muscles that counteract or neutralize the anteromedial aspect of the proximal tibia below the level of the tibial
action of other muscles to prevent undesirable movements; referred to tuberosity.
as neutralizing, they contract to resist specific actions of other physiological movement Normal movements of joints
muscles. such as flexion, extension, abduction, adduction, and rotation,
nonrotary component (horizontal component) Compo- accomplished by bones moving through planes of motion about an
nent (either stabilizing or dislocating) of muscular force acting parallel axis of rotation at the joint.
to the long axis of the bone (lever). plane of motion An imaginary two-dimensional surface
notch Depression in the margin of a bone such as the through which a limb or body segment is moved.
trochlear and radial notch of the ulna. plantar Relating to the sole or undersurface of the foot.
open kinetic chain When the distal end of an extremity plantar flexion Extension movement of the ankle, result-
is not fixed to any surface, allowing any one joint in the extremity to ing in the foot and/or toes moving away from the body.
move or function separately without necessitating movement of other plica An anatomical variant of synovial tissue folds that may
joints in the extremity. be irritated or inflamed with injuries or overuse of the knee.
opposition Diagonal movement of the thumb across the posterior axillary line A line parallel to the mid-axillary
palmar surface of the hand to make contact with the hand and/or line which passes through the posterior axillary skinfold.
fingers. preparatory phase Skill analysis phase, often referred to
origin The proximal attachment or point of attachment of a as the cocking or wind-up phase, used to lengthen the appropriate
muscle closest to the midline or center of the body, generally muscles so that they will be in position to generate more force and
considered the least movable part. momentum as they concentrically contract in the next phase.
osteoblasts Specialized cells that form new bone.
osteoclasts Specialized cells that resorb new bone. primary mover Muscles that contribute significantly to
osteokinematic motion Motion of the bones relative to causing a specific joint movement when contracting concentrically.
the three cardinal planes, resulting from physiological movements.
process Prominent projection of a bone, such as the acro-
Pacinian corpuscles A proprioceptor sensitive to pressure mion process of the scapula or the olecranon process of the humerus.
and vibration found in the subcutaneous, submucosa,

pronation Internally rotating the radius so that it lies diag- retinaculum Fascial tissue that retains tendons close to the
onally across the ulna, resulting in the palm-down position of the body in certain places such as around joints like the wrist and ankle.
forearm; term also refers to a combination of ankle dorsiflexion,
subtalar eversion, and forefoot abduction (toe-out). retraction Backward movement of the shoulder girdle
toward the spine; adduction of the scapula.
proprioception Feedback relative to the tension, length, retroversion Abnormal or excessive rotation backward of
and contraction state of muscle, the position of the body and limbs, a structure, such as femoral retroversion.
and movements of the joints provided by internal receptors located in roll (rock) A type of accessory motion characterized by a
the skin, joints, muscles, and tendons. series of points on one articular surface contacting with a series of
points on another articular surface.
protraction Forward movement of the shoulder girdle rolling friction The resistance to an object rolling across a
away from the spine; abduction of the scapula. surface, such as a ball rolling across a court or a tire rolling across the
proximal Nearest to the midline or point of reference; the ground.
forearm is proximal to the hand. rotation Movement around the axis of a bone, such as
Q angle (quadriceps angle) The angle at the patella the turning inward, outward, downward, or upward of a bone.
formed by the intersection of the line of pull of quadriceps with the line
of pull of the patella tendon. rotary component (vertical component) Component of
quadriceps A common name given to the four muscles of muscular force acting perpendicular to the long axis of the bone
the anterior aspect of the thigh: rectus femoris, vastus medialis, vastus (lever).
intermedius, and vastus lateralis. rotator cuff Group of muscles intrinsic to the glenohu-
radial Relating to the radial (lateral) side of the forearm or meral joint, consisting of the subscapularis, supraspinatus,
hand. infraspinatus, and teres minor, that is critical in maintaining dynamic
radial deviation (radial flexion) Abduction movement stability of the joint.
at the wrist of the thumb side of the hand toward the forearm. Ruffini’s corpuscles A proprioceptor sensitive to touch
and pressure found in the skin, subcutaneous tissue of fingers, and
radiate muscles A type of parallel muscle with a combined collagenous fibers of the joint capsule.
arrangement of flat and fusiform muscle in that they originate on broad sacral plexus Group of spinal nerves composed of L4, L5,
aponeuroses and converge onto a tendon such as the pectoralis major and S1 through S4, generally responsible for motor and sensory
or trapezius. Also described sometimes as being triangular, fan-shaped, function of the lower back, pelvis, perineum, posterior surface of the
or convergent. thigh and leg, and dorsal and plantar surfaces of the foot.
ramus Part of an irregularly shaped bone that is thicker
than a process and forms an angle with the main body such as the sagittal plane Plane that bisects the body from front to
superior and inferior ramus of pubis. back, dividing it into right and left symmetrical halves. Also known as
range of motion (ROM) The specific amount of move- the anteroposterior, or AP plane.
ment possible in a joint. scalar Mathematical quantities are described by a magni-
reciprocal inhibition Activation of the motor units of the tude (or numerical value) alone such as speed, length, area, volume,
agonists, causing a reciprocal neural inhibition of the motor units of mass, time, density, temperature, pressure, energy, work, and power.
the antagonists, which allows them to subsequently lengthen under
less tension. Also referred to as reciprocal innervation. scaption Movement of the humerus away from the body
in the scapula plane. Glenohumeral abduction in a plane halfway
recovery phase Skill analysis phase used after follow- between the sagittal and frontal plane.
through to regain balance and positioning to be ready for the next sport scapula line A line running vertically down the posterior
demand. surface of the body passing through inferior angle of the scapula.
rectilinear motion Motion along a straight line.
recurvatum Bending backward, as in knee hyperextension. scapular plane In line with the normal resting position of
reduction Return of the spinal column to the anatomic the scapula as it lies on the posterior rib cage, movements in the
position from lateral flexion; spine adduction. scapular plane are in line with the scapular which is at an angle of 30 to
relaxation phase In a single muscle fiber contraction, it is 45 degrees from the frontal plane.
the phase following the contraction phase in which the muscle fiber scoliosis Lateral curving of the spine.
begins relaxing; lasts about 50 milliseconds. second-class lever A lever in which the resistance is
reposition Diagonal movement of the thumb as it returns between the axis (fulcrum) and the force (effort), as in plantarflexing
to the anatomical position from opposition with the hand and/or fingers. the foot to raise up on the toes.
sellar joints Type of reciprocal reception that is found
resistance Component of the lever that is typically being only in the thumb at the carpometacarpal joint and permits
attempted to be moved, usually referred to as load, weight, or mass. ball-and-socket movement, with the exception of rotation.
resistance arm The distance between the axis and the sensory neurons Neurons that transmit impulses to the
point of resistance application. spinal cord and brain from all parts of the body.

sesamoid bones Small bones embedded within the ten- statics The study of mechanics involving the study of systems
don of a musculotendinous unit that provide protection as well as that are in a constant state of motion, whether at rest with no motion or
improve the mechanical advantage of musculotendinous units as in moving at a constant velocity without acceleration. Involves all forces
the patella. acting on the body being in balance, resulting in the body being in
shin splints Slang term frequently used to describe an equilibrium.
often chronic condition in which the tibialis posterior, tibialis anterior, strap muscles A type of parallel muscle with fibers uni-
and extensor digitorum longus muscles are inflamed, typically a form in diameter and arranged with essentially all fibers in a long
tendinitis of one or more of these structures. parallel manner, such as the sartorius.
stretch-shortening cycle An active stretch via an eccentric
sinister Relating to, or situated to the left or on the left side contraction of a muscle followed by an immediate concentric
of something. contraction of the same muscle.
sinus Cavity or hollow space within a bone, such as the submaximal stimuli Stimuli that are strong enough to pro-
frontal or maxillary sinus. duce action potentials in multiple motor units, but not all motor units of
somatic nerves (voluntary) Afferent nerves, which are a particular muscle.
under conscious control and carry impulses to skeletal muscles. subthreshold stimulus Stimulus not strong enough to
cause an action potential and therefore does not result in a
speed How fast an object is moving, or the distance an contraction.
object travels in a specific amount of time. sulcus (groove) Furrow or groovelike depression on a
sphincter muscle A type of parallel muscle that is a tech- bone, such as the intertubercular (bicipital) groove of the humerus.
nically endless strap muscle with fibers arranged to surround and
close openings upon contraction, such as the orbicularis oris. Also summation When successive stimuli are provided before
referred to as circular muscles. the relaxation phase of the first twitch is complete allowing the
spin A type of accessory motion characterized by a single point on one subsequent twitches to combine with the first to produce a sustained
articular surface rotating clockwise or counterclockwise about a single contraction generating greater tension than a single contraction would
point on another articular surface. produce on its own.
supination Externally rotating the radius to where it lies
spinal cord The common pathway between the central parallel to the ulna, resulting in the palm-up position of the forearm;
nervous system and the peripheral nervous system. term is also used in referring to the combined movements of
spinal nerves The group of 31 pairs of nerves that origi- inversion, adduction, and internal rotation of the foot and ankle.
nate from the spinal cord and exit the spinal column on each side
through openings between the vertebrae. They run directly to specific suture Line of union between bones, such as the sagittal
anatomical locations, form different plexuses, and eventually become suture between the parietal bones of the skull.
peripheral nerve branches. swing Phase of gait that occurs when the foot leaves the
ground and the leg moves forward to another point of contact.
spine (spinous process) Sharp, slender projection of a
bone, such as the spinous process of a vertebra or spine of the scapula. syndesmosis joint Type of joint held together by strong
ligamentous structures that allow minimal movement between the
stability The resistance to a change in the body’s accel- bones, such as the coracoclavicular joint and the inferior tibiofibular
eration; the resistance to a disturbance of the body’s equilibrium. joint.
synergist Muscles that assist in the action of the agonists
stabilizers Muscles that surround the joint or body part and but are not primarily responsible for the action; known as guiding
contract to fixate or stabilize the area to enable another limb or body muscles, they assist in refined movement and rule out undesired
segment to exert force and move; known as fixators, they are essential motions.
in establishing a relatively firm base for the more distal joints to work synergists (helping) Muscles that have an action common to
from when carrying out movements. each other, but also have actions antagonistic to each other; they help
another muscle move the joint in the desired manner and simultaneously
stabilizing component When the angle of pull is less than prevent undesired actions.
90 degrees, the force pulls the bone toward its joint axis, thereby synergists (true) Muscles that contract to prevent an
increasing joint compression forces. undesired joint action of the agonist and have no direct effect on the
stance phase Skill analysis phase that allows the athlete to agonist action.
assume a comfortable and balanced body position from which to synovial joints Freely movable diarthrodial joints contain-
initiate the sport skill; emphasis is on setting the various joint angles in ing a joint capsule and hyaline cartilage and lubricated by synovial fluid.
the correct positions with respect to one another and to the sport
surface. tendinous inscriptions Horizontal indentations that tran-
static equilibrium The body at complete rest or sect the rectus abdominus at three or more locations, giving the muscle
motionless. its segmented appearance.
static friction The amount of friction between two objects tendon Fibrous connective tissue, often cordlike in appear-
that have not yet begun to move. ance, that connects muscles to bones and other structures.

tetanus When stimuli are provided at a frequency high ulnar deviation (ulnar flexion) Adduction movement at
enough that no relaxation can occur between muscle contractions. the wrist of the little finger side of the hand toward the forearm.
third-class lever A lever in which the force (effort) is uniarticular muscles Those muscles that, from origin to
between the axis (fulcrum) and the resistance, as in flexion of the insertion, cross only one joint, allowing them to perform actions only
elbow joint. on the single joint that they cross.
threshold stimulus When the stimulus is strong enough unipennate muscles A type of pennate muscle with fibers
to produce an action potential in a single motor unit axon and all of the that run obliquely from a tendon on one side only, such as the biceps
muscle fibers in the motor unit contract. femoris, extensor digitorum longus, and tibialis posterior.
tibial Relating to the tibial (medial) side of the lower extremity.
toe-off Last portion of the walking or running stance phase valgus Outward angulation of the distal segment of a bone
characterized by the foot returning to supination and the leg returning or joint, as in knock-knees.
to external rotation. varus Inward angulation of the distal segment of a bone or
torque Moment of force; the turning effect of an eccentric joint, as in bowlegs.
force. vector Mathematical quantity described by both a magni-
transverse plane Plane that divides the body horizontally tude and a direction such as velocity, acceleration, direction,
into superior and inferior halves; also known as the axial or horizontal displacement, force, drag, momentum, lift, weight, and thrust.
plane.
treppe A staircase effect phenomenon of muscle contraction that velocity Includes the direction and describes the rate of
occurs when rested muscle is stimulated repeatedly with a maximal displacement.
stimulus at a frequency that allows complete relaxation between ventral Relating to the belly or abdomen, on or toward the
stimuli, the second contraction produces a slightly greater tension front, anterior part of.
than the first, and the third contraction produces greater tension than vertebral line A line running vertically down through the
the second. spinous processes of the spine.
vertical axis Axis that runs straight down through the top
triceps surae The gastrocnemius and soleus together; tri- of the head and spinal column and is at a right angle to the transverse
ceps referring to the heads of the medial and lateral gastrocnemius plane of motion. Also known as the longitudinal or long axis.
and the soleus; surae referring to the calf.
trochanter A very large bony projection, such as the visceral nerves (involuntary) Nerves that carry impulses
greater or lesser trochanter of the femur. to the heart, smooth muscles, and glands; referred to as the autonomic
trochoidal joint Type of joint with a rotational movement nervous system.
around a long axis, as in rotation of the radius at the radioulnar joint. volar Relating to the palm of the hand or the sole of the
foot.
tubercle A small, rounded, bony projection, such as the Wolff’s law States that bone in a healthy individual will
greater and lesser tubercles of the humerus. adapt to the loads it is placed under. When a particular bone is
tuberosity A large, rounded, or roughened, bony projec- subjected to increased loading, the bone will remodel itself over time
tion, such as the radial tuberosity or tibial tuberosity. to become stronger to resist that particular type of loading.
ulnar Relating to the ulnar (medial) side of the forearm or hand.

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CHAPTER 1: Fig. 1.3 Anthony CP, Kolthoff NJ: Textbook of anatomy and physiology, ed and physiology, ed 9, New York, 2002, McGraw-Hill; 4.6 Hall SJ: Basic biomechanics, ed
9, St. Louis, 1975, Mosby; 1.4 Linda Kimbrough; 3, Dubuque, IA, 1999, WCB/McGraw-Hill; 4.8, 4.9 Seeley RR, Stephens TD, Tate P: Anatomy
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2002, McGraw-Hill; 1.9 Booher JM, Thibodeau GA: Athletic injury assessment, ed 4, R.T. Floyd from Exercise Pro by BioEx Systems Inc, Smithville, TX;
New York, 2000, McGraw-Hill; Shier D, Butler J, Lewis R: Hole’s human anatomy & CHAPTER 5: 5.1, 5.3, 5.4, 5.18, 5.19, 5.20, 5.24, 5.25 Linda Kimbrough; 5.2, 5.5 Saladin
physiology, ed 9, New York, 2002, McGraw-Hill; Seeley RR, Stephens TD, Tate P: Anatomy KS: Anatomy & physiology: the unity of form and function, ed 4, New York, 2007,
& physiology, McGraw-Hill; 5.6 Booher JM, Thibodeau GA; Athletic injury assessment, ed 4,
ed 7, New York, 2006, McGraw-Hill; 1.10, 1.12, p. 29 Shier D, Butler Dubuque, IA,
J, Lewis R: Hole’s human anatomy and physiology, ed 9, Dubuque, IA, 2000, McGraw-Hill; 5.10, 5.11 Shier D, Butler J, Lewis R: Hole’s human anatomy and
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Seeley R, Stephens TD, Tate P: Anatomy and physiology, ed 6, Dubuque, IA, 2000, D, Butler J, Lewis R: Hole’s human anatomy and physiology, ed 12, New York, 2010,
McGraw-Hill; 1.22, 1.23 Prentice WE: Rehabilitation techniques in sports medicine, ed McGraw-Hill; 5.21 Seeley RR, Stephens TD, Tate P:
4, New York, 2004, McGraw-Hill; Anatomy and physiology, ed 6, Dubuque, IA, 2003, McGraw-Hill;
Table 1.7 Modified by R.T. Floyd from Exercise Pro by BioEx Systems Inc, Smithville, 5.22, 5.23 Ernest W. Beck with inserts by Linda Kimbrough;
TX; CHAPTER 2: 2.1, 2.2, p. 67, p. 68 Saladin KS: pp. 118–119, pp. 126–127, p. 129, pp. 131–137 Modified by R.T. Floyd from Exercise
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11, New York, 2007, McGraw-Hill; 2.4 Saladin KS: Anatomy & Physiology, ed 4, New York, 2007, McGraw-Hill;
Luttgens K, Hamilton N: Kinesiology: scientific basis of human motion, 6.2C Seeley RR, Stephens TD, Tate P: Anatomy & physiology, ed 7, New York, 2006,
ed 10, New York, 2002, McGraw-Hill, 2.5 Ernest W. Beck; 2.6 Booher JM, Thibodeau McGraw-Hill; 6.2D Shier D, Butler J, Lewis R: Hole’s human anatomy and physiology, ed
GA: Athletic injury assessment, ed 4, Dubuque, IA, 9, New York, 2002, McGraw-Hill;
2000, McGraw-Hill; 2.7, 2.12 Seeley RR, Stephens TD, Tate P: 6.3A–C, 6.15, 6.16 Van De Graaff KM: Human anatomy, ed 6, New York, 2002,
Anatomy & physiology, ed 8, New York, 2008, McGraw-Hill; 2.8 Mader SS: Biology, ed 9, McGraw-Hill; 6.3D Jason Alexander; 6.5, 6.6 Booher JM, Thibodeau GA: Athletic injury
New York, 2007, McGraw-Hill; 2.9, 2.13 Raven, PH, Johnson GB, Losos JB, Mason KA, assessment, ed 4, Dubuque, IA, 2000, McGraw-Hill; 6.8 Dail NW, Agnew TA, Floyd RT: Kinesiology
Singer SR: Biology, ed 8, New York, for manual therapies, ed 1, New York, 2011, McGraw-Hill; 6.9 Saladin
2008, McGraw-Hill; 2.10 Shier D, Butler J, Lewis R: Hole’s human

KS: Anatomy & physiology: the unity of form and function, ed 4, New York, 2007, KM: Human anatomy, ed 6, Dubuque, IA, 2002, McGraw-Hill; 10.4
McGraw-Hill; 6.11, 6.13 Lisa Floyd with overlay from Thibodeau GA: Anatomy and Hamilton N, Weimar W, Luttgens K: Kinesiology: scientific basis of human motion, ed
physiology, St. Louis, 1987, Mosby; 11, New York, 2008, McGraw-Hill; 10.6–10.12
6.14A–B Seeley RR, Stephens TD, Tate P: Anatomy and physiology, ed Linda Kimbrough; p. 280, pp. 284–289 Modified by R.T. Floyd from Exercise Pro by
6, Dubuque, IA, 2003, McGraw-Hill; p. 150, pp. 157–164 Modified by BioEx Systems Inc, Smithville, TX; CHAPTER 11:
R.T. Floyd from Exercise Pro by BioEx Systems Inc, Smithville, TX; 11.1 Prentice WE: Arnheim’s principles of athletic training, ed 12, New York, 2006,
CHAPTER 7: 7.1 Shier D, Butler J, Lewis R: Hole’s human anatomy & physiology, ed McGraw-Hill; 11.2, 11.3 Saladin KS: Anatomy & physiology, ed 5, New York, 2010,
11, New York, 2007, McGraw-Hill; 7.2, 7.11–7.25, McGraw-Hill; 11.4, 11.6A, C,
p. 205 Linda Kimbrough; 7.3–7.5 Booher JM, Thibodeau GA: Athletic injury assessment, ed 11.8A–D, 11.10, 11.22, 11.23 Van de Graaff KM: Human anatomy,
4, Dubuque, IA, 2000, McGraw-Hill; 7.6, 7.10, ed 6, Dubuque, IA, 2002, McGraw-Hill; 11.5 Booher JM, Thibodeau GA: Athletic injury
7.26 Van de Graaff KM: Human anatomy, ed 6, Dubuque, IA. 2002, McGraw-Hill; 7.8 Saladin assessment, ed 4, Dubuque, IA, 2000, McGraw-Hill;
KS: Anatomy & physiology: the unity of form and function, ed 4, New York, 2007, 11.6B Saladin KS: Anatomy & physiology: the unity of form and function, ed 4, New
McGraw-Hill; 7.9 Seeley RR Stephens TD, Tate P: Anatomy and physiology, ed 6, York, 2007, McGraw-Hill; 11.9 Seeley RR, Stephens TD, Tate P: Anatomy &
Dubuque, IA, physiology, ed 8, New York, 2008, McGraw-Hill; 11.11–11.14, 11.16–11.21 Ernest W.
2003, McGraw-Hill; pp. 176–177, pp. 186–200, pp. 202–203, Beck; 11.15
p. 206 Modified by R.T. Floyd from Exercise Pro by BioEx Systems Inc, Smithville, TX; CHAPTER
Linda Kimbrough; pp. 302–303, pp. 310–320, pp. 322–323 Modified by R.T. Floyd from
8: 8.1 R.T. Floyd; p. 227 Modified by Exercise Pro by BioEx Systems Inc, Smithville, TX;
R.T. Floyd from Exercise Pro by BioEx Systems Inc, Smithville, TX; CHAPTER 12: 12.1, 12.2A–B Seeley RR, Stephens TD, Tate P:
CHAPTER 9: 9.1, 9.3, 9.14, 9.23–9.38 Linda Kimbrough; 9.2, 9.6 Anatomy & physiology, ed 8, New York, 2008, McGraw-Hill; 12.2C–F,
Saladin KS: Anatomy & physiology: the unity of form and function, 12.11, 12.12, 12.17, 12.19–12.22, 12.24–12.26, p. 361 (small illustration) Linda
ed 4, New York, 2007, McGraw-Hill; 9.4, 9.5 Saladin KS: Anatomy & Kimbrough; 12.2 G–H Anthony CP, Kolthoff NJ:
physiology, ed 5, New York, 2010, McGraw-Hill; 9.7, 9.18 McKinley Textbook of anatomy and physiology, ed 9, St. Louis, 1975, Mosby;
M, O’Loughlin VD: Human anatomy, ed 2, New York, 2008, McGraw-Hill; 9.8 Booher 12.3, 12.18 Shier D, Butler J, Lewis R: Hole’s human anatomy and physiology, ed 9,
JM, Thibodeau GA: Athletic injury Dubuque, IA, 2002, McGraw-Hill; 12.4A–C, 12.9
assessment, ed 4, Dubuque, IA, 2000, McGraw-Hill; 9.11 R.T. Floyd; Lindsay DT: Functional anatomy, ed 1, St. Louis, 1996, Mosby, 12.4D
9.12 Jurch SE: Clinical massage therapy: assessment and treatment of orthopaedic Mckinley M, O’Loughlin VD: Human anatomy, ed 2, New York, 2008;
conditions, ed 1, New York, 2009, McGraw-Hill; 9.13 12.5A–B Thibodeau GA, Patton KT: Anatomy and physiology, ed 9, St. Louis, 1993,
Ernest W. Beck; 9.15–9.17, 9.20–9.22 Van de Graaff KM: Human anatomy, ed 6, New Mosby; 12.5C, 12.14 Seeley RR, Stephens TD, Tate P:
York, 2002, McGraw-Hill; 9.19 Shier D, Butler J, Lewis R: Hole’s human anatomy and Anatomy & physiology, ed 7, New York, 2006, McGraw-Hill; 12.6, 12.7
physiology, ed 12, New York, Booher JM, Thibodeau GA: Athletic injury assessment, ed 4, Dubuque, IA, 2000,
2010, McGraw-Hill; p. 237, p. 252, pp. 254–268 Modified by R.T. Floyd from Exercise McGraw-Hill; 12.10, 12.15 Van de Graaff KM: Human anatomy, ed 6, Dubuque, IA,
Pro by BioEx Systems Inc, Smithville, TX; 2002, McGraw-Hill; 12.13 Seeley RR, Stephens TD, Tate P: Anatomy and physiology, ed
CHAPTER 10: 10.1 Prentice WE: Arnheim’s principles of athletic training, ed 12, New 6, Dubuque, IA,
York, 2006, McGraw-Hill; 10.2A–B Anthony CP, Kolthoff NJ: Textbook of anatomy and 2003, McGraw-Hill; 12.16 Saladin KS: Anatomy & physiology, ed 5, New York, 2010,
physiology, ed 9, St. Louis, 1975, Mosby; 10.2C Saladin KS: Anatomy & physiology: the McGraw-Hill; 12.23 Ernest W. Beck; pp. 338–339,
unity of form and function, ed 4, New York, 2007, McGraw-Hill; 10.3 Van de Graaff p. 343, pp. 345–347, p. 351, pp. 353–357 Modified by R.T. Floyd from Exercise Pro
by BioEx Systems Inc, Smithville, TX.

I ndex
Page numbers in italics refer to tables and illustrations. A
adductor pollicis muscle, 199, 200 anteroposterior axis, 6, 6 – 7

afferent nerves, 48 anteroposterior plane, 5, 6 – 7
abdominal contractions, 369, 369
aggregate muscle action, 35, 208 agonist anterosuperior, defined, 4
abdominal curl-ups, 365, 365
muscles anteversion, 5
abdominal wall muscles, 337, 340, 352 – 356,
of ankle and foot joints, 305 – 306 aponeurosis, 40
353 – 356
contraction/action of, 42, 44, 214 of elbow and appendicular skeleton, 9–10
abduction. See also diagonal abduction;
radioulnar joints, 152 – 153 AP plane, 5, 6 – 7
horizontal abduction
of hip joint and pelvic girdle, 238 – 246 arches of ankle and foot, 297, 299
defined, 22
of knee joint, 280 – 281 arm. See elbow and radioulnar joints; wrist
of fingers, 173, 174 of hip, 235, 235, 236 of
of shoulder girdle, 96 and hand joints
shoulder girdle, 23, 92, 93 of shoulder joint,
of shoulder joint, 118 – 119 arm curls, 155, 157, 215, 215
23, 115 – 116, 116 of thumb, 173, 175 of trunk and spinal column, 338 – 339 arthrodial joints, 18, 89–90
of wrist and hand joints, 176 – 180 arthrokinematics, 26, 26
alignment variation terminology, 5 all or arthroses. See joints
of wrist and hand, 173, 174, 175 none principle, 56 articular cartilage, 12, 17–18, 275
abductor digiti minimi muscle, 199, 200, 201, alternating prone extensions, 366, 366 ASIS (anterior superior iliac spine), 278 assistant
319, 321 amphiarthrodial joints, 16, 16 movers, 44
abductor hallucis muscle, 319, 321 amplitude of muscle fibers, 40 atlantoaxial joint, 333
abductor pollicis brevis muscle, 199, 200 anatomical directional terminology, 3–5, 4 atlantooccipital joint, 333
abductor pollicis longus muscle, 176, 180, anatomical position, 2, 2 atlas (vertebrae), 330
181, 198, 198 anatomical snuffbox, 196 axes of rotation, 6–7, 6 – 7, 70 axial
AC (acromioclavicular) joints, 90, 377 anconeus muscle, 150, 153, 159, 159 plane, 5, 6 – 7
acceleration, law of, 80, 84 angle of pull, 61, 60 – 61 angular axial skeleton, 9
acceleration phase, 209 displacement, 79 axillary nerve, 123, 123
accessory motions, 26–27, 26 – 27 angular motion, 79 axis (vertebrae), 330
acetabulum, 232 ankle and foot joints, 293–323. See also toes arches of, axles and wheels, 77, 77 – 78 axons,
Achilles tendon, 302, 304 297, 299 49
ACL (anterior cruciate ligament), 275 acromioclavicular bones of, 295–296, 295 – 296
(AC) joints, 90, 377 action of muscles. See contraction/action functions of, 293
of
B
icons for, 24 – 26
muscles joint characteristics, 296–297, 298 – 299 balance, 81–82, 82, 84
action phase, 209 ligaments of, 296, 297 movements of, 22–23, ball-and-socket joints, 18, 19, 229 barbell
action potential, 56 300, 300 – 301 press, 217, 217
active insufficiency, 62, 63 muscles of, 302–304, 302 – 306, 308–318, basal ganglia, 48
active tension, 58 308 – 319, 320 – 323 baseball pitching, 208, 209, 209
activities. See exercises and activities adduction. See nerves of, 307, 307 bench press, 102, 126, 130, 158, 218, 218
also diagonal adduction; range of motion of, 297, 299, 379 walking, bent-knee sit-ups, 353
horizontal adduction phases of, 293–294, 294 biarticular muscles, 61–62
defined, 22 ankle sprains, 296, 297 annular biaxial ball-and-socket (condyloidal) joints,
of fingers, 173, 174 of ligaments, 146, 147 annulus 18, 172
hip, 235, 235 fibrosus, 334 biceps brachii muscle, 118, 150, 151 – 152,
of shoulder girdle, 23, 92, 93 of shoulder joint, antagonist muscles, 43, 44 155, 155
23, 115 – 116, 116 of thumb, 173, 175 anterior, defined, 4 biceps femoris muscle, 240, 241, 244, 261,
anterior axillary line, 3 261, 279
of wrist and hand, 173, 174, 175 anterior cruciate ligament (ACL), 275 anterior bilateral, defined, 4
adductor brevis muscle, 240, 241, 243, longitudinal ligament, 333 anterior rotation of bilateral axis, 6, 6 – 7
255, 255 pelvis, 236, 236 – 237 Biodex exercise machines, 43 biomechanics, 69–84. See
adductor gracilis muscle. See gracilis muscle adductor anterior superior iliac spine (ASIS), 278 anterior also levers balance, equilibrium, and stability, 81–82,
hallucis muscle, 319, 322 tilt of shoulder girdle, 93 anteroinferior, defined, 4
adductor longus muscle, 240, 241, 243, 82, 84
256, 256 anterolateral, defined, 4 defined, 69
adductor magnus muscle, 240, 241, 243, anteromedial, defined, 4 force and, 70, 82–83
257, 257 anteroposterior, defined, 4 friction, 81, 81

biomechanics ( continued) circuit-training, 364 diagonal axis, 7, 7

functional application of, 83–84 mechanical circumduction, 22 diagonal plane, 5–6, 7
advantage, 70, 71, 77, 77 – 78 mechanical loading, clavicle, 89, 90, 111, 112. See also diaphragm muscle, 346, 348
83, 83 shoulder girdle diaphysis, 11
motion, measurement and laws of, 79–81, closed kinetic chain activities, 210 – 211, 210 – 212 CMC diarthrodial joints
80 – 81, 84 (carpometacarpal) joint, 173 classification of, 18–19, 18 – 19
pulleys, 78, 78 CNS (central nervous system), 48, 49, 53 coccygeal range of motion of, 377–379
wheels and axles, 77, 77 – 78 nerves, 48–49, 49 stability and mobility, factors affecting,
bipennate muscles, 38 coccyx, 229, 230 19–20, 20
blood cell formation, 9, 10 body coefficient of friction, 81 structure of, 16–18, 17
parts/regions, 7, 8 – 9 collagen, 15 DIP (distal interphalangeal) joints, 172, 297 dislocating
bones, 9–15. See also skeletal system; collar bone. See clavicle components, 60
specific bones collateral ligaments, 145–146, 173, 274, 275 dislocation of shoulder, 114
of ankle and foot joints, 295–296, 295 – 296 compartment syndrome, 303–304 displacement, 79, 79 – 80
of appendicular skeleton, 9–10 of axial concentric contractions, 41, 42 – 43, 363, distal, defined, 4
skeleton, 10 364, 386 distal interphalangeal (DIP) joints, 172, 297 distance,
classification by shape, 11, 11 concurrent movement patterns, 62, 62 conditioning defined, 79
of elbow and radioulnar joints, principles, 212–213. See also dorsal, defined, 4
143–144, 144 exercises and activities dorsal flexion. See dorsiflexion dorsal interossei
features of, 11–12 condyloidal joints, 18, 172 muscles, 199–200, 200,
of fingers, 171 connective tissue, joint stability and mobility 319, 323
growth and development of, 12–13, 13 affected by, 20 dorsal scapular nerve, 97 dorsiflexion,
of hip joint and pelvic girdle, 229–231, contact phase, 209 23, 174, 300, 300
230 – 232 contractility, defined, 38 downward rotation of shoulder girdle, 23,
joint stability and mobility affected by, 19 of knee contraction/action of muscles 92, 93
joint, 273–274, 274 agonist muscles, 42, 44, 214 defined, downward tilt of shoulder girdle, 93 dumbbell
markings on, 14, 15 40, 41 bent-over row, 222, 222
properties and composition of, 15 of determination of, 46–48, 47, 386 duration of exercise, 212
shoulder girdle, 89, 90 – 91 in exercises and activities, 363–364 force–velocity dynamic contractions, 41
of shoulder joint, 112, 113 – 114 relationship in, 58–59, 59 dynamic equilibrium, 81
of toes, 295–296, 296 length–tension relationship in, 57–58, 59 dynamics, study of, 70
of trunk and spinal column, 329–333, 330 – 332 tension development, factors affecting,
of wrist and hand joints, 170, 170 – 171 brachialis 56–57, 57 – 58
E
muscle, 150, 151 – 152, 156, 156 types of, 41–44, 42 – 43
brachial plexus contraction phase, 56 eccentric contractions, 41, 42 – 43, 363,
components and functions of, 48, 49, 51 contralateral, defined, 4 364, 386
elbow and radioulnar joints and, 154 shoulder contralateral muscles, 42, 44 coracobrachialis muscle, eccentric force, 73
girdle and, 97, 97 118, 118, 120, 123, efferent nerves, 48
shoulder joint and, 123 130, 130 elasticity of muscles, 38
wrist and hand joints and, 183 brachioradialis core training, 340, 353 elbow and radioulnar joints, 143–162 bones of,
muscle, 150, 152, 157, 157 coronal axis, 6, 6 – 7 143–144, 144
brain stem, 48 coronal plane, 5, 6 – 7 icons for, 24
cortex, 11 joint characteristics, 144–147
cortical bone, 15 ligaments of, 145–147
C
countercurrent movement patterns, 62 cranial movements of, 23, 148, 148 – 149
calcaneofibular ligament, 297 nerve, 340 muscles of, 150, 150 – 153, 155 – 162,
calcaneus, 295, 296 crunches, 353 155 – 162
calcium carbonate, 15 cuboid, 295 nerves of, 154, 154
calcium phosphate, 15 cuneiform bones, 295, 296 range of motion of, 147, 147, 377 synergy
cancellous bone, 11, 15 curvilinear motion, 79 with shoulder joint, 147 views of, 144 – 146
capitate bone, 170 Cybex exercise machines, 43
cardinal planes of motion, 5 electrical muscle stimulation, 47
carpal tunnel/carpal tunnel syndrome, electromyography (EMG), 47
D
170, 180 elevation of shoulder girdle, 23, 92, 93 ellipsoid
carpometacarpal (CMC) joint, 173 carrying Davis’s law, 19 (condyloidal) joints, 18, 172 EMG
angle, 146, 147 dead lifts, 350, 368, 368 (electromyography), 47
cartilage, joint stability and mobility affected deep, defined, 4 enarthrodial joints, 19, 112, 231
by, 19–20 deltoid ligament, 297 endochondral bones, 12, 13
caudal, 4 deltoid muscle, 118, 119, 120, 123, 124, 124 endosteum, 11
center of gravity, 82 center dendrites, 49 epiphyseal plates, 12, 12
of rotation, 79 depression of shoulder girdle, 23, 92, 93 epiphysis, 11–12
central nervous system (CNS), 48, 49, 53 cephalic, dermatomes, 49, 51 equilibrium, 81–82, 82, 84 erector spinae muscles, 337, 338,
4 dexter, defined, 4 349 – 350,
cerebellum, 48 diagonal abduction 349 – 350
cerebral cortex, 48 defined, 22 eversion of ankle and foot joints, 22–23,
cervical nerves, 48, 49 of hip, 235, 236 300, 300
cervical plexus, 48, 49, 51, 97, 97 of shoulder joint, 116, 117 excitability of muscles, 38 exercises and activities. See
cervical spine, 26, 335, 335 diagonal adduction also lower-
cervical vertebrae, 329, 330 chest press. See bench defined, 22 extremity and trunk exercises; upperextremity
press chin-ups, 101, 126, 128, 155, 219, 219 of hip, 235, 236 exercises; specific exercises and activities
of shoulder joint, 116, 117

baseball pitching, 208, 209, 209 first-class levers, 70, 71, 71 – 72, 73, 74 gluteus medius muscle, 241, 245, 263, 263
circuit-training, 364 fixator muscles, 44 gluteus minimus muscle, 241, 245, 264, 264
conditioning principles, 212–213 flat-back syndrome, 334 golfer’s elbow, 150
contraction/action of muscles in, 363–364 core flat bones, 11, 11 Golgi tendon organs (GTOs), 52, 53,
training, 340, 353 flat muscles, 38 54 – 55, 60
isometric exercises, 214, 369 flexion gomphosis joints, 15
joint-isolation exercises, 210 of ankle and foot joints, 23, 300, 300 goniometry, 20–21, 21
resistance training, 364 defined, 22 gracilis muscle, 240, 241, 243, 258, 258, 279 ground
for trunk and spinal column, 363–371, 382 of elbow joint, 147, 147 – 149, 148 of fingers, 175 reaction force, 81
extensibility of muscles, 38 growth plates, 12, 12
extension of hip, 235, 235 GTOs. See Golgi tendon organs guiding
defined, 22 of knee joint, 278, 278 muscles, 44
of elbow joint, 147, 147 – 149, 148 of fingers, 175 of shoulder joint, 115 – 116, 116 of spine,
23, 336, 336 – 337
H
of hip, 235, 235 of toes, 300, 301
of knee joint, 278, 278 of wrist and hand, 23, 173, 174, 174 hamate bone, 170, 171 hammer
of shoulder joint, 115 – 116, 116 of spine, flexor carpi radialis muscle, 176, 176, 181, exercise, 160, 162 hamstring curls,
336, 336 – 337 184, 184 259–261
of toes, 300, 301 flexor carpi ulnaris muscle, 176, 176, 181, hamstring muscles, 230, 241, 261, 279,
of wrist and hand, 173, 174, 174 186, 186 286, 286
extensor carpi radialis brevis muscle, 157, flexor digiti minimi brevis muscle, 199, 200, hand. See fingers; thumb; wrist and hand
176, 178, 181, 188, 188 201, 319, 322 joints
extensor carpi radialis longus muscle, 157, flexor digitorum brevis muscle, 319, 321 head muscles, 337, 340, 341–344, 341 – 344
176, 178, 181, 189, 189 flexor digitorum longus muscle, 303, 304, heel-strike, 293
extensor carpi ulnaris muscle, 176, 178, 181, 305, 317, 317 helping synergists, 44
187, 187 flexor digitorum profundus muscle, 176, 177, hemopoiesis, 9, 10
extensor digiti minimi muscle, 176, 179, 181, 181, 191, 191 herniated disk, 334
195, 195 flexor digitorum superficialis muscle, 176, high ankle sprain, 296 hinge joints. See ginglymus
extensor digitorum brevis muscle, 319, 323 177, 181, 190, 190 joints hip joint and pelvic girdle, 229–266
extensor digitorum longus muscle, 302, 304, flexor hallucis brevis muscle, 319, 322 bones of, 229–231, 230 – 232
306, 313, 313 flexor hallucis longus muscle, 303, 304, 305,
extensor digitorum muscle, 176, 179, 181, 318, 318 icons for, 25
193, 193 flexor pollicis brevis muscle, 199, 200 joint characteristics, 231–233
extensor hallucis longus muscle, 303, flexor pollicis longus muscle, 176, 177, 181, ligaments of, 231–232, 233
304, 306, 314, 314 192, 192 movements of, 234 – 237, 235 – 236 muscles of,
extensor indicis muscle, 176, 179, 181, flexor retinaculum, 180 238–241, 238 – 246, 250,
194, 194 follow-through phase, 209 250 – 266, 252 – 266
extensor pollicis brevis muscle, 176, 180, foot. See ankle and foot joints; toes force, nerves of, 247–249, 247 – 249
181, 197, 197 application of, 70, 82–83 force arm, 73–76, 74 – range of motion of, 232–233, 234, 379 views of, 230
extensor pollicis longus muscle, 176, 179, 76 – 234
181, 196, 196 force couples, 45, 45 hitchhiker muscle. See brachioradialis muscle horizontal
extensor retinaculum, 180 force magnitude, 73 abduction
external oblique abdominal muscles, 337, force–velocity relationship, 58–59, 59 of hip, 236
339, 354, 354 frequency of exercise, 212 friction, of shoulder joint, 23, 115, 116, 117
external rotation 81, 81 horizontal adduction
defined, 22 frontal axis, 6, 6 – 7 of hip, 236
of hip, 235, 236 of knee joint, frontal plane, 5, 6 – 7 of shoulder joint, 23, 115, 116, 117
278, 278 fulcrum. See axes of rotation full-can horizontal plane, 5, 6 – 7
of shoulder joint, 115, 116, 117 exercise, 133 humerus, 111–113, 114, 143 hyaline
extrinsic muscles, 40 fundamental position, 2 cartilage, 12, 17 hyper, as prefix, 21
funny bone, 183
fusiform muscles, 38 hyperextension, 21, 147, 147
F
hypo, as prefix, 21
fascia, 40 hypothenar eminence, 199, 201
G
fast muscle fibers, 56 femoral nerve, 248,
248, 281 femur, 229, 230, 232, 273, 274 gaster, 40
I
gastrocnemius muscle, 302–304, 305,
fibula, 231, 273, 274, 274, 295, 295 308, 308 iliac spine, 230
fibular, defined, 4 gemellus inferior muscle, 241, 246, 266, 266 iliacus muscle. See iliopsoas muscle iliocostalis muscle,
fibular nerve. See peroneal nerve fingers. See also thumb; gemellus superior muscle, 241, 246, 266, 266 337, 349–350, 349 – 350
wrist and hand joints bones of, 171 Gerdy’s tubercle, 231, 274 iliofemoral ligament, 232
ginglymus joints, 19, 144, 172, 173, 275, 297 iliohypogastric nerve, 340
icons for, 25 glenohumeral internal rotation deficit ilioinguinal nerve, 340
joints of, 172 (GIRD), 114 iliopsoas muscle, 240, 242, 250, 250 – 251 ilium, 229
ligaments of, 173, 174 glenohumeral joint. See shoulder joint
movements of, 173, 174, 175 glenohumeral ligaments, 112–113, 114 impingement syndrome, 131
muscles of, 171, 176, 181, 193–195, glenoid labrum, 112 impulse, 83
199–200 glide, 26–27, 26 – 27 inclinometers, 21
nerves of, 183 gliding (arthrodial) joints, 18, 90 gluteus maximus inertia, law of, 80, 80
range of motion of, 172, 172, 378 fingertip muscle, 240, 241, 244, inferior, defined, 4
push-ups, 170 262, 262 inferolateral, 4

inferomedial, 4 defined, 1, 69 long thoracic nerve, 97 longus capitis

infraspinatus muscle, 118, 119, 120, 123, etymology of commonly used terms in, muscle, 342, 342
134, 134 383–385 longus colli muscles, 345, 346
innervation, 40 kinesthesis, 51–55, 53 – 55 lordosis, 5, 94, 330, 334 lower extremities. See ankle
insertion of muscles, 40–41 kinetic chain activities, 210 – 211, 210 – 212 kinetic and foot
instantaneous center of rotation, 79, 79 friction, 81, 81 joints; hip joint and pelvic girdle; knee
intensity of exercise, 212 intercostal kinetics, 70 joint
muscles, 346, 348 knee jerk reflex, 53, 54 lower-extremity and trunk exercises, 363–371,
intercostal nerves, 340 knee joint, 273–287 381–382
intermuscular septa, 241 bones of, 273–274, 274 abdominal contractions, 369, 369
internal oblique abdominal muscles, 337, icons for, 25 abdominal curl-ups, 365, 365
339, 355, 355 joint characteristics, 275–277, 276 – 277 alternating prone extensions, 366, 366
internal rotation ligaments of, 275, 276 dead lifts, 350, 368, 368
defined, 22 movements of, 278, 278 importance of, 363, 364 rowing
of hip, 235, 236 of knee joint, muscles of, 278–279, 279 – 287, 282 – 287 nerves of, exercise, 370, 370 – 371
278, 278 281 squats, 367, 367
of shoulder joint, 115, 116, 117 range of motion of, 277, 277, 379 Krause’s lumbar kyphosis, 330
interneurons, 49, 50 end-bulbs, 52, 55, 55 lumbar nerves, 48–49, 49
interphalangeal (IP) joint, 173, 297 kyphosis, 5, 94, 330 lumbar spine, 26, 335, 335
interspinalis muscles, 345, 346 lumbosacral plexus, 48, 49, 52, 247,
interspinous ligaments, 333 247 – 248
L
intertransversarii muscles, 345, 346 lumbrical muscles, 199, 200, 200, 319, 322
intertransverse ligaments, 333 latent periods, 56 lunate bone, 170
intervertebral disks, 333 – 334, 334 intrinsic lateral, defined, 4
muscles lateral axis, 6, 6 – 7
M
defined, 40 lateral collateral ligament (LCL), 275 lateral
of foot, 319, 320 – 323 epicondylitis, 150 malleoli, 295
of hand, 181, 199–200, 199 – 201 lateral flexion of spine, 23, 336, 336 – 337 manubrium, 330
inversion of ankle and foot joints, 23, lateral plane, 5, 6 – 7 mass, 80
300, 300 lateral rotation of pelvis, 236, 236 – 237 mastoid process, 330
inward tilt of shoulder girdle, 93 IP lateral rotator muscles, 240, 241, 266, 266 maximal stimulus, 56
(interphalangeal) joint, 173, 297 ipsilateral, lateral tilt of shoulder girdle, 93 latissimus dorsi muscle, MCL (medial collateral ligament), 275 MCP
4 118, 119, 120, 123, (metacarpophalangeal) joints, 172,
irregular bones, 11, 11 127, 127 – 128 173, 175
irritability of muscles, 38 ischial latissimus pulls, 128–130, 132, 220, 220 mechanical advantage, 70, 71, 77, 77 – 78 mechanical
tuberosity, 230 laws of motion, 80–81, 80 – 81, 84 LCL (lateral loading, 83, 83
ischiofemoral ligament, 232 collateral ligament), 275 leg curls, 259–261 mechanics, defined, 70. See also
ischium, 229 biomechanics
isokinetics, 43 length–tension relationship, 57–58, 59 medial, defined, 4
isometric contractions, 41, 42 – 43, 363, 386 isometric levator costarum muscle, 346, 348 medial collateral ligament (MCL), 275 medial
exercises, 214, 369 levator scapulae muscle, 94, 95 – 96, 97, epicondylitis, 150
isotonic contractions, 41, 42 – 43 100, 100 medial tilt of shoulder girdle, 93 median,
levers, 70–77 defined, 4
classification of, 70–73, 71 – 72 median nerve, 154, 154
J
defined, 70 median plane, 5
joint capsules, 17 factors affecting use of, 73–77, 74 – 77 mediolateral axis, 6, 6 – 7
joint cavities, 17 first-class, 70, 71, 71 – 72, 73, 74 medullary, 11
joint-isolation exercises, 210 mechanical advantage of, 71 Meissner’s corpuscles, 52, 55, 55
joints, 15–27. See also ankle and foot joints; second-class, 70, 71 – 72, 73, 75 menisci, 275, 276
elbow and radioulnar joints; hip joint and pelvic third-class, 71, 72, 73, 75 metacarpophalangeal (MCP) joints, 172,
girdle; knee joint; shoulder joint; specific joints ligaments 173, 175
and joint types of ankle and foot joints, 296, 297 metatarsals, 295–296
accessory motions, 26–27, 26 – 27 of elbow and radioulnar joints, 145–147 of fingers, metatarsophalangeal joints, 295, 297
classifications of, 15–20, 16 173, 174 mid-axillary line, 3
of fingers, 172 of hip joint and pelvic girdle, 231–232, 233 mid-clavicular line, 3
icons for, 24, 24 – 26 joint stability and mobility affected by, mid-inguinal point, 3
movement terminology, 21–23, 22 17–18, 20 midsagittal plane, 5
physiological movements, 26 of knee joint, 275, 276 midstance, 293
range of motion, methods for measuring, of trunk and spinal column, 333–334 of wrist mid-sternal line, 3
20–21 and hand joints, 173, 174 military press, 217, 217
of shoulder girdle, 89–90, 90 – 91, 92 stability and ligamentum flavum, 333 mobile wad of three, 157
mobility, factors affecting, 17, ligamentum nuchae, 333–334 momentum, 83
19–20 linea alba, 353 motion
of thumb, 173 linear displacement, 79 laws of, 80–81, 80 – 81, 84
of toes, 297 linear motion, 79 measurement of, 79–80
of trunk and spinal column, 333–335, 333 – 335 linea semilunaris, 353 planes of, 5–6, 6 – 7
lines of pull, 47, 47 – 48 long motion phase, 209
bones, 11, 11 – 13 motor control, 20
K
longissimus muscle, 337, 349–350, 349 – 350 motor neurons, 49, 50
kinematics, 70 longitudinal arches, 297, 299 motor units, 55–56, 55
kinesiology. See also structural kinesiology longitudinal axis, 6 – 7, 7 movement phase, 209

movements views of, 36 – 37 osteoblasts, 13

accessory motions, 26–27, 26 – 27 of wrist and hand joints, 176, 176 – 182, osteoclasts, 13
of ankle and foot joints, 22–23, 300, 300 – 301 180 – 181, 184–200, 184 – 200 osteokinematic motions, 26
of elbow and radioulnar joints, 23, 148, muscle spindles, 52–53, 53 – 55, 60 osteology, 9–10. See also bones; skeletal
148 – 149 musculocutaneous nerve, 123, 123 system
of fingers, 173, 174, 175 myotatic reflex, 53 outward tilt of shoulder girdle, 93 overhead
of hip joint and pelvic girdle, 234 – 237, myotomes, 49 press, 217, 217
235 – 236 overload principle, 212
icons for, 24, 24 – 26 ovoid (condyloidal) joints, 18, 172
N
of knee joint, 278, 278
passive, 41 navicular, 295
P
phases of, 208–209 neck muscles, 337, 340, 341–344, 341 – 344
physiological, 26 nerves and nervous system. See also specific Pacinian corpuscles, 52, 53, 55
of shoulder girdle, 23, 92 – 93, 92 – 94 of nerves palmar, defined, 4
shoulder joint, 23, 115 – 117, 116 terminology of ankle and foot joints, 307, 307 palmar flexion of wrist and hand, 23, 174 palmar
for, 21–23, 22 central nervous system (CNS), 48, 49, 53 interossei muscles, 199, 200
of thumb, 23, 173, 174, 175 components of, 48–49, 49 – 53 palmaris brevis muscle, 199, 201
of toes, 300, 300 of elbow and radioulnar joints, 154, 154 palmaris longus muscle, 176, 176, 181,
of trunk and spinal column, 23, 336, of fingers, 183 185, 185
336 – 337 of hip joint and pelvic girdle, 247–249, palpation, 46–47
upper-extremity exercises, analysis of, 247 – 249 parallel muscles, 38
208–209 of knee joint, 281 parasagittal planes, 5
voluntary movement, neural control of, peripheral nervous system (PNS), 48 of passive insufficiency, 62, 62
48–49, 49 – 53 shoulder girdle, 97, 97 passive movement, 41
of wrist and hand joints, 23, 173–174, of shoulder joint, 123, 123 passive tension, 58
174 – 175 of trunk and spinal column, 48–49, patella, 231, 273–274, 274
multiarticular muscles, 62 49 – 52, 340 patellar tendon reflex, 53, 54
multiaxial ball-and-socket joints. See voluntary movement, role in, 48–49, 49 – 53 patellofemoral joint. See knee joint PCL (posterior
enarthrodial joints of wrist and hand joints, 183, 183 cruciate ligament), 275 pectineus muscle, 241, 243,
multifidus muscle, 345, 346 neuromuscular concepts, 55–62 254, 254
multipennate muscles, 38 active and passive insufficiency, 62, 63 pectoralis major muscle, 118, 118, 120, 123, 125–126, 125
muscle fibers, 56 all or none principle, 56 angle – 126
muscles, 35–62. See also contraction/action of pull, 60 – 61, 61 pectoralis minor muscle, 94, 95 – 96, 97,
of muscles; neuromuscular concepts; concurrent and countercurrent movement 103, 103
specific muscles and muscle types patterns, 62, 62 pectoral nerves, 97, 123 pelvic
of abdominal wall, 337, 340, 352 – 356, fiber types, 56 bone, 230, 231
353 – 356 force–velocity relationship, 58–59, 59 pelvic girdle. See hip joint and pelvic girdle pennate
of ankle and foot joints, 302–304, 302 – 306, 308–318, 308 length–tension relationship, 57–58, 59 muscles, 38
– 319, 320 – 323 motor units, 55–56, 55 periodization, 212
development of, 213. See also exercises reciprocal inhibition or innervation, 60, 60 periosteum, 11
and activities stretch-shortening cycle, 59 peripheral nervous system (PNS), 48 peroneal
of elbow and radioulnar joints, 150, tension development, factors affecting, nerve, 249, 281, 307, 307
150 – 153, 155 – 162, 155 – 162 56–57, 57 – 58 peroneus brevis muscle, 303, 304, 306,
features of, 35 neuromuscular junction, 55 311, 311
of fingers, 171, 176, 181, 193–195, 199–200 functions neuron cell bodies, 49 peroneus longus muscle, 303, 304, 306,
of, 35, 44–46 neurons, 49, 50 310, 310
for head and neck movement, 337, 340, neutralizer muscles, 45 peroneus tertius muscle, 302, 304, 306,
341–344, 341 – 344 Newton’s laws of motion, 80–81, 80 – 81, 84 nonrotary 312, 312
of hip joint and pelvic girdle, 238–241, components, 60 pes anserinus, 279
238 – 246, 250, 250 – 266, 252 – 266 nucleus pulposus, 334 phalanges, 171, 295, 297. See also
joint stability and mobility affected by, 20 of knee fingers; toes
joint, 278–279, 279 – 287, 282 – 287 neural control of physical fitness. See exercises and activities
O
voluntary movement, physiological movements, 26
48–49, 49 – 53 oblique abdominal muscles, 337, 354–355, PIP (proximal interphalangeal) joints,
nomenclature, 35–37 354 – 355 172, 297
proprioception and kinesthesis, 51–55, oblique axis, 7, 7 piriformis muscle, 241, 246, 266, 266
53 – 55 oblique plane, 5–6, 7 pisiform bone, 170, 171
shape and fiber arrangement obliquus capitis inferior muscle, 342, 342 pitching, 208, 209, 209
classifications, 38, 39 obliquus capitis superior muscle, 342, 342 pivot (trochoidal) joints, 19, 147 plane
of shoulder girdle, 94, 95 – 96, 98, 98 – 104, obturator externus muscle, 241, 246, (arthrodial) joints, 18, 90 planes of
100 – 104 266, 266 motion, 5–6, 6 – 7
of shoulder joint, 118–122, 118 – 122, 124–127, 124 obturator internus muscle, 241, 246, 266, 266 plantar, defined, 4
– 135, 129 – 135 obturator nerve, 248, 249 plantar fascia, 297
terminology, 38, 40–41 open kinetic chain activities, 210 – 211, plantar fasciitis, 297
of thorax, 337, 340, 346–351, 347 – 351 210 – 212 plantar flexion of ankle and foot joints, 23,
of thumb, 171, 176, 181, 196–199 tissue opponens digiti minimi muscle, 199, 200, 201 300, 300
properties of, 38 opponens pollicis muscle, 199, 200 plantar interossei muscles, 319, 322
of toes, 319 opposition of thumb, 23, 174, 175 plantaris muscle, 303, 304
of trunk and spinal column, 337–340, origin of muscles, 40 os plantar nerve, 307
338 – 356, 341 – 356 coxae, 229 plica, 277
of vertebral column, 340, 345, 345 – 346 osteoarthritis, 232 plyometric training, 60

PNS (peripheral nervous system), 48 popliteus muscle, reciprocal innervation, 60 scoliosis, 5, 330
279, 281, 287, 287, 303 posterior, defined, 4 recovery phase, 209 screw (trochoidal) joints, 19, 147
rectilinear motion, 79 SC (sternoclavicular) joints, 89–90, 377
posterior axillary line, 3 rectus abdominis muscle, 337, 339, 353, 353 second-class levers, 70, 71 – 72, 73, 75
posterior cruciate ligament (PCL), 275 posterior rectus capitis anterior muscle, 342, 342 sellar joints, 19
longitudinal ligament, 333 posterior rotation of pelvis, rectus capitis lateralis muscle, 342, 342 semimembranosus muscle, 240, 241, 244,
236, 236 – 237 rectus capitis posterior muscle, 342, 342 260, 260, 279
posterior tilt of shoulder girdle, 93 rectus femoris muscle, 241, 242, 252, 252, semispinalis muscles, 342, 342, 345, 346
posteroinferior, 4 278, 282 semitendinosus muscle, 240, 241, 244, 259,
posterolateral, 4 recurvatum, 5 259, 279
posteromedial, 4 reduction of spine, 23, 336 sensory neurons, 49, 53
posterosuperior, 4 reference lines, 2–3, 3 sensory receptors, 55. See also
posture, 94 reference positions, 2, 2 proprioception
preparatory phase, 208–209 relaxation phase, 57 serratus anterior muscle, 94, 95 – 96, 97,
primary movers, 44 reposition of thumb, 23, 174, 175 102, 102
pronation resistance, application of, 70 serratus posterior muscle, 346, 348
of ankle and foot joints, 23, 300, 301 resistance arm, 74–76, 74 – 76 sesamoid bones, 11, 11, 171, 273, 295 shin
of radioulnar joint, 23, 147, 147 – 149, 148 pronator resistance training, 364 splints, 304, 316
quadratus muscle, 150, 152, 161, retinaculum, 40 short bones, 11, 11
161 retraction. See adduction shoulder blade. See scapula
pronator teres muscle, 150, 152, 160, 160 retroversion, 5 shoulder girdle, 89–104
prone, defined, 5 reversal of muscle function, 46 rhomboid muscles, 94, 95 bones of, 89, 90 – 91
proprioception, 20, 51–55, 53 – 55 – 96, 97, 101, 101 icons for, 24
protraction. See abduction ribs, 330, 332 joints of, 89–90, 90 – 91, 92 movements of, 23, 92
proximal, defined, 5 roll, 26–27, 26 – 27 – 93, 92 – 94 muscles of, 94, 95 – 96, 98, 98 – 104,
proximal interphalangeal (PIP) joints, 172, rolling friction, 81, 81
297 ROM. See range of motion 100 – 104
psoas muscle. See iliopsoas muscle pubis, rope climbing, 128, 129, 132, 155 rotary nerves of, 97, 97
229, 230 components, 60 synergy with shoulder joint, 93–94, 111,
pubofemoral ligament, 232 rotary motion, 79 112, 113
pulleys, 78, 78 rotation views of, 90 – 91
pull-ups. See chin-ups axes of, 6, 6 – 7, 70 shoulder joint, 111–135
push-ups, 102, 103, 126, 158, 221, 221 center of, 79 bones of, 112, 113 – 114
of hip, 235, 236 of knee joint, icons for, 24
278, 278 injuries common to, 114 joint
Q
of pelvis, 236, 236 – 237 characteristics, 112–114
Q angle, 278, 279 of shoulder girdle, 23, 92, 93 of shoulder movements of, 23, 115 – 117, 116 muscles of,
quadratus femoris muscle, 241, 246, 266, 266 joint, 115, 116, 117 118–122, 118 – 122, 124–127,
quadratus lumborum muscle, 337, 339, of spine, 336, 336 – 337 124 – 135, 129 – 135
351, 351 types of, 22 nerves of, 123, 123
quadratus plantae muscle, 319, 322 rotator cuff muscles, 114, 118, 131, 131 range of motion of, 377
quadriceps muscles, 278, 282–285, rotatores muscle, 345, 346 synergy with elbow and radioulnar joints,
282 – 285, 364 rowing exercise, 370, 370 – 371 147
Ruffini’s corpuscles, 52, 53, 55 synergy with shoulder girdle, 93–94, 111,
running muscles. See hamstring muscles 112, 113
R
views of, 113 – 115
radial, defined, 5 shoulder pulls, 214, 214
S
radial flexion of wrist and hand, 23, 174 radial side bending of spine, 23, 336, 336 – 337
nerve, 154, 154, 183 radiate muscles, 38 sacral nerves, 48–49, 49 sinister, 5
sacral plexus. See lumbosacral plexus sacroiliac sit-ups, 353
radioulnar joint. See elbow and radioulnar joints, 231 skeletal muscles. See muscles skeletal system, 7, 9–15, 10.
joints sacrum, 229, 230 See also bones slide, 26–27, 26 – 27
radius, 143, 144, 170 range of saddle joints, 19
motion (ROM) sagittal axis, 6, 6 – 7 slipped disk, 334
of ankle and foot joints, 297, 299, 379 of sagittal plane, 5, 6 – 7 slow muscle fibers, 56 soleus muscle, 302–304, 305,
diarthrodial joints, 377–379 SAID (Specific Adaptations to Imposed 309, 309
of elbow and radioulnar joints, 147, Demands) principle, 212–213 Specific Adaptations to Imposed Demands
147, 377 sartorius muscle, 241, 242, 253, 253, 279 scalar (SAID) principle, 212–213
of fingers, 172, 172, 378 quantities, 79 specificity of exercise, 213 speed,
of hip joint and pelvic girdle, 232–233, scalene muscles, 346, 348 defined, 80
234, 379 scaphoid bone, 170, 171 scaption of shoulder joint, spheroidal joints. See enarthrodial joints sphincter
of knee joint, 277, 277, 379 23 scapula, 89, 91, 111, 112, 143. See also muscles, 38
measuring, 20–21 spin, 26–27, 26 – 27
of shoulder joint, 377 of thumb, shoulder girdle spinal column. See trunk and spinal column spinal cord,
173, 173, 378 of toes, 379 scapula line, 3 48–49, 49 – 52
scapular plane, 5 spinalis muscle, 337, 349–350, 349 – 350
of trunk and spinal column, 335, 335, 379 of wrist and scapular winging, 94 spinal nerves, 48–49, 49 – 52, 340 spinous
hand joints, 172–173, scapulohumeral rhythm, 113 processes, 330
172 – 173, 378 scapulothoracic joints, 90, 92, 377 sciatic splenius muscles, 337, 338, 342, 344, 344
reaction, law of, 80–81, 81, 84 nerve, 249, 266, 281, 307 scissors exercise, sprains, ankle, 296, 297
reciprocal inhibition, 60, 60 256 squats, 367, 367

stability, 81–82, 82 symphysis joints, 17 transverse rotation of pelvis, 236, 236 – 237
stabilizer muscles, 44 symphysis pubis, 231 transversus abdominis muscle, 337, 339,
stabilizing components, 60 synarthrodial joints, 16, 16 356, 356
stance phase, 208, 293 static synchondrosis joints, 17 transversus thoracis muscle, 346, 348
contractions, 41 syndesmosis joints, 16, 147, 296 trapezium bone, 170
static equilibrium, 81 synergist muscles, 44 trapezius muscle, 94, 95 – 96, 97, 98, 98 – 99 trapezoid
static friction, 81, 81 synovial cavity, 275, 277 synovial joints. See diarthrodial bone, 170
statics, study of, 70 joints Trendelenburg gait, 263
sternoclavicular (SC) joints, 89–90, 377 treppe, 57, 58
sternocleidomastoid muscle, 337, 338, 342, triceps brachii muscle, 118, 150, 151, 153,
T
343, 343 158, 158
strap muscles, 38 tailor’s muscle. See sartorius muscle talocrural joint. See triceps extensions, 216, 216
strength-training. See exercises and activities stretch ankle and foot joints talofibular ligament, 297 triceps surae, 302, 308. See also
reflex, 53 gastrocnemius muscle; soleus muscle
stretch-shortening cycle, 59–60 talus, 295 triquetrum bone, 170
structural kinesiology tarsals, 295 trochanter, 230–231
alignment variation terminology, 5 anatomical tendinous inscriptions, 353 trochoidal joints, 19, 147 true
directional terminology, 3–5, 4 tendons, 40 synergists, 44
ankle and foot joints, 293–323. See also tennis elbow, 150 trunk and spinal column, 329–356 bones of,
ankle and foot joints axes of tension, 56–57, 57 – 59. See also contraction/ 329–333, 330 – 332
rotation, 6, 6 – 7, 70 biomechanics, action of muscles core training, 340, 353
69–84. See also tensor fasciae latae muscle, 241, 245, exercises and activities for, 363–371, 382 exercises
biomechanics 265, 265 for, 382
body parts/regions, 7, 8 – 9 teres ligament, 232 icons for, 26
defined, 1 teres major muscle, 118, 119, 120, 123, joints of, 333–335, 333 – 335
elbow and radioulnar joints, 143–162. See 129, 129 ligaments of, 333–334
also elbow and radioulnar joints exercises. See teres minor muscle, 118, 119, 120, 123, movements of, 23, 336, 336 – 337
exercises and activities hip joint and pelvic girdle, 135, 135 muscles of, 337–340, 338 – 356, 341 – 356 nerves of,
229–266. See tetanus, 57, 58 48–49, 49 – 52, 340 range of motion of, 335, 335, 379
also hip joint and pelvic girdle joints, 15–27. See thenar eminence, 199, 200 twitches, phases of, 57, 57 – 58
also joints knee joint, 273–287. See also knee joint thigh, 230, 239 – 240, 241 third-class levers,
muscles, 35–62. See also muscles planes of motion, 71, 72, 73, 75
5–6, 6 – 7 thoracic nerves, 48, 49, 51
U
thoracodorsal nerve, 123
reference lines and positions, 2–3, 2 – 3 thorax. See also trunk and spinal column bones of, UCL (ulnar collateral ligament), 145–146 ulna, 143, 144,
shoulder girdle, 89–104. See also shoulder 330, 332, 333 170 ulnar, defined, 5
girdle muscles of, 337, 340, 346–351, 347 – 351
shoulder joint, 111–135. See also shoulder threshold stimulus, 56, 57 ulnar collateral ligament (UCL), 145–146 ulnar
joint throwing, biomechanics of, 83–84 thumb. See also fingers; flexion of wrist and hand, 23, 174 ulnar nerve, 183, 183
skeletal system, 7, 9–15, 10. See also bones; wrist and hand joints icons for, 25
skeletal system uniarticular muscles, 61
trunk and spinal column, 329–356. See also joints of, 173 unipennate muscles, 38
trunk and spinal column movements of, 23, 173, 174, 175 upper extremities. See elbow and radioulnar
wrist and hand joints, 169–201. See also muscles of, 171, 176, 181, 196–199 range of joints; shoulder girdle; shoulder joint; wrist and
wrist and hand joints subclavius motion of, 173, 173, 378 tibia, 231, 273, 274, 274, hand joints
muscle, 94, 95, 104, 104 295, 295 upper-extremity exercises, 207–222, 380–381 alternating
subcostale muscles, 346, 348 tibial, defined, 5 prone extensions, 366, 366
submaximal stimulus, 56 tibialis anterior muscle, 302, 304, 306, analysis of movement in, 208–209 arm
subscapularis muscle, 118, 118, 120, 123, 315, 315 curls, 155, 157, 215, 215
132, 132 tibialis posterior muscle, 303, 304, 305, barbell press, 217, 217
subscapular nerves, 123 316, 316 bench press, 102, 126, 130, 158, 218, 218
subthreshold stimulus, 56 tibial nerve, 249, 249, 307 tibiofemoral chin-ups, 101, 126, 128, 155, 219, 219
summation of contractions, 57, 58 joint. See knee joint tibiofibular joint, 296 conditioning principles, 212–213
superficial, 5 dead lifts, 350, 368, 368
superior, defined, 5 toe-off, 293 dumbbell bent-over row, 222, 222
Superman exercise, 366, 366 toes. See also ankle and foot joints importance of, 207–208
superolateral, 5 bones of, 295–296, 296 kinetic chain activities, open vs. closed,
superomedial, 5 icons for, 26 210 – 211, 210 – 212
supination joints of, 297 latissimus pulls, 128–130, 132, 220, 220
of ankle and foot joints, 23, 300, 301 movements of, 300, 300 push-ups, 102, 103, 126, 158, 221, 221
of radioulnar joint, 23, 147, 147 – 149, 148 supinator muscles of, 319 rowing exercise, 370, 371
muscle, 150, 153, 162, 162 range of motion of, 379 Tommy shoulder pulls, 214, 214
supine, defined, 5 John procedure, 146 torque, 73–76, 74 triceps extensions, 216, 216
suprascapular nerve, 123 – 77 Valsalva maneuver, 213
supraspinatus muscle, 118, 119, 120, 123, trabecular bone, 11 upward rotation of shoulder girdle, 23, 92, 93 upward tilt
133, 133 training. See exercises and activities of shoulder girdle, 93
supraspinous ligament, 334 translation, 27, 26 – 27
suture joints, 15 translatory motion, 79
V
swimmer’s muscle, 128. See also latissimus transverse arches, 297, 299
dorsi muscle transverse plane, 5, 6 – 7 valgus, 5
swing phase, 293 transverse processes, 330, 333 Valsalva maneuver, 213

varus, 5 vertebral line, 3 icons for, 24 – 25

vastus intermedius muscle, 241, 278, 279, vertical axis, 6 – 7, 7 importance of, 169
280, 284, 284 VMO (vastus medialis obliquus), 285 volar, 5 ligaments of, 173, 174
vastus lateralis muscle, 241, 278, 279, 280, movements of, 23, 173–174, 174 – 175
283, 283 voluntary movement, neural control of, muscles of, 176, 176 – 182, 180 – 181, 184–200, 184
vastus medialis muscle, 241, 278, 279, 280, 48–49, 49 – 53 – 200
285, 285 nerves of, 183, 183
vastus medialis obliquus (VMO), 285 vector range of motion of, 172–173, 172 – 173, 378 views of, 170
W
quantities, 79 – 171
velocity, defined, 80 walking, phases of, 293–294, 294 wrist curls, 184
velocity–force relationship, 58–59, 59 wheels and axles, 77, 77 – 78 Wolff’s
ventral, defined, 5 law, 15
X
vertebral column. See also trunk and workouts. See exercises and activities wrist and
spinal column hand joints, 169–201. See also xiphoid process, 330
bones of, 329–330, 330 – 331 fingers; thumb
muscles of, 340, 345, 345 – 346 bones of, 170, 170 – 171

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Library of Congress Katalogisasi-dalam-Data Publikasi

1 Fondasi Kinesiologi Struktural, 1

4 The Shoulder Girdle, 89

5 Sendi Bahu, 111

8 Analisis Otot Ekstremitas Atas

9 Sendi Pinggul dan Korset Panggul, 229

10 Sendi Lutut, 273

12 Kolom Batang dan Tulang Belakang, 329

13 Analisis Otot Batang dan

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Tulang bervariasi dalam ukuran dan bentuk, yang menjadi

Garis aksila posterior: Garis yang sejajar 1

Garis skapula: Sebuah garis yang membentang secara vertikal ke

Ligamentum cruciatum posterior

ARA. 1.3 • Terminologi arah anatomi.

Epikondilus lateral Epikondilus medial

Kondilus tibialis lateral

ARA. 1.4 • Terminologi arah anatomi.

Depan: Di depan atau di depan

Belakang: Di belakang, di belakang, atau di belakang

Skoliosis: Lekukan lateral tulang belakang

1 Unggul Sumbu vertikal

Sumbu sagital Frontal

Sumbu sagital atau anteroposterior

TABEL 1.1 • Bidang gerak dan sumbu rotasinya

Pesawat Deskripsi pesawat Sumbu rotasi Deskripsi sumbu Gerakan umum

Sagittal Membagi tubuh menjadi dua Frontal (koronal, lateral,

1 TABEL 1.2 • Bagian tubuh dan wilayah

Berhubung dgn telinga Telinga

Yg berhubung dgn kuduk Leher posterior

Costal Tulang iga

Tulang belikat Tulang belikat

Pinggang Punggung bawah atau

Olecranon Titik siku

Antebrachial Lengan bawah

Carpal Pergelangan tangan

Palmar telapak tangan

Manual Dorsal Punggung tangan

Tungkai bawah Lereng Pergelangan kaki

Dorsum Kaki bagian atas

Nasal (hidung) Cephalic (kepala) Cranial

Lisan (mulut) Orbital (mata) Berhubung dgn tengkuk

Klavikula (tulang selangka) Mental (dagu) Belakang (leher posterior)

Tarsal (punggung kaki)

ARA. 1.7 • Wilayah tubuh. SEBUAH, Tampilan anterior; B, Tampilan posterior.

Tulang pangkal paha Tulang sulbi Lebih besar

Trochanter kecil Falang (5)

Maleolus medial Calcaneus

Tulang tarsal (7)

ARA. 1.8 • Kerangka. SEBUAH, Tampilan anterior; B, Tampilan posterior.

1. Perlindungan jaringan lunak vital seperti jantung, paru-paru,