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Chapter 8 (PART TWO)

Types of Contractions

  • Isotonic Contractions: Muscle contracts and changes length while generating equal force.

    • Concentric Contraction: Muscle shortens while contracting.

    • Eccentric Contraction: Muscle lengthens while contracting.

  • Isometric Contractions: Muscle contracts but does not change length; there is a change in force.

    • (a) Muscle contracts with a force greater than resistance, resulting in a shortening contraction (concentric contraction).

    • (b) Muscle contracts with a force less than resistance, leading to a lengthening contraction (eccentric contraction).

    • (c) Muscle contracts but does not change length, indicating an isometric contraction.


Smooth Muscle

Characteristics of Smooth Muscle Cells

  • Smooth muscle cells are elongated with tapered ends and lack striations, giving them a "smooth" appearance.

  • They possess a relatively undeveloped sarcoplasmic reticulum.

  • Contains thick and thin filaments arranged more randomly compared to skeletal muscle.

Types of Smooth Muscle

  • Multiunit Smooth Muscle:

    • Found in blood vessels and the iris of the eye.

    • Fibers occur separately rather than as sheets and are stimulated by neurons and certain hormones.

  • Visceral Smooth Muscle:

    • Found in sheets within the walls of hollow organs.

    • Fibers can stimulate one another and demonstrate rhythmicity, contributing to peristalsis in tubular organs.


Smooth Muscle Contraction

Similarities with Skeletal Muscle Contraction

  • Both contractions involve reactions between actin and myosin.

  • Both are stimulated by membrane impulses, require an increase in calcium ions in the cells, and utilize ATP energy.

Differences from Skeletal Muscle Contraction

  • Neurotransmitters: Both acetylcholine (ACh) and norepinephrine can stimulate or inhibit smooth muscle contraction; however, only ACh stimulates skeletal muscle contraction.

  • Hormonal Influence: Hormones can stimulate or inhibit smooth muscle contraction but do not have this effect on skeletal muscle.

  • Speed of Contraction and Relaxation: Smooth muscle is slower to contract and relax compared to skeletal muscle.

  • Duration of Contraction: Smooth muscle can maintain a contraction longer with the same amount of ATP.

  • Length Change without Tautness Change: Smooth muscle can change length without altering tautness.


Cardiac Muscle

  • Location: Cardiac muscle is exclusively found in the heart.

  • Structure: Consists of branching, striated cells that interconnect to form three-dimensional networks.

Mechanism of Contraction

  • Similar to that of skeletal and smooth muscle but with differences:

    • Sarcoplasmic reticulum is not well-developed and does not store much calcium.

    • Transverse tubules provide additional calcium from extracellular fluid, resulting in longer-lasting twitches in cardiac muscle cells.

    • Cardiac muscle is self-exciting and rhythmic, creating a regular pattern of contraction and relaxation.

    • Intercalated Discs: Complex membrane junctions that join cells and transmit the force of contraction from one cell to another.


Types of Muscle Tissue

Table 8.3: Summary of Muscle Types

  • Skeletal Muscle:

    • Major Location: Skeletal muscles.

    • Major Function: Movement of bones at joints, maintenance of posture.

    • Cellular Characteristics: Striations (present), multiple nuclei.

    • Special Features: Well-developed transverse tubule system.

    • Mode of Control: Voluntary.

    • Contraction Characteristics: Contracts and relaxes rapidly when stimulated by a motor neuron.

  • Smooth Muscle:

    • Major Location: Walls of hollow viscera and blood vessels.

    • Major Function: Movement of viscera, peristalsis, vasoconstriction.

    • Cellular Characteristics: Striations (absent), single nucleus.

    • Special Features: Lacks transverse tubules.

    • Mode of Control: Involuntary.

    • Contraction Characteristics: Contracts and relaxes slowly; single-unit type is self-exciting and rhythmic.

  • Cardiac Muscle:

    • Major Location: Wall of the heart.

    • Major Function: Pumping action of the heart.

    • Cellular Characteristics: Striations (present), single nucleus.

    • Special Features: Well-developed transverse tubule system; intercalated discs separating adjacent cells.

    • Mode of Control: Involuntary.

    • Contraction Characteristics: Network of cells contracts as a unit; self-exciting; rhythmic.


Skeletal Muscle Actions

Key Terminology

  • Origin: The less movable end of a skeletal muscle.

  • Insertion: The more movable end of a skeletal muscle.

  • Muscle contraction pulls the insertion towards the origin.

Example Muscle: Biceps Brachii

  • Originates from the scapula (coracoid process and tubercle above the glenoid cavity).

  • Inserts at the radial tuberosity of the radius.

  • Located on the anterior surface of the humerus.

  • Action includes the flexion of the forearm at the elbow.


Muscle Relationships

Common Movements Across Joints

  • Flexion: Decrease in the angle between bones at a joint; e.g., flexion of the arm at the elbow bends the arm.

  • Extension: Increase in the angle between bones at a joint; e.g., extension of the arm at the elbow straightens the arm.

Muscle Groups Involved

  • Agonist (Prime Mover): The muscle that causes the action and does the majority of the work; e.g., brachialis.

  • Synergists: Muscles that assist the prime mover; e.g., biceps brachii.

  • Antagonists: Muscles that oppose an action; e.g., triceps brachii.

  • Functional Dependency: The relationships between muscles can change based on the action; a muscle can be a synergist for one action and an antagonist for another.


Naming of Skeletal Muscles

Naming Criteria Include:

  • Size.

  • Shape.

  • Location.

  • Action.

  • Number of attachments.

  • Direction of fibers.

  • Combinations of the above.

Examples of Muscle Names

  • Pectoralis Major: Named for size and location; large size and located in the chest.

  • Deltoid: Named for shape; triangular in shape.

  • Extensor Digitorum: Named for action; extends digits (fingers/toes).

  • Biceps Brachii: Named for number of attachments and location; has 2 origins (heads) and is found in the arm (brachium).

  • Sternocleidomastoid: Named for attachments; attaches to the sternum, clavicle, and mastoid process.

  • External Oblique: Named for location and direction of fibers; located on the outside of the body with fibers running at a slant.


Muscles of Facial Expression

Overview

  • Muscles of facial expression attach to underlying bones and the overlying connective tissue of skin, enabling a wide range of facial expressions (e.g., anger, fear, pain, disgust, surprise, happiness).

Major Muscles of Facial Expression:

  • Epicranius:

    • Origin: Occipital bone.

    • Insertion: Skin around the eye.

    • Action: Elevates the eyebrow.

  • Orbicularis Oculi:

    • Origin: Maxilla and frontal bone.

    • Insertion: Skin around the eye.

    • Action: Closes the eye.

  • Orbicularis Oris:

    • Origin: Muscle near the mouth.

    • Insertion: Skin of lips.

    • Action: Closes and protrudes lips.

  • Buccinator:

    • Origin: Alveolar processes of maxilla and mandible.

    • Insertion: Orbicularis oris.

    • Action: Compresses cheeks.

  • Zygomaticus:

    • Origin: Zygomatic bone.

    • Insertion: Skin and muscle at the corner of the mouth.

    • Action: Elevates the corner of the mouth.

  • Platysma:

    • Origin: Fascia in the upper chest.

    • Insertion: Skin and muscles below the mouth.

    • Action: Depresses the lower lip and angle of the mouth.


Muscles of Mastication

Overview

  • Chewing movements are derived from muscles attached to the mandible.

Major Chewing Muscles:

  • Masseter:

    • Origin: Zygomatic arch.

    • Insertion: Posterior lateral surface of mandible.

    • Action: Elevates and protracts mandible.

  • Temporalis:

    • Origin: Temporal bone.

    • Insertion: Coronoid process of mandible.

    • Action: Elevates and retracts mandible.


Muscles that Move the Head

Overview

  • Paired muscles in the neck and upper back cause flexion, extension, and rotation of the head.

Major Muscles:

  • Sternocleidomastoid:

    • Origin: Manubrium of sternum and medial clavicle.

    • Insertion: Mastoid process of temporal bone.

    • Action: Individually - laterally flexes head and neck to the same side, rotates head to the opposite side. Together - pulls head forward and down; aids in forceful inhalation by elevating sternum and first ribs.

  • Splenius Capitis:

    • Origin: Ligamentum nuchae; spinous processes of 7th cervical and upper thoracic vertebrae.

    • Insertion: Occipital bone and mastoid process of temporal bone.

    • Action: Individually - rotates head to the same side; Together - brings head into an upright position.

  • Semispinalis Capitis:

    • Origin: Below the articular facets of lower cervical vertebrae; transverse processes of upper thoracic vertebrae.

    • Insertion: Occipital bone.

    • Action: Individually - rotates head to the opposite side; Together - extend head and neck.

  • Scalenes:

    • Origin: Transverse processes of cervical vertebrae.

    • Insertion: Superior and lateral surface of first two ribs.

    • Action: Individually - laterally flexes head and neck to the same side; Together - elevate first two ribs during forceful inhalation.


Muscles That Move the Pectoral Girdle

Overview

  • Muscles that move the pectoral girdle are associated with those that move the arm and include chest and shoulder muscles affecting the scapula.

Major Muscles:

  • Trapezius:

    • Origin: Occipital bone, ligamentum nuchae, and spinous processes of 7th cervical and all thoracic vertebrae.

    • Insertion: Clavicle; spine and acromion process of scapula.

    • Action: Rotates and retracts scapula; superior portion elevates scapula, inferior portion depresses scapula.

  • Rhomboid Major:

    • Origin: Spinous processes of upper thoracic vertebrae.

    • Insertion: Medial border of scapula.

    • Action: Elevates and retracts scapula.

  • Levator Scapulae:

    • Origin: Transverse processes of cervical vertebrae.

    • Insertion: Superior angle and medial border of scapula.

    • Action: Elevates scapula.

  • Serratus Anterior:

    • Origin: Anterior surfaces of ribs 1 to 10.

    • Insertion: Medial border of scapula.

    • Action: Protracts and rotates scapula.

  • Pectoralis Minor:

    • Origin: Anterior surfaces of ribs 3 to 5.

    • Insertion: Coracoid process of scapula.

    • Action: Depresses and protracts scapula, elevates ribs during forceful inhalation.


Muscles that Move the Arm

Overview

  • Muscles connect the arm to the pectoral girdle, ribs, and vertebral column, allowing the arm to move freely.

Grouping by Action:

  • Flexors: Include coracobrachialis and pectoralis major.

  • Extensors: Include teres major and latissimus dorsi.

  • Abductors: Include supraspinatus and deltoid.

  • Rotators: Include subscapularis, infraspinatus, and teres minor.

Major Muscles:

  • Coracobrachialis:

    • Origin: Coracoid process of scapula.

    • Insertion: Medial midshaft of humerus.

    • Action: Flexes and adducts the arm at the shoulder.

  • Pectoralis Major:

    • Origin: Clavicle, sternum, and costal cartilages of upper ribs.

    • Insertion: Intertubercular sulcus of humerus.

    • Action: Flexes, adducts, and medially rotates the arm at the shoulder.

  • Teres Major:

    • Origin: Lateral border of scapula.

    • Insertion: Intertubercular sulcus of humerus.

    • Action: Extends, adducts, and medially rotates the arm at the shoulder.

  • Latissimus Dorsi:

    • Origin: Spinous processes of lower thoracic and lumbar vertebrae, iliac crest, and lower ribs.

    • Insertion: Intertubercular sulcus of humerus.

    • Action: Extends, adducts, and medially rotates the arm at the shoulder.

  • Supraspinatus:

    • Origin: Supraspinous fossa of scapula.

    • Insertion: Greater tubercle of humerus.

    • Action: Abducts the arm.

  • Deltoid:

    • Origin: Acromion process, spine of scapula, and clavicle.

    • Insertion: Deltoid tuberosity of humerus.

    • Action: Lateral portion abducts the arm; anterior portion flexes the arm at the shoulder; posterior portion extends the arm at the shoulder.

  • Subscapularis:

    • Origin: Anterior surface of scapula.

    • Insertion: Lesser tubercle of humerus.

    • Action: Medially rotates the arm.

  • Infraspinatus:

    • Origin: Infraspinous fossa of scapula.

    • Insertion: Greater tubercle of humerus.

    • Action: Laterally rotates the arm.

  • Teres Minor:

    • Origin: Lateral border of scapula.

    • Insertion: Greater tubercle of humerus.

    • Action: Laterally rotates the arm.


Muscles that Move the Forearm

Overview

  • Most forearm movements are accomplished by muscles arising from the humerus or pectoral girdle connecting to the ulna and radius.

Muscle Groupings:

  • Flexors: Biceps brachii, brachialis, brachioradialis.

  • Extensor: Triceps brachii muscle.

  • Rotators: Include supinator, pronator teres, and pronator quadratus.

Major Muscles:

  • Biceps Brachii:

    • Origin: Coracoid process (short head); tubercle above glenoid cavity of scapula (long head).

    • Insertion: Radial tuberosity.

    • Action: Flexes forearm at elbow and supinates forearm and hand.

  • Brachialis:

    • Origin: Anterior surface of humerus.

    • Insertion: Coronoid process of ulna.

    • Action: Flexes forearm at elbow.

  • Brachioradialis:

    • Origin: Distal lateral end of humerus.

    • Insertion: Lateral surface of radius above styloid process.

    • Action: Flexes forearm at elbow.

  • Triceps Brachii:

    • Origin: Tubercle below glenoid cavity of scapula (long head); lateral surface of humerus (lateral head); posterior surface of humerus (medial head).

    • Insertion: Olecranon process of ulna.

    • Action: Extends forearm at elbow.

  • Supinator:

    • Origin: Lateral epicondyle of humerus and proximal ulna.

    • Insertion: Anterior and lateral surface of radius.

    • Action: Supinates forearm and hand.

  • Pronator Teres:

    • Origin: Medial epicondyle of humerus and coronoid process of ulna.

    • Insertion: Lateral surface of radius.

    • Action: Pronates forearm and hand.

  • Pronator Quadratus:

    • Origin: Anterior distal end of ulna.

    • Insertion: Anterior distal end of radius.

    • Action: Pronates forearm and hand.


Muscles that Move the Hand

Overview

  • Hand movements are caused by various muscles originating from the distal humerus, radius, and ulna.

Muscle Groupings:

  • Flexors: Include flexor carpi radialis, flexor carpi ulnaris, palmaris longus, and flexor digitorum profundus.

  • Extensors: Include extensor carpi radialis longus, extensor carpi radialis brevis, extensor carpi ulnaris, and extensor digitorum.

Major Muscles:

  • Flexor Carpi Radialis:

    • Origin: Medial epicondyle of humerus.

    • Insertion: Base of second and third metacarpals.

    • Action: Flexes wrist and abducts hand.

  • Flexor Carpi Ulnaris:

    • Origin: Medial epicondyle of humerus and olecranon process of ulna.

    • Insertion: Carpal bones and fifth metacarpal bone.

    • Action: Flexes wrist and adducts hand.

  • Palmaris Longus:

    • Origin: Medial epicondyle of humerus.

    • Insertion: Fascia of palm.

    • Action: Flexes wrist.

  • Flexor Digitorum Profundus:

    • Origin: Anterior and medial surface of ulna.

    • Insertion: Distal phalanges of fingers 2 to 5.

    • Action: Flexes wrist and joints of fingers.

  • Extensor Carpi Radialis Longus:

    • Origin: Lateral distal end of humerus.

    • Insertion: Base of second metacarpal.

    • Action: Extends wrist, abducts hand.

  • Extensor Carpi Radialis Brevis:

    • Origin: Lateral epicondyle of humerus.

    • Insertion: Base of third metacarpal.

    • Action: Extends wrist and abducts hand.

  • Extensor Carpi Ulnaris:

    • Origin: Lateral epicondyle of humerus and proximal, posterior ulna.

    • Insertion: Base of fifth metacarpal.

    • Action: Extends wrist, adducts hand.

  • Extensor Digitorum:

    • Origin: Lateral epicondyle of humerus.

    • Insertion: Posterior surfaces of phalanges in fingers 2 to 5.

    • Action: Extends wrist and joints of fingers.


Muscles of the Abdominal Wall

Overview

  • Abdominal wall does not have bony support, unlike the chest and pelvic regions. Instead, it is supported by broad, flattened muscles.

  • The abdominal muscles connect the rib cage and vertebral column to the pelvic girdle, and they increase abdominal pressure while decreasing the size of the abdominal cavity.

Major Muscles:

  • External Oblique:

    • Origin: Outer surfaces of lower 8 ribs.

    • Insertion: Outer lip of iliac crest and linea alba.

    • Action: Compresses abdomen, flexes and rotates vertebral column.

  • Internal Oblique:

    • Origin: Iliac crest and inguinal ligament.

    • Insertion: Lower 3 to 4 ribs, linea alba, and crest of pubis.

    • Action: Compresses abdomen, flexes and rotates vertebral column.

  • Transverse Abdominis:

    • Origin: Costal cartilages of lower 6 ribs, processes of lumbar vertebrae, lip of iliac crest, and inguinal ligament.

    • Insertion: Linea alba and crest of pubis.

    • Action: Compresses abdomen.

  • Rectus Abdominis:

    • Origin: Crest of pubis and pubic symphysis.

    • Insertion: Xiphoid process of sternum and costal cartilages of ribs 5 to 7.

    • Action: Compresses abdomen, flexes vertebral column.


Muscles of the Pelvic Floor

Overview

  • The pelvic floor is composed of two muscular sheets that close off the inferior outlet of the pelvis and form the floor of the pelvis:

    • The deeper pelvic diaphragm, which includes the levator ani and coccygeus.

    • The superficial urogenital diaphragm, which includes the superficial transverse perineal, bulbospongiosus, and ischiocavernosus.

Major Muscles:

  • Levator Ani:

    • Origin: Pubis and ischial spine.

    • Insertion: Coccyx.

    • Action: Supports pelvic viscera, compresses the anal canal.

  • Coccygeus:

    • Origin: Ischial spine.

    • Insertion: Sacrum and coccyx.

    • Action: Supports pelvic viscera, compresses the anal canal.

  • Superficial Transversus Perinei:

    • Origin: Ischial tuberosity.

    • Insertion: Central tendon.

    • Action: Supports pelvic viscera.

  • Bulbospongiosus:

    • Origin: Central tendon.

    • Insertion:

      • Males: Corpus cavernosa of penis; Assists emptying of urethra, assists erection of penis.

      • Females: Corpus cavernosa of clitoris; Constricts vagina, assists erection of clitoris.

  • Ischiocavernosus:

    • Origin: Ischial tuberosity.

    • Insertion:

      • Males: Corpus cavernosa of penis; Contributes to erection of the penis.

      • Females: Corpus cavernosa of clitoris; Contributes to erection of the clitoris.


Muscles that Move the Thigh

Overview

  • The muscles that move the thigh attach to the femur and the pelvic girdle and are classified into anterior, medial, and posterior groups.

Major Muscle Groups:

  • Anterior Group:

    • Function: Flex the thigh.

    • Muscles Include: Psoas major and iliacus.

  • Medial Group:

    • Function: Adduct the thigh.

    • Muscles Include: Adductor magnus, adductor longus, gracilis.

  • Posterior Group:

    • Function: Extend, abduct, or rotate the thigh.

    • Muscles Include: Gluteus maximus, gluteus medius, gluteus minimus, and tensor fasciae latae.

Major Muscles:

  • Psoas Major:

    • Origin: Bodies and transverse processes of lumbar vertebrae.

    • Insertion: Lesser trochanter of femur.

    • Action: Flexes thigh at the hip.

  • Iliacus:

    • Origin: Iliac fossa of ilium.

    • Insertion: Lesser trochanter of femur.

    • Action: Flexes thigh at the hip.

  • Gluteus Maximus:

    • Origin: Sacrum, coccyx, and posterior surface of ilium.

    • Insertion: Posterior surface of femur and fascia of thigh.

    • Action: Extends thigh at hip, laterally rotates thigh.

  • Gluteus Medius:

    • Origin: Lateral surface of ilium.

    • Insertion: Greater trochanter of femur.

    • Action: Abducts and medially rotates thigh.

  • Gluteus Minimus:

    • Origin: Lateral surface of ilium.

    • Insertion: Greater trochanter of femur.

    • Action: Abducts and medially rotates thigh.

  • Tensor Fasciae Latae:

    • Origin: Anterior iliac crest.

    • Insertion: Fascia of thigh.

    • Action: Abducts and medially rotates thigh.

  • Adductor Longus:

    • Origin: Pubic bone near the pubic symphysis.

    • Insertion: Posterior surface of femur.

    • Action: Adducts thigh and flexes thigh at the hip.

  • Adductor Magnus:

    • Origin: Pubis and ischial tuberosity.

    • Insertion: Posterior surface of femur.

    • Action: Adducts and extends thigh at the hip.

  • Gracilis:

    • Origin: Lower edge of pubis.

    • Insertion: Proximal medial surface of tibia.

    • Action: Adducts thigh, flexes thigh at hip, medially rotates thigh and leg.


Muscles that Move the Leg

Overview

  • The muscle group of the leg connects the tibia or fibula to the femur or pelvic girdle.

  • Two major groups are identified: flexors and extensors of the knee.

Major Muscle Groups:

  • Flexors: Hamstring group includes biceps femoris, semitendinosus, semimembranosus, and sartorius.

  • Extensors: Quadriceps femoris group, consisting of 4 muscles: rectus femoris, vastus lateralis, vastus medialis, and vastus intermedius.

Major Muscles:

  • Sartorius:

    • Origin: Anterior superior iliac spine.

    • Insertion: Proximal medial surface of tibia.

    • Action: Flexes leg at knee, flexes thigh at hip, abducts thigh, laterally rotates thigh, medially rotates leg.

  • Hamstring Group:

    • Biceps Femoris:

      • Origin: Ischial tuberosity and posterior surface of femur.

      • Insertion: Head of fibula.

      • Action: Flexes leg at knee, extends thigh at hip.

    • Semitendinosus:

      • Origin: Ischial tuberosity.

      • Insertion: Proximal medial surface of tibia.

      • Action: Flexes leg at knee, extends thigh at hip.

    • Semimembranosus:

      • Origin: Ischial tuberosity.

      • Insertion: Medial condyle of tibia.

      • Action: Flexes leg at knee, extends thigh at hip.

  • Quadriceps Femoris Group:

    • Rectus Femoris:

      • Origin: Anterior inferior iliac spine and margin of acetabulum.

      • Insertion: Patella (via tendon, continuing as patellar ligament to tibial tuberosity).

      • Action: Extends leg at knee, flexes thigh at hip.

    • Vastus Lateralis:

      • Origin: Greater trochanter and posterior surface of femur.

      • Insertion: Patella (via tendon, continuing as patellar ligament to tibial tuberosity).

      • Action: Extends leg at knee.

    • Vastus Medialis:

      • Origin: Medial surface of femur.

      • Insertion: Patella (via tendon, continuing as patellar ligament to tibial tuberosity).

      • Action: Extends leg at knee.

    • Vastus Intermedius:

      • Origin: Anterior and lateral surfaces of femur.

      • Insertion: Patella (via tendon, continuing as patellar ligament to tibial tuberosity).

      • Action: Extends leg at knee.


Muscles that Move the Foot

Overview

  • Many muscles that move the foot are located in the leg, attached from the femur, fibula, or tibia to the bones of the foot.

Directions of Movement:

  • Upward (Dorsiflexion): Muscles include tibialis anterior, fibularis (peroneus) tertius, and extensor digitorum longus.

  • Downward (Plantar Flexion): Muscles include gastrocnemius, soleus, and flexor digitorum longus.

  • Invert: Muscles include tibialis posterior.

  • Evert: Muscles include fibularis (peroneus) longus, and fibularis (peroneus) brevis.

Major Muscles:

  • Tibialis Anterior:

    • Origin: Lateral condyle and lateral surface of tibia.

    • Insertion: Tarsal bone (medial cuneiform) and first metatarsal.

    • Action: Dorsiflexion and inversion of foot.

  • Fibularis Tertius:

    • Origin: Anterior surface of fibula.

    • Insertion: Dorsal surface of fifth metatarsal.

    • Action: Dorsiflexion and eversion of foot.

  • Extensor Digitorum Longus:

    • Origin: Lateral condyle of tibia and anterior surface of fibula.

    • Insertion: Dorsal surfaces of middle and distal phalanges of the four lateral toes.

    • Action: Dorsiflexion of foot, extension of four lateral toes.

  • Gastrocnemius:

    • Origin: Lateral and medial condyles of femur.

    • Insertion: Posterior surface of calcaneus.

    • Action: Plantar flexion of foot, flexion of leg at knee.

  • Soleus:

    • Origin: Head and shaft of fibula and posterior surface of tibia.

    • Insertion: Posterior surface of calcaneus.

    • Action: Plantar flexion of foot.

  • Flexor Digitorum Longus:

    • Origin: Posterior surface of tibia.

    • Insertion: Distal phalanges of the four lateral toes.

    • Action: Flexion of the four lateral toes.

  • Tibialis Posterior:

    • Origin: Lateral condyle and posterior surface of tibia, and posterior surface of fibula.

    • Insertion: Tarsal and metatarsal bones.

    • Action: Inversion and plantar flexion of foot.

  • Fibularis Longus:

    • Origin: Lateral condyle of tibia and head and shaft of fibula.

    • Insertion: Tarsal bone (medial cuneiform) and first metatarsal.

    • Action: Eversion and plantar flexion of foot; supports the arch.

  • Fibularis Brevis:

    • Origin: Lower lateral surface of fibula.

    • Insertion: Base of fifth metatarsal.

    • Action: Eversion and plantar flexion of foot.