UNIT OF STUDY 6, B MED 2806.

SENSORY AND MOTOR FUNCTIONS.

LECTURE, U5L13, THE LIMBS.

GENERAL.
UPPER LIMB.
BONES.
JOINTS.
MUSCLES.
FUNCTION.
LOWER LIMB.
BONES.
JOINTS.
MUSCLES.
FUNCTION.

STRUCTURE OF THE LIMBS.

GENERAL.
Upper and lower limb similar development, homologous.
Function differs, not analogous.
Upper limb, specialized for manipulation.
Mobile, gracile, three dimensional, shorter, neurological.
Hand. Platform. Medial four digits curvable, spreadable, oppose platform. Thumb at right angles, mobile,
curves, opposes platform and other four digits, grasp. Skin and subcutaneous tissue adapted for grip.
Lower limb, specialized for bipedal locomotion (standing and walking).
Stable, robust, one dimensional, longer, mechanical.
Foot. Arches, able to be both rigid and flexible. Acts as lever when rigid and a gripping, moulding, resilient
structure when flexible. Grip partly a property of the plantar skin.
Define, proximal, distal, anatomical position.
Bones. Allow force transfer (resist deformity), help form joints (articulations), provide muscle attachment.
Joints. Particularly synovial joints, allow and direct movement. Associated ligaments limit movement and
stabalise joints. Typical synovial joint, bones, articular surfaces, articular cartilage, joint space, synovial
membrane, synovial fluid, capsule, ligaments, muscles, other structures eg labrum, disc, bursae. Classification
histological and mechanical.
Muscles. Move and stabalise joints.
UPPER LIMB.
Define regions. Shoulder, arm, elbow, forearm, wrist, hand.
Bones. Location. Articulations listed under joints.
Clavicle. Shoulder.
Scapula. Shoulder.
Humerus. Arm.
Radius. Lateral forearm.
Ulna. Medial forearm.
Carpal (8) Proximal hand.
Metacarpal (5). Mid hand.
Phalanges (14). Distal hand.
Joints. Bones forming, classification (histological, mechanical), major directions of movement. All are
histologically synovial. Many joints in the hand.
Scapula on chest wall, not a joint but acts like one, 6 directions of movement.
Shoulder joint (SJ). Humerus and scapula. Ball and socket, 6.
Elbow joint (EJ). Humerus, radius, ulna. Hinge, 2.
Radio-ulna joints (SRUJ, IRUJ). Radius, ulna. Pivot, 2, rotation.
Wrist joint (WJ). Radius, proximal carpal. Ellipsoid, 4.
Intercarpal joints.
Carpo-Metacarpal joints ( CMJs x5). CMJ 1, triquetral, base first metacarpal, saddle, 5/6 directions of
movement, contributes to thumb mobility.
Metacarpo-Phalangeal joints (MPJ x5), 4 directions of movement except thumb only 2.
Interphalangeal joints (IPJ x9), hinge, digit flexion and extension.
Muscles. Classification (by position, group), approximate number of individual muscles, regional location,
major action(s). All are skeletal.
Shoulder muscles (14). Shoulder. Move and stabalise scapula and SJ.
Arm muscles. Anterior (3) and posterior (1). Arm. Move EJ.

Forearm muscles. Anterior (8) and posterior (11). Forearm. Rotation of forearm. Also act on the WJ and hand
joints (extrinsic hand muscles), flex and extend digits, grasp, power movements.
Intrinsic hand muscles (18), several subgroups. Hand. Act on hand joints, precision movements.
Overall Function of The Regions in Manipulation.
Shoulder. Mobility of limb and hand, sphere, rotate limb including hand.
Arm and Elbow. Hand within the sphere, to and from body.
Forearm. Rotate, adjust hand (pronation, supination), some muscles (EHM) act on hand power function.
Wrist. Adjust hand.
Hand. Grasp, power and precision movements.
LOWER LIMB.
Define regions. Hip and gluteal, thigh, knee, leg, ankle, foot.
Define walking cycle and its phases. Stance (foot on ground), swing (foot off ground), heel strike (HS), toe off
(TO). Swing plus stance equals a stride or one cycle. Early and late stance both feet on ground.
Bones. Location. Articulations listed under joints.
Hip. Hip.
Femur. Thigh.
Patella. Knee.
Tibia. Medial leg.
Fibula. Lateral leg.
Tarsal (7). Proximal foot.
Metatarsal (5). Mid foot.
Phalanges (14). Distal foot.
Joints. Bones forming, classification (histological, mechanical), major directions of movement. All but one
(inferior tibio-fibula joint, fibrous) are histologically synovial. Many joints in the foot.
Hip joint (HJ).Hip, femur. Ball and socket. 6 directions of movement
Knee joint (KJ). Femur, patella, tibia. Hinge with modification. 2.
Tibio-fibula (STFJ, ITFJ). Tibia, fibula. Immobile. Compare with RUJs.
Ankle joint (AJ). Tibia, fibula, talus. Hinge. 2.
Joints of the foot, many. Provide flexibility and moulding.
Muscles. Classification (by position, group), approximate number of individual muscles, regional location,
major action(s). All are skeletal.
Gluteal muscles (10). Gluteal. Act on the HJ.
Thigh muscles. Anterior (2), medial (5) and posterior (3). Thigh. Act on HJ and KJ.
Leg muscles. Anterior (3), posterior (6) and lateral (2). Leg. Act on KJ, AJ, and foot. Includes the extrinsic foot
muscles.
Intrinsic foot muscles, many. Foot. Act on the foot, stabalise arches.
Overall Function of The Regions in Walking.
Hip and Gluteal. Advance limb during swing (HJ flexion), provide thrust throughout stance (HJ extension).
Thigh and Knee. Shorten limb (KJ flexion), resilience.
Leg and Ankle. Lengthen limb, provide thrust in late stance (AJ plantarflexion).
Foot. Arches provide both flexibility and rigidity. Grip, moulding, resilience, assist thrust in late stance.
REFERENCES.
Kapit. W. and Elson. L.M. 02. The Anatomy Coloring Book. 3rd edition. Pages 21, 22, 36, 43, 60, 68.

UPPER LIMB.
Region(s).

Bones.

Joints.

Muscles.

Function in
Manipulation.

Shoulder.

Clavicle.
Scapula.
Proximal Humerus.

Scapula/Thorax.
SJ.

Shoulder.

Mobility.
Rotation.

Arm, Elbow.

Humerus.
Proximal Radius &
Ulna.

EJ.

Anterior &
Posterior Arm.

Hand to and from

body.

Forearm.

Radius & Ulna.

RUJs.

Anterior and
Posterior Forearm.

Rotation of hand.

Wrist.

Distal Radius &

Ulna.
Proximal carpal.

WJ.

Anterior and
Posterior Forearm.

Adjust hand.

Hand.

Carpal.
Metacarpal.
Phalanges.

ICJs.
CMCJs.
MCPJs.
IPJs.

Intrinsic Hand
Muscles. Tendons
of some forearm
muscles (EHM).

Grasp.
Power & Precision.

Region(s).

Bones.

Joints.

Muscles.

Function in
Walking.

Hip & Gluteal.

Hip.
Proximal Femur.

SIJ.
HJ.

Gluteal.
Thigh.

Thigh & Knee.

Femur.
Patella.
Proximal Tibia &
Fibula.
Tibia.
Fibula.
Talus.

KJ.

Thigh and some

Leg.

Advance limb in
swing.
Thrust throughout
stance.
Shorten limb.
Resilience.

TFJs.
AJ.

Leg.

Thrust in late
stance.

Tarsal.
Metatarsal.
Phalanges.

ITJs.
TMTJs.
MTPJs.
IPJs.

Intrinsic Foot
Muscles. Tendons
of some leg
muscles.

Moulding.
Resilience.
Grip.
Thrust late stance.

LOWER LIMB.

Leg & Ankle.

Foot

WALKING CYCLE.
HS
Stance.
Foot on Ground. 60%.
Hip Joint / Region

Ankle Joint / Region.

Extension throughout.
Posterior Thigh Muscles.
Thrust 1.
Late Plantarflexion.
Posterior Leg Muscles.
Thrust 2.

TO

HS
Swing.
Foot in Air. 40%.
Flexion throughout.
Anterior Thigh Muscles.

UPPER LIMB.
BONES.
Clavicle A. Scapula B. Humerus C. Ulna D. Radius E. Carpal F. Metacarpal G. Phalanges H.
JOINTS.
Shoulder 2. Elbow 3. Superior radio-ulna 6. Inferior radio-ulna 7. Wrist 8. Carpometacarpal 10.
Metacarpophalageal 12. Interphalangeal 13.
MUSCLES.
Trapezius A. Deltoid B. Pectoralis major B1. Serratus anterior A2. Lataissimus dorsi B2. Biceps
brachii C. Triceps C2. Pronator teres C5. Pronator quadratus not on diag. Supinator not on diag.
Hypothenar G G1 G2. Thenar F F1 F2. Interosseus (dorsal) H2. Flexor digitorum superficialis not on
diag. Flexor digitorum profundus not on diag.
LOWER LIMB.
BONES.
Hip A. Femur B. Patella C. Tibia D. Fibula E. Tarsal F. Metatarsal G. Phalanges H.
JOINTS.
Hip 2. Knee 3,4. Tibio-fibula 5,6. Ankle 7.
MUSCLES.
Gluteus maximus A4. Gluteus medius A2. Gluteus minimus not on diag. Quadraceps femoris B B1 B2.
Biceps femoris B5. Semitendinosus B6. Semimembranosus B7. Gastrocnemeus C. Soleus C2.
MUSCLE GROUPS. (not all the muscles in the groups are shown).
Shoulder, A-A2 B-B5.
Anterior Arm. B6 C C1.
Posterior Arm. C2.
Anterior Forearm. C5-D2.
Posterior Forearm. C4 D3-E2.
Intrinsic Hand Muscles. All F G H.
Gluteal. A2-A4.
Anterior Thigh. B-B3.
Medial Thigh. A5-A7 B4.
Posterior Thigh B5-B7.
Anterior Leg. C5-C7.
Posterior Leg. C-C4.
Lateral Leg. C8.
Intrinsic foot muscles not on diagram.