msucularsystemfinallec 120125071900-phpapp02

The Muscular SystemThe Muscular System

Specialized tissue that enable the Specialized tissue that enable the body and its parts to move.body and its parts to move.

Anterior ViewAnterior View

Posterior ViewPosterior View

TRIVIA!TRIVIA! How many muscles are there in the human body?

Answer: 640 Muscles The muscles make up about 40 % of the body mass.

What is the longest muscle in the body? Answer: The Sartorius The Sartorius runs from the outside of the hip, down and across to the

inside of the knee. It twists and pulls the thigh outwards.

What is the smallest muscle in the body? Answer: The Stapedius The Stapedius is located deep in the ear. It is only 5mm long and thinner

than cotton thread. It is involved in hearing.

What is the biggest muscle in the body? Answer: The Gluteus Maximus The Gluteus Maximus is located in the buttock. It pulls the leg

backwards powerfully for walking and running.

Functions of the MusclesFunctions of the Muscles

MovementMovementMaintenance of posture and muscle Maintenance of posture and muscle

tonetoneHeat productionHeat productionProtects the bones and internal Protects the bones and internal

organs.organs.

Muscle ClassificationMuscle Classification

FunctionallyFunctionallyVoluntarily – can be moved at willVoluntarily – can be moved at willInvoluntarily – can’t be moved Involuntarily – can’t be moved

intentionallyintentionally

StructurallyStructurallyStriated – have stripes across the fiberStriated – have stripes across the fiberSmooth – no striations Smooth – no striations

The 3 Types of MusclesThe 3 Types of Muscles

S ke le ta l M u sc le S m ooth M u sc le C ard iac M u sc le

3 Typ es o f M u sc les

Smooth MuscleSmooth Muscle

Fibers are thin Fibers are thin and spindle and spindle shaped.shaped.

No striationsNo striationsSingle nucleiSingle nuclei InvoluntaryInvoluntaryContracts slowlyContracts slowly

Smooth MuscleSmooth Muscle They fatigue… but very slowlyThey fatigue… but very slowly Found in the circulatory systemFound in the circulatory system

Lining of the blood vesselsLining of the blood vessels Helps in the circulation of the bloodHelps in the circulation of the blood

Found in the digestive systemFound in the digestive system Esophagus, stomach, intestineEsophagus, stomach, intestine Controls digestionControls digestion

Found in the respiratory systemFound in the respiratory system Controls breathingControls breathing

Found in the urinary systemFound in the urinary system Urinary bladderUrinary bladder Controls urinationControls urination

Cardiac MuscleCardiac Muscle

Cells are branched Cells are branched and appear fused and appear fused with one anotherwith one another

Has striationsHas striations Each cell has a Each cell has a

central nucleicentral nuclei InvoluntaryInvoluntary

Cardiac MuscleCardiac Muscle

Found ONLY in the heartFound ONLY in the heartContractions of the heart muscles Contractions of the heart muscles

pump blood throughout the body and pump blood throughout the body and account for the heartbeat.account for the heartbeat.

Healthy cardiac muscle NEVER fatigues Healthy cardiac muscle NEVER fatigues or else… or else…

Skeletal MuscleSkeletal Muscle

Fibers are long and Fibers are long and cylindricalcylindrical

Has many nucleiHas many nuclei Has striationsHas striations

Have alternating Have alternating dark and light bandsdark and light bands

VoluntaryVoluntary

Skeletal MuscleSkeletal Muscle

Attached to skeleton by tendonsAttached to skeleton by tendonsCauses movement of bones at the Causes movement of bones at the

joints.joints.And yes… they do fatigue And yes… they do fatigue Muscle fatigue activity Muscle fatigue activity what what

substance forms causing muscle substance forms causing muscle fatigue???fatigue???

Functions of Skeletal MuscleFunctions of Skeletal Muscle

Movement – muscle move bones by Movement – muscle move bones by pulling not pushing.pulling not pushing. SynergistsSynergists – any movement is generally – any movement is generally

accomplished by more than one muscle. All accomplished by more than one muscle. All of the muscles responsible for the movement of the muscles responsible for the movement are synergists. are synergists.

The one that is most responsible for the The one that is most responsible for the movement is the movement is the Prime Mover (agonist)Prime Mover (agonist)..

Functions of Skeletal MuscleFunctions of Skeletal Muscle

MovementMovement AntagonistsAntagonists – muscles and muscle groups – muscles and muscle groups

usually work in pairs usually work in pairs

– – example the biceps flex your arm and example the biceps flex your arm and its partner the triceps extend your arm. The its partner the triceps extend your arm. The two muscles are two muscles are antagonistsantagonists, i.e. cause , i.e. cause opposite actions. opposite actions.

– – when one contracts the other relaxes.when one contracts the other relaxes. LevatorsLevators – muscle that raise a body part. – muscle that raise a body part.

All skeletal muscles have fascicles

Fascicle arrangement allows different functions of muscles

• parallel (fusiform)--strap• pennate (feather)

• convergent—fan, triangle

• circular (sphincter)—squeeze

Fascicle ArrangementFascicle Arrangement

Determined by fascicular Determined by fascicular arrangement arrangement

Skeletal muscle shortens to 70% of resting length

• parallel--shorter, not powerful

• pennate--lots of fibers, powerful

Power and Range of Motion

Pennate Muscles Pennate Muscles

Unipennate: : fibers on 1 side of tendon fibers on 1 side of tendon e.g.,e.g., extensor digitorum extensor digitorum

Bipennate: fibers on both sides of tendon fibers on both sides of tendon e.g.,e.g., rectus femoris rectus femoris

Figure 11–1c, d, e

– tendon branches within muscle e.g., deltoid• MultipennateMultipennate::• Form angle with tendon• Don’t move as far as

parallel muscles• Contain more myofibrils

than parallel muscles• Develop more tension

than parallel muscles

Functions of Skeletal MuscleFunctions of Skeletal Muscle

Maintenance of posture or muscle toneMaintenance of posture or muscle tone We are able to maintain our body position because We are able to maintain our body position because

of tonic contractions in our skeletal muscles. These of tonic contractions in our skeletal muscles. These contractions don’t produce movement yet hold our contractions don’t produce movement yet hold our muscles in position.muscles in position.

Heat productionHeat production – contraction of muscles – contraction of muscles produces most of the heat required to maintain produces most of the heat required to maintain body temperature.body temperature.

Structure of Skeletal MuscleStructure of Skeletal Muscle

Composed of striated muscle cells (=muscle Composed of striated muscle cells (=muscle fibers) and connective tissue.fibers) and connective tissue. Most muscles attach to 2 bones that have a Most muscles attach to 2 bones that have a

moveable joint between them. moveable joint between them. The attachment to the bone that does not move is the The attachment to the bone that does not move is the

originorigin. . The attachment to the bone that moves is the The attachment to the bone that moves is the insertioninsertion..

TendonsTendons anchor muscle firmly to bones. Tendons anchor muscle firmly to bones. Tendons are made of dense fibrous connective tissue.are made of dense fibrous connective tissue.

LigamentsLigaments connect bone to bone at a joint. connect bone to bone at a joint.

Structure of Skeletal MuscleStructure of Skeletal Muscle

BursaeBursae – small fluid filled sacs that lie – small fluid filled sacs that lie between some tendons and the bones between some tendons and the bones beneath them. They are made of beneath them. They are made of connective tissue and are lined with connective tissue and are lined with synovial membrane that secretes synovial synovial membrane that secretes synovial fluid.fluid.

Movement of MusclesMovement of Muscles

Origin:Origin: the attachment of the attachment of the muscle to the bone the muscle to the bone that remains stationarythat remains stationary

Insertion:Insertion: the attachment the attachment of the muscle to the bone of the muscle to the bone that movesthat moves

Belly:Belly: the fleshy part of the fleshy part of the muscle between the the muscle between the tendons of origin and/or tendons of origin and/or insertion insertion

origin

insertion

belly

Movement of skeletal muscleMovement of skeletal muscle

These muscles move when the brain These muscles move when the brain sends messages to the musclesends messages to the muscle

Always work in pairsAlways work in pairs2 movements of skeletal muscle2 movements of skeletal muscle

Contraction (shorten)Contraction (shorten)Extension (lengthen)Extension (lengthen)

Categories of Categories of skeletal muscle actionsskeletal muscle actions

CategoriesCategories ActionsActions

Extensor Extensor Increases the angle at a jointIncreases the angle at a joint FlexorFlexor Decreases the angle at a jointDecreases the angle at a joint AbductorAbductor Moves limb away from midline of Moves limb away from midline of

bodybody AdductorAdductor Moves limb toward midline of bodyMoves limb toward midline of body Levator Levator Moves insertion upward Moves insertion upward DepressorDepressor Moves insertion downwardMoves insertion downward RotatorRotator Rotates a bone along its axisRotates a bone along its axis SphincterSphincter Constricts an openingConstricts an opening

Practice these MovementsPractice these Movements

1.1. Bend armBend arm

- biceps - biceps contract contract

- triceps - triceps extend extend

2.2. Straighten armStraighten arm

- biceps - biceps extend extend

- triceps - triceps contract contract

3. Bend knee3. Bend knee

- quadriceps - quadriceps extend extend

- hamstrings - hamstrings contract contract

4. Straighten knee4. Straighten knee - quadriceps - quadriceps contract contract - hamstrings - hamstrings extend extend

5.5. Crunches Crunches- abdomen - abdomen contract contract- back muscles - back muscles extend extend

6.6. Point toesPoint toes- calf muscle - calf muscle contract contract- shin muscle - shin muscle extend extend

More MovementsMore Movements

Naming Skeletal MusclesNaming Skeletal Muscles

Location of the muscleLocation of the muscleShape of the muscleShape of the muscleRelative Size of the muscleRelative Size of the muscleDirection/Orientation of the muscle Direction/Orientation of the muscle

fibers/cellsfibers/cellsNumber of OriginsNumber of OriginsLocation of the AttachmentsLocation of the AttachmentsAction of the muscleAction of the muscle

Muscles Named by LocationMuscles Named by Location

EpicraniusEpicranius

(around cranium)(around cranium)

Tibialis anteriorTibialis anterior (front of tibia)(front of tibia)

tibialis anterior

Naming Skeletal MusclesNaming Skeletal Muscles

Shape:Shape:

deltoid (triangle)deltoid (triangle)

trapezius (trapezoid, 2 trapezius (trapezoid, 2 parallel sides)parallel sides)

serratus (saw-serratus (saw-toothed)toothed)

rhomboideus rhomboideus (rhomboid, 4 parallel (rhomboid, 4 parallel sides)sides)

orbicularis and orbicularis and sphincters (circular)sphincters (circular)

Rhomboideusmajor

Trapezius

Deltoid

Serratus anterior

maximus (largest)maximus (largest)minimis (smallest)minimis (smallest) longus (longest)longus (longest)brevis (short)brevis (short)major (large)major (large)minor (small)minor (small)

Psoas major

Psoas minor

Muscles Named by SizeMuscles Named by Size

Muscles Named by Muscles Named by Direction of FibersDirection of Fibers

Rectus (straight) Rectus (straight)

––parallel to long parallel to long axisaxis

TransverseTransverse

ObliqueOblique

Rectusabdominis

External oblique

Biceps (2)Biceps (2)

Triceps (3)Triceps (3)

Quadriceps (4)Quadriceps (4)

Muscles Named for Muscles Named for Number of OriginsNumber of Origins

Biceps brachii

Muscles Named for Origin and Muscles Named for Origin and InsertionInsertion

SternocleidomastoidSternocleidomastoid originates from originates from sternum and clavicle sternum and clavicle and inserts on and inserts on mastoid process of mastoid process of temporal bonetemporal bone

origins

insertion

Muscles Named for ActionMuscles Named for Action

Flexor carpi radialis Flexor carpi radialis (extensor carpi radialis) (extensor carpi radialis) – – flexes wristflexes wrist

Abductor pollicis brevis Abductor pollicis brevis (adductor pollicis)(adductor pollicis)– – flexes thumbflexes thumb

Abductor magnus Abductor magnus – – abducts thighabducts thigh

Extensor digitorum Extensor digitorum – – extends fingersextends fingers

Adductormagnus

CLINICAL CORRELATIONCLINICAL CORRELATION

Exercise-Induced Muscle DamageExercise-Induced Muscle Damage Intense exercise can cause muscle damageIntense exercise can cause muscle damage

electron micrographs reveal torn electron micrographs reveal torn sarcolemmas, damaged myofibrils an sarcolemmas, damaged myofibrils an disrupted Z discsdisrupted Z discs

increased blood levels of myoglobin & creatine increased blood levels of myoglobin & creatine phosphate found only inside muscle cellsphosphate found only inside muscle cells

Delayed onset muscle sorenessDelayed onset muscle soreness 12 to 48 Hours after strenuous exercise12 to 48 Hours after strenuous exercise stiffness, tenderness and swelling due to stiffness, tenderness and swelling due to

microscopic cell damagemicroscopic cell damage

AtrophyAtrophywasting away of muscleswasting away of musclescaused by disuse (disuse atrophy) or severing of the caused by disuse (disuse atrophy) or severing of the

nerve supply (denervation atrophy)nerve supply (denervation atrophy) the transition to connective tissue can not be the transition to connective tissue can not be

reversedreversed HypertrophyHypertrophy

increase in the diameter of muscle fibers increase in the diameter of muscle fibers resulting from very forceful, repetitive muscular resulting from very forceful, repetitive muscular

activity and an increase in myofibrils, SR & activity and an increase in myofibrils, SR & mitochondriamitochondria

Axial MusculatureAxial Musculature

Arises from and inserts on the axial Arises from and inserts on the axial skeletonskeleton

Positions the head and spinal columnPositions the head and spinal column Moves the rib cage, assisting in breathingMoves the rib cage, assisting in breathing

• Axial musculature– Originates and inserts on axial skeleton

• Appendicular musculature– Stabilizes or moves components of the

appendicular skeleton

Axial muscles organized into four Axial muscles organized into four groupsgroups

Muscles of the head and neckMuscles of the head and neckMuscles of the vertebral columnMuscles of the vertebral columnOblique and rectus musclesOblique and rectus musclesMuscles of the pelvic floorMuscles of the pelvic floor

Muscles of the Head and NeckMuscles of the Head and Neck

Muscles of facial expressionMuscles of facial expression Extrinsic eye musclesExtrinsic eye muscles Muscles of masticationMuscles of mastication Muscles of the tongueMuscles of the tongue Muscles of the pharynxMuscles of the pharynx Muscles of the anterior neckMuscles of the anterior neck

Muscles of Facial ExpressionMuscles of Facial Expression

Originate on surface of skullOriginate on surface of skull Largest group associated with mouthLargest group associated with mouth

Orbicularis orisOrbicularis orisBuccinatorBuccinator

Occipitofrontalis muscleOccipitofrontalis muscleMovement of eyebrows, forehead, scalpMovement of eyebrows, forehead, scalp

PlatysmaPlatysmaSkin of neck, depresses mandibleSkin of neck, depresses mandible

Six Extra-Ocular (Oculomotor) Six Extra-Ocular (Oculomotor) MusclesMuscles

Inferior rectusInferior rectus Superior rectusSuperior rectus Medial rectusMedial rectus Lateral rectusLateral rectus Superior obliqueSuperior oblique Inferior obliqueInferior oblique

Muscles of MasticationMuscles of MasticationAct on the mandibleAct on the mandible

MasseterMasseterTemporalisTemporalisPterygoid musclesPterygoid muscles

Muscles of the TongueMuscles of the TongueNecessary for speech and swallowingNecessary for speech and swallowing

GenioglossusGenioglossusHyoglossusHyoglossusPalatoglossusPalatoglossusStyloglossus Styloglossus

Muscles of the PharynxMuscles of the Pharynx Initiate swallowingInitiate swallowing

Pharyngeal constrictorsPharyngeal constrictorsLaryngeal elevatorsLaryngeal elevators

PalatopharyngeusPalatopharyngeusSalpingopharyngeusSalpingopharyngeusStylopharyngeusStylopharyngeus

Palatal musclesPalatal muscles

Muscles of the PharynxMuscles of the Pharynx

Anterior Muscles of the NeckAnterior Muscles of the Neck Foundation for the muscles of the tongue and pharynxFoundation for the muscles of the tongue and pharynx

DigastricDigastricMylohyoidMylohyoidStylohyoidStylohyoidSternocleidomastoid Sternocleidomastoid

Anterior Muscles of the NeckAnterior Muscles of the Neck

Muscles of the Vertebral ColumnMuscles of the Vertebral Column Covered by a superficial layer of back Covered by a superficial layer of back

musclesmuscles TrapeziusTrapezius Latissimus dorsiLatissimus dorsi

Superficial and deep layersSuperficial and deep layers• Superficial muscles:

• Splenius muscles

• Spinal extensors

– Spinalis– Longissimus– Iliocostalis

• Longissimus and iliocostalis merge in lumbar region

• Deep muscles: Interconnect and stabilize the vertebrae

– Transversospinal group• Semispinalis

• Multifidus

• Rotatores

• Interspinales

– Intertransversarii

Muscles of the Vertebral ColumnMuscles of the Vertebral Column Longus capitusLongus capitus Longus colliLongus colli

Rotate and flex the neckRotate and flex the neck

Quadratus lumborum Quadratus lumborum musclesmuscles Flex the spineFlex the spine Depress the ribsDepress the ribs

Muscles of the Vertebral ColumnMuscles of the Vertebral Column

Oblique muscles of neck Oblique muscles of neck and thoraxand thorax ScalenesScalenes IntercostalsIntercostals Transverses musclesTransverses muscles

Important in respirationImportant in respiration

DiaphragmDiaphragm Separates abdominopelvic Separates abdominopelvic

and thoracic cavitiesand thoracic cavities Most important muscle in Most important muscle in

respirationrespiration

The Oblique and Rectus The Oblique and Rectus MusclesMuscles

• Oblique and Rectus Muscles

• Rectus abdominus

• Abdominal oblique muscles

– Compress underlying organs

– Rotate the vertebral column

• External oblique muscle

• Internal oblique muscle

• Rectus abdominis muscle

The Oblique and Rectus The Oblique and Rectus MusclesMuscles

The DiaphragmThe Diaphragm

Muscles of the Pelvic FloorMuscles of the Pelvic Floor Extend from the sacrum and coccyx to the ischium and pubisExtend from the sacrum and coccyx to the ischium and pubis Support the organs of the pelvic cavitySupport the organs of the pelvic cavity Flex the joints of the sacrum and coccyxFlex the joints of the sacrum and coccyx Control movement of materials through anus and urethraControl movement of materials through anus and urethra

• Perineum– Anterior urogenital triangle

• Urogenital diaphragm

– Posterior anal triangle• Pelvic diaphragm

Muscles of the Pelvic FloorMuscles of the Pelvic Floor

Figure 10.15c Muscles of the Figure 10.15c Muscles of the Pelvic FloorPelvic Floor

Appendicular musculature is Appendicular musculature is responsible forresponsible for

Stabilizing pectoral girdleStabilizing pectoral girdleStabilizing pelvic girdleStabilizing pelvic girdleMoving upper and lower limbsMoving upper and lower limbs

Four groups of muscles• Muscles that position the pectoral girdle• Muscles that move the arm• Muscles that move the forearm and hand• Muscles that move the hand and fingers

Muscles that move the pectoral Muscles that move the pectoral girdlegirdle

Trapezius muscleTrapezius muscle Affects position of pectoral girdle,Affects position of pectoral girdle,

neck, headneck, head

Rhomboid musclesRhomboid muscles Adducts scapulaAdducts scapula Deep to trapeziusDeep to trapezius Inserts on scapulaInserts on scapula

Levator scapulae muscleLevator scapulae muscle Elevates scapulaElevates scapula

• Serratus anterior muscle

– Abducts scapula– Swings shoulder anteriorly– Originates on ribs

• Subclavius and pectoralis minor muscles

– Arise along ventral surface of ribs

– Depress and protract shoulder

Muscles that Move the ArmMuscles that Move the Arm Deltoid and supraspinatusDeltoid and supraspinatus

Abduction at the shoulderAbduction at the shoulder

Supscapularis and teres Supscapularis and teres majormajor Rotate arm mediallyRotate arm medially

Infraspinatus and teres Infraspinatus and teres minorminor Rotate arm laterallyRotate arm laterally

• Rotator cuff

– Supraspinatus– Infraspinatus– Teres minor– Subscapularis

• Coracobrachialis

– Flexion and adduction at shoulder• Pectoralis major muscle

– Flexes shoulder– Adducts and medially rotates arm

• Latissumus dorsi muscle

– Extends shoulder– Adducts and medially rotates arm

Muscles that Move the ArmMuscles that Move the Arm

Muscles of the pelvic girdle and Muscles of the pelvic girdle and lower limbslower limbs

Three groupsThree groupsMuscles that move the thighsMuscles that move the thighsMuscles that move the legMuscles that move the legMuscles that move the foot and toesMuscles that move the foot and toes

Muscles that Move the ThighMuscles that Move the Thigh Gluteal muscles cover lateral Gluteal muscles cover lateral

surface of iliumsurface of ilium Gluteus maximusGluteus maximus

Extension and lateral rotation of hipExtension and lateral rotation of hip Pulls on iliotibial tractPulls on iliotibial tract

Tensor fasciae latae muscleTensor fasciae latae muscle Produces flexion, abduction and Produces flexion, abduction and

medial rotationmedial rotation Pulls on iliotibial tractPulls on iliotibial tract

• Piriformis and obturator muscles

– Lateral rotators• Psoas major and iliacus

– Merge to form iliopsoas– Power flexor of hip

• Adductor group adducts hip

– Adductor magnus muscle

– Adductor brevis muscle

– Adductor longus muscle

– Pectineus muscle– Gracilis muscle

Muscles that Move the Thigh

Muscles that Move the Thigh Muscles that Move the Thigh

Muscles that Move the LegMuscles that Move the Leg Extensor muscles of the Extensor muscles of the

knee knee Anterior and lateral surfaces of Anterior and lateral surfaces of

the thighthe thigh

Flexor muscles of the kneeFlexor muscles of the knee Posterior and medial surfaces Posterior and medial surfaces

of the thighof the thigh

Flexors and adductorsFlexors and adductors Originate on pelvic girdleOriginate on pelvic girdle

ExtensorsExtensors Originate at femoral surfaceOriginate at femoral surface

• Flexors of the knee and extensors of hip

– Biceps femoris– Semimembranosus muscle– Semitendinosus muscle

• Sartorius muscle

– Flexor of knee• Popliteal muscle

– Medial rotation of tibia– Unlocks knee joint

• Quadriceps femoris knee extensors

– Vastus intermedius muscle– Vastus lateralis muscle– Vastus medialis muscle– Rectus femoris muscle

Muscles that Move the Foot and Muscles that Move the Foot and ToesToes

Gastrocnemius and soleus musclesGastrocnemius and soleus muscles Plantar flexionPlantar flexion

Tibialis anteriorTibialis anterior DorsiflexionDorsiflexion

Fibularis musclesFibularis muscles Eversion and plantar flexionEversion and plantar flexion

• Smaller muscles of calf and shin

– Position foot– Move toes

• Precise control of phalanges

– Muscles on tarsal and metatarsal bones

Muscles that Move the Forearm Muscles that Move the Forearm and Handand Hand

Biceps brachii Biceps brachii Flexes elbowFlexes elbowSupinates forearmSupinates forearm

Triceps brachiiTriceps brachiiExtends elbowExtends elbow

Muscles that Move the Forearm Muscles that Move the Forearm and Handand Hand

Brachialis and Brachialis and brachioradialisbrachioradialis Flex the elbowFlex the elbow

Anconeus muscle and Anconeus muscle and triceps brachiitriceps brachii Extend the elbow (oppose Extend the elbow (oppose

brachialis)brachialis)

Flexor carpi ulnaris, flexor Flexor carpi ulnaris, flexor carpi radialis, palmaris carpi radialis, palmaris longuslongus Flex the wristFlex the wrist Flexor carpi ulnaris adducts Flexor carpi ulnaris adducts

wristwrist Flexor carpi radialis abducts Flexor carpi radialis abducts

wristwrist

• Extensor carpi radialis muscle

– Abducts and extends wrist• Extensor carpi ulnaris muscle

– Adducts and extends wrist• Pronator teres, pronator quadratus

muscles

– Pronate forearm without flexion or extension

• Suppinator muscle

– Opposes pronator muscles

Muscles that Move the Hand and Muscles that Move the Hand and FingersFingers

Superficial and deep muscles of Superficial and deep muscles of the forearm the forearm

Large musclesLarge muscles Tendons cross wristTendons cross wrist

Synovial tendon sheathsSynovial tendon sheaths Thickened fasciaThickened fascia

Extensor retinaculum and flexor Extensor retinaculum and flexor retinaculumretinaculum

Carpal tunnel syndromeCarpal tunnel syndrome

Extrinsic Muscles that Move the Hand and Extrinsic Muscles that Move the Hand and FingersFingers

Intrinsic Muscles, Tendons and Ligaments of Intrinsic Muscles, Tendons and Ligaments of the Handthe Hand