Table Of ContentAnatomy and Human Movement
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ANATOMY
AND HUMAN
MOVEMENT
STRUCTURE AND FUNCTION
FOURTH EDITION
NIGEL PALASTANGA MA, BA, FCSP, DMS, DipTP
Dean of Healthcare Studies and Head of Department of Physiotherapy, University of Wales College of Medicine, Cardiff, UK
DEREK FIELD FCSP, Grad Dip Phys, DipTP, SRP
Formerly Vice Principal, North London School of Physiotherapy, London, UK
ROGER SOAMES Bsc, PHD
Head, Department of Human Biology, University of Leeds, Leeds, UK
B
U T T E R W O R TH
H E I N E M A N N
OXFORD AUCKLAND BOSTON JOHANNESBURG MELBOURNE NEW DELHI
Butterworth-Heinemann
Elsevier Science Limited
Robert Stevenson House
1-3 Baxter's Place, Leith Walk,
Edinburgh, EH1 3AF
An imprint of Elsevier Science Ltd
First published 1989
First published as a paperback edition 1990
Second edition 1994
Third edition 1998
Fourth edition 2002
Reprinted 2002
© N. Palastanga, D. Field, R. Soames 1989, 1994, 1998, 2002
© Chapter 8 n. Bogduk 1989, 1994, 1998, 2002
All rights reseved. No part of this publication may be reproduced in
any material form (including photocopying or storing in any medium by
electronic means and whether or not transiently or incidentally to some
other use of this publication) without the written permission of the
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Copyright Licensing Agency Ltd, 90 Tottenham Court Road, London,
WIT 4LP UK. Applications for the copyright holder's written permission
to reproduce any part of this publication should be addressed to the publishers
British Library Cataloguing in Publication Data
A catalogue record for this book is available from
the British Library
Library of Congress Cataloging in Publication Data
A catalog record for this book is available from
the Library of Congress
ISBN 0 7506 5241 1
Printed and bound in Malta by Gutenberg Press
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Contents
Preface to the first edition ix Muscles laterally rotating the pectoral
Preface to the fourth edition X (shoulder) girdle 67
Muscles medially rotating the pectoral
1 . Introduction 1
(shoulder) girdle 68
Terminology 3 Muscles stabilizing the clavicle 68
Levers 4 Movements of the shoulder joint 68
Terms used in describing movement 5 Muscles abducting the arm at the
Components of the musculoskeletal shoulder joint 69
system 6 Muscles flexing the arm at the
Spin roll and slide 16 shoulder joint 71
Early embryology 17 Muscles extending the arm at the
Summary of the stages of shoulder joint 72
development 22 Muscles adducting the arm at the
shoulder joint 74
Muscles medially rotating the arm
2. Skin, its appendages and special
at the shoulder joint 75
senses 23
Muscles laterally rotating the arm
Introduction 25 at the shoulder joint 76
Structure 26 Muscles flexing the elbow joint 78
Appendages of the skin 29 Muscles extending the elbow joint 81
Glands 30 Muscles supinating the forearm 84
Blood supply and lymphatic Muscles pronating the forearm 85
drainage of the skin 31 Muscles flexing the wrist 86
Nerves of the skin 31 Muscles flexing the fingers 89
Application 31 Muscles flexing the thumb 92
The ear 31 Muscles extending the wrist 94
The eye 34 Muscles extending the fingers 96
Muscles extending the thumb 99
Muscles abducting/adducting/
3. The upper limb 41
opposing the thumb 101
Introduction 43 Muscles abducting/adducting/
Development of the musculoskeletal opposing the fingers 104
system 43 Fasciae of the upper limb 106
Simple activities of the upper limb 109
BONES 48
Pectoral girdle 48
JOINTS 114
The humerus 51
The pectoral girdle 114
The forearm 53
The sternoclavicular joint 115
The carpus 57
The acromioclavicular joint 120
The hand 59
The shoulder joint 126
MUSCLES 61 The elbow joint 142
Movements of the pectoral Radioulnar articulations 154
(shoulder) girdle 61 The superior radioulnar joint 156
Muscles retracting the pectoral The inferior radioulnar joint 159
(shoulder) girdle 61 The wrist 163
Muscles protracting the pectoral The radiocarpal joint 164
(shoulder) girdle 64 The intercarpal joints 168
Muscles elevating the pectoral The midcarpal joint 169
(shoulder) girdle 66 Articulations within the hand 177
VI
CONTENTS
The common carpometacarpal joint 179 Muscles dorsiflexing the ankle
The intermetacarpal joints 181 joint 275
The joints of the thumb 181 Muscles inverting the foot 276
The joints of the fingers 188 Muscles everting the foot 277
Muscles extending the toes 281
NERVE SUPPLY 201 Muscles flexing the toes 285
The brachial plexus 201 Abduction and adduction of
Dermatomes of the upper limb 211 the toes 290
Muscles abducting the toes 290
BLOOD SUPPLY 213
Muscles adducting the toes 292
The arteries and pulses 213
Fasciae of the lower limb 293
The veins 215
Simple activities of the lower limb 297
LYMPHATICS 218 JOINTS 304
Joints of the pelvis 304
The scaroiliac joint 304
4. The lower limb 219
The symphysis pubis 310
Introduction 221 The lumbrosacral joint 312
Development of the musculoskeletal The sacrococcygeal joint 315
system 223 The hip joint 315
The knee joint 334
BONES 227 Tibiofibular articulations 372
Pelvic girdle 227 The superior tibiofibular joint 372
The innominate (hip) bone 228 The inferior tibiofibular joint 374
The sacrum 232 The ankle joint 378
The coccyx 234 Joints of the foot 391
The femur 234 The subtalar joint 395
The patella 237 The talacalcaneonavicular joint 398
The tibia 237 The calcaneocuboid joint 399
The fibula 240 The transverse (mid) tarsal joint 402
The bony structure of the foot 241 The cuneonavicular joint 405
The tarsals 242 The intercuneiform joints 406
The metatarsals 244 The cuneocuboid joint 406
The phalanges 244 The tarsometatarsal joints 406
The intermetatarsal joints 408
MUSCLES 246
The metatarsophalangeal joints 410
Muscles around the hip joint 246
The interphalangeal joints 412
Muscles extending the hip joint 246
Muscles abducting the hip joint 251 NERVE SUPPLY 422
Muscles adducting the hip joint 253 Introduction 422
Muscles flexing the hip joint 256 The lumbar plexus 422
Muscles medially rotating the The lumbosacral plexus 426
hip joint 260 The sacral plexus 432
Muscles laterally rotating the Dermatomes of the lower limb 432
hip joint 260
BLOOD SUPPLY 434
Muscles producing movement of
The arteries 434
the knee joint 263
The veins 438
Muscles flexing the knee joint 263
Muscles extending the knee joint 266 LYMPHATICS 440
Muscles laterally rotating the tibia
at the knee joint 270 5. The trunk and neck 443
Muscles medially rotating the tibia
Introduction 445
at the knee joint 271
Muscles plantarflexing the ankle BONES 453
joint 272 Lumbar vertebrae 453
VII
CONTENTS
Thoracic vertebrae 454 Articulations of the ribs and their
Cervical vertebrae 455 costal cartilages 533
The vertebral column 457
NERVE SUPPLY 538
The thoracic cage 460
The cervical plexus 538
The ribs 460
The sternum 463
6. The head 541
MUSCLES 466 BONES 543
Muscles producing movements of Introduction 543
the trunk and thorax 466 The skull 543
Muscles flexing the trunk 466 The mandible 549
Muscles extending the trunk 469 The hyoid bone 550
Muscles rotating the trunk 472
MUSCLES 551
Muscles laterally flexing the trunk 473
Muscles which change the shape
Muscles raising intra-abdominal
of the face 551
pressure 474
Movements of the eyebrows 552
The inguinal canal 475
Muscles around the eye 552
Muscles of the pelvic floor 476
Muscles around the nose 553
Muscles producing inspiration 478
Muscles around the mouth 553
Muscles producing expiration 482
Muscles moving the mandible 554
Fasciae of the trunk 483
Muscles elevating the mandible 555
Simple activities of the trunk 484
Muscles retracting the mandible 556
Muscles of the neck 485
Muscles protracting the mandible 557
Muscles flexing the neck 486
Muscles depressing the mandible 557
Muscles flexing the head and neck 487
Muscles depressing the hyoid bone 559
Muscles flexing the head on
Muscles elevating the hyoid bone 560
the neck 487
Mastication and swallowing
Muscles laterally flexing the neck 487
(deglutition) 560
Muscles laterally flexing the head
and neck 489 JOINTS 562
Muscles laterally flexing the head The temporomandibular joint 562
on the neck 489
Muscles extending the neck 490 7. The viscera 569
Muscles extending the head and
neck 490 THE CARDIOVASCULAR SYSTEM 571
Muscles extending the head on Introduction 571
the neck 490 Development of the cardiovascular
Muscles rotating the neck 490 system 571
Muscles rotating the head and neck 490 The heart 574
Muscles rotating the head on the The great vessels 579
neck 490
THE RESPIRATORY SYSTEM 580
Introduction 580
JOINTS 492
Development of the respiratory
Articulations of the vertebral
system 580
column 492
Upper respiratory tract 581
Joints between vertebral bodies 493
The lungs and pleura 583
The uncovertebral joints 499
Joints between vertebral arches 499 THE DIGESTIVE SYSTEM 588
The zygapophyseal joints 500 Introduction 588
The atlantoaxial articulations 502 Development of the digestive
The lateral antlantoaxial joints 502 system 588
The median atlantoaxial joint 502 Oral cavity 590
The atlanto-occipital joint 504 Pharynx and oesophagus 592
Joints of the thorax 531 Abdomen and pelvis 592
viii
CONTENTS
Abdominal regions 594 8. The nervous system 611
Chewing and swallowing 597
Introduction 613
THE UROGENITAL SYSTEM 598 Cellular structure 613
Introduction 598 Interneural connections 613
Development of the urinary system 598 Myelination 614
The urinary system 598 Structure of a peripheral nerve 616
Development of the genital system 602 The central nervous system 617
Female reproductive system 604 The peripheral nervous system 644
The autonomic nervous system 653
THE ENDOCRINE SYSTEM 608
Glands 608
Index 661
ACKNOWLEDGEMENTS
We would like to thank Professor Nikolai
Bogduk of the University of Newcastle, New
South Wales, Australia for his extremely
valuable contribution The Nervous System.
Preface to the first edition
We have designed and written this book for movement with respect to the joints and
the student of anatomy who is concerned muscles involved, as well as any accessory
with the study of the living body, and who movements. The course and distribution of
wishes to use this knowledge functionally the major peripheral nerves and blood
for a greater understanding of the mechan- vessels, together with the lymphatic drai-
isms which allow movement to take place. nage of the region are given at the end of
Traditional anatomy texts are written as an each relevant section. There are separate
adjunct to the study of the human body in chapters on embryology, the skin and its
the dissecting room; but only the surgeon appendages, and we have included, in the
has the advantage of directly viewing living introduction, a section on the terminology
musculoskeletal structures. The vast major- used in the book. There is also an account of
ity of students interested in musculoskeletal the structure and function of the nervous
anatomy as well as those involved with system written by Nikolai Bogduk whose
human movement and its disorders are contribution has been extremely valuable.
confronted by an intact skin, and therefore The format of the book matches a page of
must visualize the structures involved by text to a page of illustrations, whenever
palpation and analysis of movement. Anat- possible, and we hope that this will allow the
omy and Human Movement presents the reader to confirm his or her understanding
musculoskeletal structures as a living dy- of the text with the visual information
namic system - an approach lacking in many provided. The book is extensively illustrated
existing text-books. The applied anatomy of with large, clear, fully-labelled diagrams, all
the musculoskeletal system occupies the of which have been specially prepared. In
greater part of the book, and is built up the sections covering the joints and biome-
from a study of the bones and muscles chanics the illustrations have been drawn by
(which are grouped according to their major Roger Soames, and these are particularly
functions, rather than as seen in the dissect- detailed as they pull together the anatomy
ing room) to a consideration of joints and from the previous parts of that chapter.
their biomechanics. Anatomical descriptions We hope that this new approach to the
of each joint are given with a detailed teaching of anatomy will serve to fill the gap
explanation of how it functions, the forces which has always existed for those who have
generated across it and how it might fail. We to learn their anatomy on a living subject,
have placed great emphasis on the joints as and eventually have to determine their
these are of major concern to those interested diagnoses and apply their treatments
in active movement and passive through an intact skin.
manipulation, and we give examples of
common traumatic or pathological problems Nigel Palastanga, Derek field, Roger Soames
affecting the structures described. Where 1989
possible we describe palpation and analyse
