Dorsal fascia of hand

The fascia has the superficial and the deep layers. The superficial layer covers the tendons of the extensors. The deep layer covers the dorsal interossei muscles.

The topography of the forearm and the hand

• In front of the elbow joint, in the bend of the arm, there is the cubital fossa (fossa cubitalis/локтевая ямка). It is bounded by the brachioradial muscle (laterally) and the pronator teres muscle (medially). The floor and the superior border of the fossa are formed by the brachial muscle.

• There are three grooves between the forearm muscles.

• The medial ulnar groove lies between flexor carpi ulnaris (medially) and the flexor digitorum superficialis (laterally). It transmits the ulnar nerve, artery and veins.

• The lateral radial groove lies between brachioradialis (laterally) and the flexor carpi radialis (medially). It transmits the radial nerve, artery and veins.

• The median groove lies between the flexor carpi radialis (laterally) and the flexor digitorum superficialis (medially). It transmits the median nerve.

The muscles of lower limb

(musculi membri inferioris/мышцы верхней конечности)

The muscles of the hip region The anterior group

Iliacus (m. iliacus/подвздошная мышца)

• Origin. From the concave inner surface of the ilium.

• Insertion. Passes under the inguinal ligament to the lesser trochanter, in company with psoas major.

• Action. Flexion of the thigh.

• Nerve supply. Femoral nerve.

Psoas major (m. psoas major/большая поясничная мышца)

• Origin. From the transverse processes and the sides of the bodies and intervertebral discs of the lumbar vertebrae.

• Insertion. Passes under the inguinal ligament to the lesser trochanter in company with iliacus. Joint muscle often called iliopsoas.

• Action. Flexion of the thigh.

• Nerve supply. Femoral nerve.

Psoas minor (m. psoas minor/малая поясничная мышца)

• Origin. From the twelfth thoracic and first lumbar vertebrae.

• Insertion. To the iliopubic eminence. It blends with the iliac fascia.

• Action. Tenses the iliac fascia.

• Nerve supply. Femoral nerve.

The posterior group

Gluteus maximus (m. gluteus maximus/большая ягодичная мышца)

• Origin. From the posterior part of the gluteal surface of the ilium, the back of the sacrum and its associated ligaments.

• Insertion. To the gluteal tuberosity of the femur (25%) and the iliotibial tract (75%).

• Actions. Extension and lateral rotation of the thigh.

• Nerve supply. Inferior gluteal nerve.

Gluteus medius (m. gluteus medius/средняя ягодичная мышца)

• Origin. From the gluteal surface of the ilium.

• Insertion. To the greater trochanter.

• Actions. Abduction and medial rotation of the thigh.

• Nerve supply. Superior gluteal nerve.

Gluteus minimus (m. gluteus minimus/малая ягодичная мышца)

• Origin. From the gluteal. surface of the ilium below gluteus medius.

• Insertion. To the greater trochanter.

• Actions. Abduction and medial rotation of the thigh. The most import­ant action of medius and minimus is to prevent the pelvis tilting to the unsupported side when taking the weight on one leg, as in walking.

• Nerve supply. Superior gluteal nerve.

Tensor fasciae latae (m. tensor fasciae latae/напрягатель широкой фасции)

• Origin. From the anterior part of the crest of the ilium.

• Insertion. To the lateral condyle of the tibia via the iliotibial tract.

• Actions. Extension of the knee joint. Helps the gluteal muscles to pre­vent tilting of the pelvis.

• Nerve supply. Superior gluteal nerve.

Piriformis (m. piriformis/грушевидная мышца)

• Origin. From the front of the sacrum.

• Insertion. Into the greater trochanter via the greater sciatic notch.

• Action. Lateral rotation of the thigh.

• Nerve supply. From the sacral plexus.