MARIAN DIAMOND: Let's continue
with our muscular system then,
our rectus abdominis.
Rectus means straight.
Dominal-- so it's going to be
a straight muscle, very easy.
And we said these
abdominal muscles
were supporting and protecting
abdominal pelvic viscera.
So if you didn't
know anything, you
can figure out where
it's connecting.
If it's straight down
the abdominal wall,
we're going to see
that it's going
to originate at the fifth,
sixth, seventh, costal
cartilages and xiphoid and
come down to the pubic bone.
So originate at the fifth,
sixth, seventh costal
cartilages, and the
xiphoid process.
And we'll insert at the
pubic bone and symphysis--
the symphysis, the
joining of the pubic bone.
So it's simple to put in.
We of our sternum,
our xiphoid, are
seven, sixth, fifth,
costal cartilages here.
Xiphoid.
And we'll just put our pubic
bones down here and just run
our muscle between
them, originating there.
You see there's no pattern
for origin and insertion
in this case as we've
had before using
either proximal, or distal,
or medial, or lateral.
This is just
central essentially.
And our pubic
symphysis down here.
So, rectus abdominus,
straight down.
We'll put in the
umbilicus as a landmark.
Your belly button.
And what we want to do is look
at the aponeuroses around this
to give it strength.
It's got a major function here.
So we'll look at the aponeuroses
and a cross section through A
and cross section through B. So
as we look at a cross section
here, we'll see two
bellies with muscle.
And this will be
a cross section A.
And we said this is rectus
adominis obviously, right?
But we have then the
other abdominal muscles,
the external oblique.
The internal oblique.
And the transverses.
And all of these are necessary
in different directions--
external oblique, internal
oblique, transverses, rectus,
all giving support to
our abdominal wall.
But when they
approach the middle,
they connect with
the aponeuroses.
So let's give the external
oblique aponeuroses
a blue color.
So we'd have muscle
out here, but as it
comes around the
rectus abdominus,
it will go up and
around and down.
What I want to do-- excuse me.
I want to change that
just a little bit.
I don't want it so high there.
I want it come down the middle
a little bit sort of like this.
So that's our external oblique.
When the internal
oblique comes along,
it's aponeuroses we'll split.
Some will go anterior, and
some will go posterior.
And that leaves the transverses
to just go posterior here.
So this is above or as
superior to the umbilicus.
We have this arrangement
of our aponeuroses.
This is superior to
umbilicus, and these
are all the
aponeuroses, which we
learned were sheets
of connective tissue.
Now, what do we see
inferior to the umbilicus
where we need much more
support down here as we said,
especially for the
pregnant woman?
So let's see, use
the same colors,
and you can perhaps
just guess what we get.
This is going to be B. This
is inferior to umbilicus.
And this is our
aponeuroses again.
And we need our section
through our recti muscles
in the abdominal wall here.
And here we'll bring in the
fleshy part of the muscle,
of the external
oblique is out here.
But as it approaches
the midline,
it changes into an aponeuroses.
And the aponeuroses at this
level from the external oblique
will do this.
And the aponeuroses of the
internal oblique will do this.
And the aponeuroses of the
transverses will do this.
So we'll have to just increased
the support for these muscles
inferior to the umbilicus.
Rather nice design.
And what have we developed here?
We've developed a midline
that has no muscle,
but only has this thin
layer of connective tissue
in the midline in through here.
So as we had it on
our rectus abdominis,
we just had the rectus
abdominis coming like this.
We had the umbilicus.
I put in a white line here.
Who knows what that
white line is called?
STUDENT: Linea alba.
MARIAN DIAMOND: Linea
alba, white line.
Linea alba.
Linea alba, white line.
So, it's just connective tissue.
There are no blood
vessels in the linea alba.
So you can see if
you have to get
into the abdominal
cavity for any reason,
cut straight through
the linea alba
and you won't have bleeding,
but it is an important landmark
there as you'll learn later on.
All right now then, let's
take the external oblique.
I'm not going to take
each one in detail.
I'm going to take
the external oblique
and our rectus abdominus because
they each have some peculiarity
just like this formation
with our aponeuroses.
So I'm going to take
the external oblique,
and it will originate
from the lower eight ribs.
And will insert
in the linea alba.
And we'll do our
little cartoon again
of what we're up here to show
what makes this muscle unique.
Let's have our sternum.
And we're not going to
put it on all eight ribs--
lower eight ribs, just
a selection of them.
These just represent ribs.
And here we have
our rectus abdominus
coming down in the midline.
And we have the fleshy muscle of
our external oblique coming in
from these lower ribs.
And blending into
the aponeuroses--
we had it blue over there,
let's keep it blue--
as it comes to the midline.
And it's going to, as we said,
be over our rectus abdominis
here.
And it was over our
rectus abdominis here.
As we get down to the inferior
boarder of our aponeuroses
related to the external oblique,
it's going to fold upon itself.
Just like take a piece of
material and tuck it under,
it's going to fold
upon itself, and we'll
come back to that in a minute.
And it will attach out here
to the anterior iliac spine.
The anterior iliac spine.
And what bones do we have here?
Pubic bone to what's
called the pubic tubercle.
Pubic tubercle.
And we form then a
rather tight ligament
here joining the anterior iliac
spine to the pubic tubercle.
And this is called
the inguinal ligament.
Inguinal ligament.
Just superior to-- here we are
with our anterior iliac spine.
So you can see where here's
the anterior iliac spine, very
prominent.
Here's the pubic tubercle layer.
This fascia, or
aponeuroses, has come down
and bend over, and formed
the inguinal ligament.
We're going to be using
that for landmarks.
Just superior to the
inguinal ligament
is the inguinal canal found in
the fold of the aponeuroses.
I put it in white just
to make it stand out.
I want to put this up.
This should come
a little bit here.
So I have formed here
the inguinal canal.
It has a superficial
ring that's out here.
Equals a superficial ring.
And a deep ring, which is at
the other end of the canal.
This is all part of my canal.
Equals the deep-- well, they're
really called inguinal rings.
But here, let's put it in.
Inguinal ring.
And here are the
deep inguinal ring.
And who knows what
travels through all
of this canal in the male?
It's different in the female.
Well, the sperm are being formed
outside the body in the male.
And therefore, they
have to travel.
So let's put a testis down here.
Does anybody know why sperm need
a cooler temperature than ova?
This is testis.
There's a tube on the testis--
the sperm are formed
in the testis.
Testis forms sperm, but they
have to get out of the body,
so they're going to
go through a tube.
We're just going
to give a name now.
When we get to the
reproductive system,
we'll go into this in detail.
This part of the tube is
called the epididymis.
Epididymis.
It's messy back there.
What's epi?
STUDENT: Upon.
MARIAN DIAMOND: Upon.
Didymis is testis.
So it's a tube,
it's carrying sperm.
It's doing much more than that,
but right now all I want to do
is develop it.
And then it becomes
the ductus deferens,
which comes in the
superficial ring ,
travels through the inguinal
canal, out the deep ring,
and into the pelvic viscera.
So this portion is called
the ductus deferens.
Carrying sperm
into pelvic organs,
which we'll study later.
But I want to put this here to
let you see that it does exist.
It's made out of
folded aponeuroses,
and it's right at the surface.
What's there in the female?
I'll just give the name now.
Do you know your round ligament?
Your round ligament is
connecting your uterus
to your external genitalia?
Did you know that?
Ever heard of your round-- nope.
All right.
Well we get it when
we get to female.
So this is obviously for males.
For females, we have
the round ligament.
We'll just put from uterus to--
I think I've got
enough room here--
external genitalia.
But we'll see this again
later, but it gives you
the sex difference here.
Now this area then
is vulnerable.
You've got a tube going
through an opening
down at the inferior part
of your abdominal wall.
So with stress and strain,
sometimes the small intestine
will follow this route
and come out here.
It's what we call
an inguinal hernia.
An inguinal hernia.
Inguinal hernia is when
the small intestine
enters the deep ring, goes
through the inguinal canal,
and out the superficial ring.
Anybody had an inguinal hernia?
Couple of you?
Yes.
No, my son was born with one.
All they is go in then and push
that small intestine back up
into the pelvic cavity
where it belongs,
and just strengthen this so
it doesn't come down again,
but allows freedom for the
vas deferens to go through.
And if you think hernias
are rare in the human body,
look at your medical
dictionary and look up hernia.
And just for fun to
see what mine had--
one page of areas
where you can have
different kinds of hernias.
This is an inguinal hernia.
So you, as anatomists, you want
to be specific and say exactly
which kind you're referring to.
All right so this is our--
what are some of the
functions then of our superior
oblique just to show how
many that it can play a role.
We've given it for its
support and protection.
So let's just summarize
them quickly for one muscle.
So external oblique--
this is basic functions.
Well, we know that it
will support and protect
abdominal and pelvic viscera.
We know it will flex
the vertebral column.
But when you lie on your back
and look at your abdomen,
you'll see that it's
playing a role in breathing.
It aids breathing.
How many of you
vomited recently?
How many of you vomited
when you're little kids?
There you get the hands.
It's an interesting-- sort
of lose that fortunately.
And aids vomiting.
It aids defecating.
It's going to aid child birth.
Pressed down you giving birth.
Contract that external oblique.
And then other areas which
you perhaps are aware of.
When you're laughing
really hard,
you get more of a body response.
So laughing, coughing when you
really want a cough, sneezing--
all of these.
Laughing, coughing, sneezing.
So you can see it's doing
more than just every day
supporting the abdominal wall.
Now the internal oblique and
the transverses, we'll just say
are interior to these.
I'm not going to go into
their origins and insertions.
But this had this
peculiar arrangement,
and it's aponeuroses
which decided
that it needed more attention.
So let's go on from here.
Muscles of the pelvic floor.
I'm only going to give
two, because we have
to support our pelvic viscera.
All right.
Muscles of pelvic floor.
We'll give two--
the levator ani.
Levator ani.
And the superficial transverses.
Superficial transverses.
So let's take the
levator ani first.
It will originate on the
pubic bone and the ischium.
Ischium.
And we'll insert-- see this
is my pelvic cavity here,
and I'm putting a floor
in my pill that cavity.
So I've come from my
pubic bone, my ischium.
And it will insert on
the coccyx posterior,
and what's called
the median raphe.
Median raphe.
So if we put in our pubic
bone up here, two of them,
we'll put ischium here and
we'll have coccyx back here.
So this is anterior,
this poster here.
These are pubic bones.
This is just rough
ischium here to show
the form the-- those
are lateral boundaries.
And this will be the coccyx.
So we're in the floor.
The floor of our
pelvis in the female--
let's do female first here--
will have three openings.
We'll have the urethra--
I'll go A, because I don't have
enough room to write there.
So A is the urethra to
eliminate your urine.
Then, we'll have the vagina--
--for copulation and
for the elimination of,
let's call, secretions
for the menstrual flow.
Eliminate secretions.
We'll see it's a
lot more than that
when we study the
menstrual flow,
but for now, it's all we need.
Then we have the anus back here.
The anus for feces elimination.
Now we have then our levator
ani, it has many parts.
And I'm just sort
of summarizing them
to give you the basics that it
forms quite a bit of the floor.
And the direction will
be anterior posterior.
So in general, the
levator ani has parts
that are coming like this.
But it's quite complex.
I mean, that takes a whole
couple of lectures in itself,
but I just wanted to get
the pelvic floor built.
And then the transverses,
the superficial transverses,
just as the name implies,
will be going transversely
to give support
in this direction.
So seeing that we're getting
the floor with extra transverse
anterior, posterior, of
medial, lateral support.
Now we might mention this
median raphe, where is it?
It's found-- another color--
back here between the
pubic bone and the anus.
So we'll just put this in as
our median raphe back here, back
here, just strengthening
the midline there.
There are structures that
strengthen your transverses,
but I think it shows that you're
getting this dual support here.
So with that, I think we're
ready to go onto the lower
extremity and look first
at the muscles of the hip.
Muscles of hip-- how
many of those are there?
So say we're abbreviating.
There are some 19--
amazing, isn't it?
So function in general--
well, we know they're
going to flex,
we know they're going
to extend, they're
going to adduct
and abduct, right?
Flex, extend, adduct, abduct.
And what's the other one?
Circumduct.
How many of you can do it?
How many are dancers?
Can you circumduct?
Sure she can.
Anybody else?
No, all right.
Circumduct.
So we have the
design muscles that
are going to allow all of these
functions at our hip joint.
So there are two
groups of muscles
as I put over there-- the
gluteal muscles and the thigh
muscles.
Let's start with
the gluteal muscles.
These will be on the posterior
surface of the pelvis,
so posterior pelvis.
They constitute the buttocks.
You often wonder where
the term butt comes from,
it comes from buttocks.
Did you know that?
And these buttocks
then give the shape
to the poster of your pelvis.
And having large muscles
here is uniquely human.
These muscles uniquely human.
But the female adds
to it by depositing
fat around these muscles,
creating what we call
a secondary sex characteristic.
Has fat over gluteal muscles
giving us a secondary sex
characteristic.
We'll see these when we get
to the reproductive system.
Sex characteristic.
All right.
Let's look at these
gluteal muscles.
Do you ever think of them
as being uniquely human?
Have you ever seen another
animal with gluteal muscles
like we have?
So the gluteal
muscles are posterior.
The thigh muscles that
we're going to study
will be anterior.
And there are three
gluteal muscles.
Can I take this off?
STUDENT: No.
MARIAN DIAMOND: No.
Why not?
What?
There's lots of time
to get that, right?
Thank you.
So our gluteal muscles, three
of them-- gluteus maximus,
gluteus medius, and
gluteus minimus.
Let's take our maximus.
It will be coming from,
obviously, the ilium,
because of the ilium is
making up most of this area,
and it will go
over to the shaft,
proximal shaft of the femur.
So originate posterior ilium.
Insert on proximal femur
and on the iliotibial band.
Iliotibial band.
Ever knew you had one of those?
Where do we find it?
I have to backtrack for a moment
and introduce the term fascia
lata.
Fascia lata.
Fascia lata is this
thin, strong layer
of connective tissue, which
in cases, the thigh muscles.
It always reminds me
of a sausage skin,
sort of the same principle--
keep the meat inside.
If you didn't have
something in casing,
what's going to keep all
those muscles together
to do the functions
that the thigh does?
So the fascia lata is a
thin, strong encasement
of safety around thigh muscles.
And at the lateral aspect
of this fascia lata, which
is all over here, we have
what's called a special band,
extra thick, the iliotibial band
that'll come down laterally.
So if we have our
encasement of fascia,
this would be our fascia
lata in very brief formation.
This iliotibial
band is out here.
This is fascia lata.
And the thick, lateral band
is the iliotibial band.
And we've said that our
gluteus maximus will
come around and insert in that.
So when it contracts, it's
going to extend the thigh.
Now the other two muscles--
medius and minimus.
--will, again,
originate on the ilium,
but they will insert on this
very large lateral protrusion
at the proximal femur.
What do we call it?
STUDENT: Greater trochanter.
MARIAN DIAMOND: Greater
trochanter, right.
They will answer on
the greater trochanter.
So you can tell how
athletic an individual was
when you get the skeletons
by the dimensions
of these protrusions,
because if their athletic,
this would be much bigger as
this muscle is pulling on it.
So this muscle then coming
will abduct, it'll take it out.
It's coming from
here, out to here
when it contracts, its going
to take the leg sideways.
Abduct the thigh
and medial rotate.
All right, so that gives
us our gluteal muscles.
Now for our thigh-- whoops.
A little too ferocious here.
All right, thigh muscles.
You already know the first one.
What's the muscle that crosses
from your anterior iliac spine
to your medial proximal tibia?
STUDENT: Sartorius.
MARIAN DIAMOND:
Sartorius, right.
The first one is the sartorius.
What does that mean?
Thank you.
Tailor's muscle.
Sartorius mean tailor.
Tailor's used to sit
cross-legged on the floor,
and they were using this muscle.
So as we've seen before,
it will originate here.
What is this?
Anterior iliac spine.
Put your hands on it.
You'll know exactly where it is.
Anterior iliac spine.
And we'll insert on
medial proximal tibia.
Media proximal.
So it's crossing two joints--
what's it going to
do to the hip joint?
It's crossing coming
here when it contracts,
what's the hip
joint going to do?
Flex.
Flex The hip.
What's it going to do
for the knee joint?
It's crossing the knee joint.
When it contracts, what's
going to do for the knee?
Flex.
So you can figure that one out.
All right.
I still have a little time.
Let's mention, then,
your big thigh muscles--
your quads.
We'll just get them started.
We'll finish next time.
Let's see, our quadriceps.
These will be anterior thigh
encased in fascia lata--
four of them.
One, the rectus femoris.
Two, the vastus-- vastus just
means like it sounds, vast,
wide--
vastus lateralis.
Three, vastus intermedius.
Intermedius.
And vastus medialis.
The rectus femoris is
coming from the ilium.
The other two are
coming from proximal--
other three, excuse me, femur.
And they'll insert in the
quadriceps tendon, which
will in encase-- or let's
put surround, patella.
And from the patella, we'll
have the patellar ligament.
Patellar ligament,
which we'll insert
on the tibial tuberosity.
Tuberosity.
So you can take your
quads all the way down
coming down to your patella,
enclosing the patella.
And then there your
pubic tuberosity.
I'll wait for slides, because
I only have one minute.
OK.
All right.
But you can feel your patella.
You can see exactly where it is.
You could see what
its function is.
But we'll finish a
statement of this next time.
