The fluid contains hyaluronan secreted by fibroblast-like cells in the synovial membrane, lubricin

(proteoglycan 4; PRG4) secreted by the surface chondrocytes of the articular cartilage and
interstitial fluid filtered from the blood plasma. This fluid forms a thin layer (roughly 50 μm) at the
surface of cartilage and also seeps into microcavities and irregularities in the articular cartilage
surface, filling all empty space. During movement, the synovial fluid held in the cartilage is
squeezed out mechanically to maintain a layer of fluid on the cartilage surface (so-
called weeping lubrication). The functions of the synovial fluid include:

 reduction of friction — synovial fluid lubricates the articulating joints[5][page needed]

 shock absorption — as a dilatant fluid, that possesses rheopectic properties,[6] becoming
more viscous under applied pressure; the synovial fluid in diarthrotic joints becomes thick the
moment shear is applied in order to protect the joint and subsequently, thins to normal
viscosity instantaneously to resume its lubricating function between shocks.[7][dubious – discuss]
 nutrient and waste transportation — the fluid supplies oxygen and nutrients and removes
carbon dioxide and metabolic wastes from the chondrocytes in the surrounding cartilage
 molecular sieving - pressure within the joint forces hyaluronan in the fluid against the
synovial membrane forming a barrier against cells migrating into, or fluid migrating out of, the
joint space. This function is dependent on the molecular weight of the hyaluronan.[8]

“MUSCLES OF THE UPPER LIMB”

MUSCLES OF THE PECTORAL REGION

Pectoralis Major
The pectoralis major is the most superficial muscle in the pectoral region. It is large
and fan shaped, and is composed of a sternal head and a clavicular head:

 Function: Adducts and medially rotates the upper limb, and draws the scapula
anteroinferiorly. The clavicular head also acts individually to flex the upper limb.
Pectoralis Minor
The pectoralis minor lies underneath its larger counterpart muscle, pectoralis major.
Both of these muscles form part of the anterior wall of the axilla region.

 Function: Stabilises the scapula by drawing it anteroinferiorly against the thoracic

wall.
Serratus Anterior
 Function: Rotates the scapula, allowing the arm to be raised over 90 degrees. It
also holds the scapula against the ribcage.
Subclavius
The subclavius is small muscle, which is located directly underneath the clavicle,
running horizontally.
 Function: Anchors and depresses the clavicle.
MUSCLES OF THE SHOULDER REGION

THE EXTRINSIC MUSCLES OF THE SHOULDER

Superficial
There are two superficial extrinsic muscles – the trapezius and latissimus dorsi.

Trapezius
The trapezius is a broad, flat and triangular muscle. The muscles on each side form a
trapezoid shape. It is the most superficial of all the back muscles.

Actions: The upper fibres of the trapezius elevate the scapula and rotates it during
abduction of the arm. The middle fibres retract the scapula and the lower fibres pull
the scapula inferiorly.

Latissimus Dorsi
The latissimus dorsi originates from the lower part of the back, where it covers a
wide area.
 Actions: Extends, adducts and medially rotates the upper limb.

Deep
There three muscles in this group –
the levator scapulae and the two
rhomboids.

Levator Scapulae
By TeachMeSeries Ltd (
The levator scapulae is a
small strap-like muscle.
Actions: Elevates the scapula
Rhomboids
There are two rhomboid muscles –
major and minor.

Rhomboid Major
Actions: Retracts and rotates the scapula.
Rhomboid Minor
Actions: Retracts and rotates the scapula.

THE INTRINSIC MUSCLES OF THE SHOULDER

Deltoid
By TeachMeSeries Ltd
Fig 1.0 – The deltoid and teres major
The deltoid muscle is
shaped like the Greek letter
delta – Δ. It can be divided
into an anterior, middle and
posterior part
 Actions:
o Anterior fibres – flexion and
medial rotation.
o Posterior fibres – extension and
lateral rotation.
o Middle fibres – the major
abductor of the arm (takes over
from the supraspinatus, which
abducts the first 15 degrees).
 Teres Major
 The teres major forms the inferior border of the quadrangular space – the
‘gap’ that the axillary nerve and posterior circumflex humeral artery pass
through to reach the posterior scapula region.
 Actions: Adducts at the shoulder and medially rotates the arm.
Rotator Cuff Muscles
The rotator cuff muscles are a group of four muscles that originate from the scapula
and attach to the humeral head.
Supraspinatus
 Actions: Abducts the arm 0-15o, and assists deltoid for 15-90o
 Infraspinatus
 Actions: Laterally rotates the arm.
 Subscapularis
 Actions: Medially rotates the arm.
 Teres Minor
 Actions: Laterally rotates the arm.
 
By TeachMeSeries Ltd
(2019)

MUSCLES OF THE UPPER ARM

The upper arm is located between the shoulder joint and elbow joint. It contains four
muscles – three in the anterior compartment (biceps brachii, brachialis,
coracobrachialis), and one in the posterior compartment (triceps brachii).
Anterior Compartment
Biceps Brachii
 Function: Supination of the forearm. It also flexes the arm at the elbow and at the
shoulder.
Coracobrachialis
 Function: Flexion of the arm at the shoulder, and weak adduction.

Brachialis
 Function: Flexion at the elbow.

By TeachMeSeries Ltd (2019)
MUSCLES IN THE ANTERIOR COMPARTMENT OF THE
FOREARM
Superficial
Compartment
 Actions: Flexion and adduction
at the wrist.

Palmaris Longus
 Actions: Flexion at the wrist.
 Flexor Carpi Radialis
 Actions: Flexion and
abduction at the wrist.
 Pronator Teres
 Actions: Pronation of the
forearm.
Intermediate Compartment
 Actions: Flexes the metacarpophalangeal joints and proximal interphalangeal
joints at the 4 fingers, and flexes at the wrist.
Deep Compartment
 Actions: It is the only muscle that can flex the distal interphalangeal joints of the
fingers. It also flexes at metacarpophalangeal joints and at the wrist.
Flexor Pollicis Longus
 Actions: Flexes the interphalangeal joint and metacarpophalangeal joint of the
thumb.

Pronator Quadratus

 Actions: Pronates the forearm.

(2019)

(2019)
MUSCLES IN THE POSTERIOR COMPARTMENT OF THE
FOREARM
Superficial Muscles
Brachioradialis

 Actions: Flexes at the elbow.

Extensor Carpi Radialis Longus and Brevis

 Actions: Extends and abducts the wrist.

Extensor Digitorum

 Actions: Extends medial four fingers at the MCP and IP joints.

 Extensor Digiti Minimi

 Actions: Extends the little
finger, and contributes to
extension at the wrist.
 Extensor Carpi Ulnaris
 Actions: Extension and
adduction of wrist.
 Anconeus
 Actions: Extends and
stablises the elbow joint.
Abducts the ulna during pronation of the forearm.
MUSCLES OF THE HAND
Thenar Muscles
 Actions: Opposes the thumb, by medially rotating and flexing the metacarpal on
the trapezium.
  Abductor Pollicis Brevis
 Actions: Abducts the thumb.
 Flexor Pollicis Brevis
 Actions: Flexes the metacarpophalangeal (MCP) joint of the thumb.

Hypothenar
Muscles
Opponens Digiti Minimi
 Actions: It rotates the
metacarpal of the little finger
towards the palm, producing
opposition.
 Abductor Digiti Minimi
 Actions: Abducts the
little finger.

Flexor Digiti Minimi Brevis

 Actions: Flexes the MCP

joint of the little finger.
Lumbricals
 Actions: The flex at the MCP joint, and extend at the interphalangeal (IP) joints of
each finger.
 By TeachMeSeries Ltd (2019)

Interossei
Dorsal Interossei
 Actions: Abduct the fingers at the
MCP joint.
 Palmar Interossei

 Actions: Adducts the fingers
at the MCP joint.

Other Muscles in the Palm

Palmaris Brevis
 Actions: Wrinkles the skin of the hypothenar eminence and deepens the
curvature of the hand, improving grip.
 Adductor Pollicis
 Actions: Adductor of the thumb.
“Muscles of the Lower Limb”

Gluteal Group

Gluteus Maximus: The gluteus maximus is the largest of the gluteal muscles and
gives structure to the buttocks.
 Actions: Extends of the thigh and assists with rotation. Is only used when the
generation of force is required (e.g. when climbing).

Gluteus Medius: The fan-shaped gluteus medius muscle lies between the
gluteus maximus and minimus and performs a similar function to the gluteus
minimus.
 Actions: Abducts and medially rotates the thigh and fixes the pelvis during
walking.
 Gluteus Minimus: The gluteus minimus is the deepest and smallest of the
superficial gluteal muscles and performs a similar function to the gluteus
medius.
 Actions: Abducts and medially rotates the thigh and fixes the pelvis during
walking.

Lateral Rotator Group

Piriformis: The piriformis is the most superior of the lateral rotator group muscles.
Actions: Lateral rotation and abduction of the thigh at the hip.
 
Obturator Internus: The obturator internus lines the internal wall of the pelvis.
 Actions: Lateral rotation and abduction of the thigh at the hip.
 Gemelli:
 Actions: Lateral rotation and abduction of the thigh at the hip.
 Quadratus Femoris
 Actions: Lateral rotation of the thigh at the hip, plays a major role in extension
of the lower leg at the knee as well.

 Anterior Compartment
Actions: Dorsiflexion and inversion of the foot.

 Extensor Digitorum Longus

Actions: Extension of the toes and dorsiflexion of the foot.
 Extensor Hallucis Longus
 Actions: Extension of the big toe, and dorsiflexion of the foot.

Plantar Compartment

Abductor Hallucis:
 Actions: Abducts and flexes the big toe.
 Flexor Digitorum Brevis:
 Actions: Flexes the toes at the proximal interphalangeal (between the
phalanges preoxmales and phalanges mediae) joints.

 Lumbricals: The lumbricals are four small skeletal muscles, accessory to the
tendons of the flexor digitorum longus and numbered from the medial side of
the foot.
o Attachments: Originates from the tendons of flexor digitorum longus.
Attaches to the toes.
o Actions: Flexes at the metatarsophalangeal (between the metatarsals
and phalanges proximale) joints, while extending the interphalangeal
joints (between the phalanges proximale and phalanges mediae).
 Flexor Hallucis Brevis: The flexor hallucis brevis muscle is located on the
medial side of the foot.
o Attachments: Originates from the plantar surfaces of the cuboid and
lateral cuneiform bones in the sole of the foot and attaches to the big toe.
o Actions: Flexes the big toe.
 Adductor Hallucis: The adductor hallucis muscle is located laterally to the flexor
hallucis brevis.
 o Attachments: The adductor hallucis originates from the bases of the first
four metatarsals, and also from the plantar ligaments before attaching to
the big toe.
o Actions: Adduct the big toe and maintains the arch of the foot.
 Plantar Interossei: The three plantar interossei lie beneath rather than between
the metatarsal bones. Each is connected with one metatarsal bone.
o Attachments: Originates from the medial side of metatarsals three to five.
Attaches to the medial sides of the phalanges of digits three to five.
o Actions: Adducts and flexes digits three to five.
 Flexor Digiti Minimi Brevis: Similar to the interossei in structure, the flexor digiti
minimi brevis muscle is located on the lateral side of the foot underneath the
metatarsal of the little toe.
o Attachments: Originates from the base of the fifth metatarsal and
attaches to the base of phalanx of the little toe
o Actions: Flexes the little toe.