DELTOID MUSCLES AND ABDOMINAL PRESS MUSCLES Close-grip barbell row to the chin (variations) Seated barbell press (barbell behind the head) Seated dumbbell press (variations) Raising arms with dumbbells to the sides (sitting, standing, bent over) Perform “twisting” turns of the torso

Biceps femoris, m. biceps femoris: long head – 1, short head– 2. Origin: ischial tuberosity – 1, lateral lip rough line–2. Attachment: caput fibulae. Function: extends and extends the thigh, rotates it outward - 1, bends the lower leg and - 1.2 rotates it outward. Innervation: 1 – n. tibialis, 2 – n. fibularis communis. Blood supply: a. circumflexa femoris medialis, aa. perforantes.

Semitendinosus muscle, m. semitendinosus. Origin: ischial tuberosity. Insertion: tuberosity tibia. Function: extends, adducts and internally rotates the hip, tightens the capsule knee joint. Innervation: n. tibialis. Blood supply: aa. perforantes.

Semimembranosus muscle, m. semimembranalis. Origin: ischial tuberosity. Insertion: medial condyle of the tibia. Function: extends, adducts and internally rotates the thigh. Innervation: n. tibialis. Blood supply: a. circumflexa femoris medialis, aa. perforantes, a. poplitea.

Thin muscle, m. gracilis. Origin: inferior branch of the pubic bone, near the symphysis. Insertion: fascia of the leg, near the tibial tuberosity. Function: adducts the thigh, flexes the tibia. Innervation: n. obturatorius. Blood supply: a. abturatoria, a. pudenta externa, a. profunda femoris.

Pectineus muscle, m. pectineus. Beginning: superior branch and crest of the pubic bone, lig. pubicum superior. Attachment: linea pectiniae of the femur (pectineal line). Function: adduct the thigh, bend it. Innervation: n. obturatorius. Blood supply: a. abturatoria, a. pudenta externa, a. profunda femoris.

Adductor longus muscle, m. adductor longus. Origin: near the pubic symphysis. Attachment: medial lip, lineia aspera. Function: adducts and flexes the hip. Innervation: n. obturatorius. Blood supply: a. abturatoria, a. pudenta externa, a. profunda femoris.

Adductor brevis muscle, m. adductor brevis. Origin: inferior branch of the pubic bone. Insertion: medial linea aspera. Function: adducts, flexes and externally rotates the thigh. Innervation: n. obturatorius. Blood supply: a. abturatoria, aa. perforantes.

Adductor magnus muscle, m. adductor magnus. Origin: branches of the pubic and ischial bones. Insertion: medial lip, linea aspera. Function: adducts and flexes the hip. Innervation: n. obturatorius, n. ishiadicus. Blood supply: a. abturatoria, aa. perforantes.

adductor channel,canalis adductorius(femoral-popliteal, or Gunter's canal), connects the anterior region of the thigh with the popliteal fossa. The medial wall of this canal is the adductor magnus muscle, the lateral wall is the vastus medialis muscle, the anterior wall is the fibrous plate, which spreads between these muscles. The channel has three holes. The first is the entrance, which is like a continuation of the femoral groove. The second, lower one, is the outlet of the adductor canal, called the tendon gap (adductor magnus muscle). The exit hole is located on the back of the thigh, in the popliteal fossa, between the tendon bundles of the adductor magnus muscle, which are attached to the lower segment of the inner lip of the linea aspera of the femur and to the medial epicondyle. The third (anterior) opening of the adductor canal is located in the fibrous plate. The femoral artery and vein pass through the adductor canal and under cutaneous nerve.

Fascia lata of the thigh,fascia lata It has tendon structure. In the form of a dense case, it covers the thigh muscles on all sides. It inserts proximally on the iliac crest, inguinal ligament, pubic symphysis and ischium. On the back surface lower limb connects to the gluteal fascia.

In the upper third of the anterior region of the thigh, within the femoral triangle, the fascia lata of the thigh consists of two records- deep and superficial. The deep plate covering the pectineus muscle and the distal iliopsoas muscle in front is called the iliopsoas fascia.

Superficial plate fascia lata immediately below the inguinal ligament there is an oval thinned area called the subcutaneous fissure, hiatus saphenus through which the great saphenous vein of the leg passes and flows into

into the femoral vein. From the fascia lata deep into the femur, dense plates extend that separate groups of thigh muscles - the lateral and medial intermuscular septa of the thigh. They participate in the formation of osteofascial containers for these muscle groups.

Lateral intermuscular septum of the thigh, septum intermusculare femoris laterale, separating quadriceps muscle thighs from the posterior thigh muscle group. Medial intermuscular septum of the thigh, septum intermusculare femoris mediale, separates the quadriceps femoris muscle from the adductor muscles.

The fascia lata forms fascial sheaths for the tensor fascia lata, sartorius muscle and gracilis muscle.

2.Topography of the lower floor of the peritoneum, “pockets”, canals, mesenteric sinuses, depressions.

IN ground floor peritoneal cavity The peritoneum, descending into the pelvic cavity, covers not only the upper and partially middle sections of the rectum, but also the organs of the genitourinary apparatus.

In men, a formation forms between the bladder and rectum. rectovesical recess,excavatio rectovesicalis, limited on the sides rectovesical folds,plicae rectoveslcdles. In women, a formation forms between the uterus and rectum. rectouterine cavity,excavatio rectouterina. It is edged on the sides rectal-uterine folds,plicae rectouterinae. Forms between the uterus and bladder vesicouterine cavity,excavdtio vesicouterina.

The long fold of peritoneum is called greater omentum,omentum majus, which in origin is the posterior (dorsal) mesentery of the stomach. The four layers of the peritoneum of the greater omentum fuse two at a time into two plates - anterior and posterior, which fuse with the mesentery of the transverse colon.

3. The choroid of the eye, its parts, the mechanism of accommodation. The choroid of the eyeball,tunica vasculosa bulbi, rich in blood vessels and pigment. It is directly adjacent to inside to the sclera, with which it is firmly fused at the site where the optic nerve exits the eyeball and at the border of the sclera by the cornea. The choroid is divided into three parts: the choroid itself, the ciliary body and the iris.

The choroid itself, choroidea, lines the large posterior part of the sclera, with which, except for the indicated places, it is loosely fused, limiting from the inside the so-called perivascular space, spatium perichoroideale.

ciliary body, corpus ciliare is a middle thickened section of the choroid, located in the form of a circular ridge in the area of ​​​​the transition of the cornea to the sclera, behind the iris. The ciliary body is fused with the outer ciliary edge of the iris. Posterior part of the ciliary body - ciliary circle, orbiculus ciliaris, has the appearance of a thickened circular strip, passes into the choroid itself. The anterior part of the ciliary body forms ciliary processes, processus ciliares. These processes consist mainly of blood vessels and make up ciliary crown, corona ciliaris.

In the thickness of the ciliary body lies ciliary muscle, m. ciliaris. When a muscle contracts, it occurs accommodation of the eye- adaptation to clear vision of objects located at different distances. In the ciliary muscle, meridional, circular and radial bundles of non-striated muscle cells are distinguished. Meridional (longitudinal) fibers, This muscle originates from the edge of the cornea and from the sclera and is woven into the anterior part of the choroid proper. When they contract, the membrane moves anteriorly, resulting in a decrease in tension ciliary girdle, zonula ciliaris, on which the lens is attached. At the same time, the lens capsule relaxes, the lens changes its curvature, becomes more convex, and its refractive power increases. Circular fibers, fibrae circulares, they narrow the ciliary body, bringing it closer to the lens, which also helps to relax the lens capsule. Radial fibers, librae radiates, they begin from the cornea and sclera in the region of the iridocorneal angle, are located between the meridional and circular bundles of the ciliary muscle, bringing these bundles closer together during their contraction. Elastic fibers present in the thickness of the ciliary body straighten the ciliary body when its muscle relaxes.

The iris, ins, is the most anterior part of the choroid, visible through the transparent cornea. It looks like a disk. There is a round hole in the center of the iris - pupil, ririlla. The diameter of the pupil is not constant: the pupil narrows in strong light and expands in the dark, acting as the diaphragm of the eyeball. The anterior surface of the iris faces the anterior chamber of the eyeball, and the posterior surface faces the posterior chamber and the lens.

Blood vessels are located in the connective tissue stroma of the iris. The cells of the posterior epithelium are rich in pigment, the amount of which determines the color of the iris (eye). In the thickness of the iris there are two muscles. Around the pupil there are bundles of smooth muscle cells arranged in a circular manner - sphincter of the pupil, m. sphincter pupitlae, and thin tufts extend radially from the ciliary edge of the iris to its pupillary edge muscle that dilates the pupil, i.e. dilatator puplllae(pupil dilator).

4.Brachial plexus: structure, topography, long plexus nerves and areas of innervation.

Brachial plexus, plexus brachialis, formed by the anterior branches of the four lower cervical, part of the anterior branch of the IV cervical and I thoracic spinal nerves. In the interstitial space, the anterior branches form three trunks: the upper trunk, truncus superior middle trunk, truncus medius, and the lower trunk truncus inferior. These trunks emerge from the interscalene space into the greater supraclavicular fossa and stand out here together with the branches extending from them as the supraclavicular part, pars supraclavicularis, brachial plexus.

The branches extending from the brachial plexus are divided into short and long. Short branches arise mainly from the trunks of the supraclavicular part of the plexus and innervate the bones and soft fabrics shoulder girdle.

1. Dorsal nerve of the scapula, n. dorsdlis scapulae, starts from the anterior branch of the V cervical nerve, lies on the anterior surface of the levator scapulae muscle. Then between this muscle and the posterior scalene muscle, the dorsal scapular nerve travels back along with the descending branch of the transverse cervical artery and branches into the levator scapulae and rhomboid muscles.

2. Long thoracic nerve, n. thordcicus longus, originates from the anterior branches of the V and VI cervical nerves, descends down behind the brachial plexus, lies on the lateral surface of the serratus anterior muscle between the lateral thoracic artery in front and the thoracodorsal artery behind, innervates the serratus anterior muscle.

3. Subclavian nerve, n. subcldvius, is directed by the shortest route to the subclavian muscle in front of the subclavian artery.

4. Suprascapular nerve, n. suprascapuldris, goes laterally and backwards. Together with the suprascapular artery, it passes through the notch of the scapula under its superior transverse ligament into the supraspinous fossa, and then under the acromion into the infraspinatus fossa. Innervates the supra- and infraspinatus muscles, the capsule of the shoulder joint.

5. Subscapular nerve, n. subscapuldris runs along the anterior surface of the subscapularis muscle, innervates this and the greater teres muscle.

6. Thoracospinal nerve, n. thoracodorsails, along the lateral edge of the scapula descends to the latissimus dorsi muscle, which it innervates.

7. Lateral and medial thoracic nerves, pp. pectordles lateralis et medidlls, start from the lateral and medial bundles of the brachial plexus, go forward, pierce the clavipectoral fascia and end in the major (medial nerve) and minor (lateral nerve) pectoral muscles,

8. Axillary nerve, n. axilldris, starts from the posterior bundle of the brachial plexus. Along the anterior surface of the subscapularis muscle it goes down and laterally, then turns back and, together with the posterior circumflex humeral artery, passes through the quadrilateral foramen. After wrapping around the surgical neck of the humerus from behind, the nerve lies under the deltoid muscle. The axillary nerve innervates the deltoid and teres minor muscles, capsule shoulder joint. Terminal branch of the axillary nerve - superior lateral cutaneous nerve of the shoulder, n. cutaneus brdchii lateralis superior, goes around the back edge deltoid muscle and innervates the skin covering the posterior surface of this muscle and the skin of the upper part of the posterolateral region of the shoulder. Long branches of the brachial plexus originate from the lateral, medial and posterior bundles of the infraclavicular part of the brachial plexus.

The lateral pectoral and musculocutaneous nerves, as well as the lateral root of the median nerve, originate from the lateral fascicle. The medial thoracic nerve, medial, cutaneous nerves of the shoulder and forearm, the ulnar nerve and the medial root of the median nerve begin from the medial fascicle. The axillary and radial nerves arise from the posterior bundle.

1. Musculocutaneous nerve, n. musculocutdneus, begins in the axillary fossa behind the small pectoral muscle. The nerve travels laterally and downward, piercing the brachiocracoid muscle. Having passed through the belly of this muscle in an oblique direction, the musculocutaneous nerve is then located between the posterior surface of the biceps brachii muscle and the anterior surface of the brachialis muscle and exits into the lateral ulnar groove. By supplying these three muscles muscular branches, rr. musculares, as well as a capsule elbow joint, the musculocutaneous nerve in the lower part of the shoulder pierces the fascia and descends to the forearm as lateral cutaneous nerve of the forearm, n. cutaneus antebrachii lateralls. The terminal branches of this nerve are distributed in the skin of the anterolateral surface of the forearm to the eminence thumb.

2. Median nerve, n. medianus, It does not produce branches on the shoulder. On the forearm it innervates with its muscular branches, rr. musculares, a number of muscles: pronator teres and quadratus, flexor digitorum superficialis, flexor pollicis longus, longus palmaris muscle, flexor radialis wrists, deep flexor digitorum, i.e. all the muscles of the anterior surface of the forearm, except for the ulnar flexor of the hand and the medial part of the deep flexor digitorum. The largest branch is anterior interosseous nerve, n. interosseus anterior innervates the deep muscles of the anterior surface of the forearm and gives off a branch to the anterior part of the wrist joint.

The terminal branches of the median nerve are three common palmar digital nerve, pp. digitales palmares communes.

3. The ulnar nerve does not give branches on the shoulder. On the forearm, the ulnar nerve innervates the flexor carpi ulnaris and the medial part of the flexor digitorum profundus, giving rise to them muscle branches, rr. muscles, as well as the elbow joint. The dorsal branch of the ulnar nerve goes to the back of the forearm between ulnar flexor hand and ulna.

4. Medial cutaneous nerve of the shoulder, n. cutaneus brachii medidlis, starts from the medial bundle of the brachial plexus, accompanies the brachial artery. Two or three branches pierce the axillary fascia and the fascia of the shoulder and innervate the skin of the medial surface of the shoulder.

5. Medial cutaneous nerve of the forearm, n. cutaneus antebrachii medidlis, comes out of the axillary fossa, adjacent to brachial artery. Innervates the skin of the anteromedial surface of the forearm.

6. Radial nerve, n. radialis starts from the posterior bundle of the brachial plexus at the level of the lower edge of the pectoralis minor muscle between the axillary artery and the subscapularis muscle. Together with the deep brachial artery, the radial nerve passes through the so-called brachiomuscular canal, bends around the humerus and leaves the canal in the lower third of the shoulder on its lateral side. Next, the nerve pierces the lateral intermuscular septum of the shoulder and goes down between the brachialis muscle and the beginning of the brachioradialis muscle. At the level of the elbow joint, the radial nerve is divided into superficial and deep branches. r. profundus.Superficial branch, r.superficiales, innervates the palmar digital nerves of the median nerve.

In the shoulder, the radial nerve innervates the muscles of the posterior group of the shoulder ( triceps shoulder and elbow muscle) and the shoulder joint bursa.

In the brachial canal from radial nerve the posterior cutaneous nerve of the forearm arises, n. cutaneus antebrachii posterior,- innervates the skin of the posterior surface lower section shoulder and skin of the back of the forearm.

Ticket number 49

1.Femoral canal, its walls and rings: deep and subcutaneous. Fascia of the thigh, hidden (oval) fossa.

femoral canal,canalis femoralis, is formed in the area of ​​the femoral triangle during the development of a femoral hernia. This is a short section medial to the femoral vein, it extends from the femoral (internal) ring of this canal to the saphenous fissure, which, in the presence of a hernia, becomes the external opening of the canal.

Inner femoral ring,anulus femoralis, located in the medial part of the vascular lacuna. It is bounded anteriorly by the inguinal ligament, posteriorly by the pectineal ligament, medially by the lacunar ligament, and laterally by the femoral vein. From the outside abdominal cavity the femoral ring is closed by a section of loosened transverse fascia of the abdomen - the femoral septum, septum femorale.

At the femoral canal there is three walls : anterior, lateral and posterior. The anterior wall of the canal is the inguinal ligament and the superior horn of the falciform edge of the lata fascia of the thigh, fused with it. The lateral wall is formed by the femoral vein, and the posterior wall is formed by a deep plate of fascia lata covering the pectineus muscle.

3.Anatomy of the middle ear: walls of the tympanic cavity, openings, auditory ossicles, auditory tube. Blood supply and innervation of the middle ear.

Middle ear, auris media includes the air-filled tympanic cavity and the auditory (Eustachian) tube. The middle ear cavity communicates with the mastoid cave and through it with the mastoid cells located in the thickness of the mastoid process.

tympanic cavity,cavitas tympani, located in the thickness of the pyramid of the temporal bone, between the external auditory canal laterally and the bony labyrinth of the inner ear medially. There are 6 walls in the tympanic cavity:

1. Upper tegmental wall, paries tegmentalis

2. Bottom jugular wall, paries jugularis

3. Medial labyrinth wall, paries labyrinthicus,

4. Rear mastoid wall, paries mastoideus

5. Front carotid wall, paries caroticus

6. Lateral membranous wall paries membranaceus

In the tympanic cavity there are three auditory ossicles covered with mucous membrane, as well as ligaments and muscles.

auditory ossicles, ossicula auditus , form a chain that continues from the eardrum to the end of the vestibule, which opens into the inner ear. In accordance with their shape, the bones are named: hammer, anvil, stirrup. Hammer, malleus, has a rounded head, which turns into a long one hammer handle, with two processes: lateral and anterior. Anvil, incus consists of a body, with an articular fossa for articulation with the head of the malleus and two legs: one short leg, another - long. Stirrup, stages, has a head, two legs - front and back, crus anterius et crus posterius, connected by base of the stirrup, basis stapedis, inserted into the window of the vestibule. Vibrations of the eardrum, resulting from the impact of a sound wave on it, are transmitted to the window of the vestibule. Two muscles attached to the auditory ossicles regulate the movements of the ossicles and protect them from excessive vibrations during strong sounds. Tensor tympani muscle, m. tensor tympani pulling up the handle of the hammer, strains the eardrum. Stapedius muscle, m. Stapedius, p When it contracts, the pressure of the base of the stapes inserted into the window of the vestibule is weakened.

Auditory (Eustachian) tube,tuba auditiva, serves to bring air from the pharynx into the tympanic cavity and maintain pressure in the cavity equal to the external one, which is important for the normal operation of the sound-conducting apparatus. The auditory tube consists of bone And cartilaginous part. The upper bony part of the tube is located in the hemicanal of the same name of the muscular-tubal canal of the temporal bone and opens on the anterior wall of the tympanic cavity tympanic opening of the auditory tube, ostium tympdnicum tubae auditivae. The lower cartilaginous part is formed by the medial and lateral cartilaginous plates and the membranous plate connecting them

The tensor muscle and the levator palatine muscle originate from the cartilaginous part of the auditory tube. When they contract, the cartilage of the tube and its membranous plate, lamina membranacea, are retracted, the pipe channel expands and air from the pharynx enters the tympanic cavity.

Blood supply: the walls of the auditory tube are supplied with blood by the anterior tympanic artery and the pharyngeal branches of the ascending pharyngeal artery, the petrous branch - from the middle meningeal artery. The artery of the pterygoid canal (a branch of the maxillary artery) gives branches to the auditory tube. The veins drain into the pharyngeal venous plexus, into the meningeal veins (tributaries of the internal jugular vein) and the mandibular vein.

Innervation: in the tympanic cavity - the tympanic plexus, formed by the branches of the tympanic nerve (a branch of the glossopharyngeal nerve). The branches of the pharyngeal plexus are the auditory tube.

4. Morphological differences between somatic and autonomic reflex arcs. Gray and white connecting branches

REFLECTOR SOMATIC ARC- consists of a chain H, including sensory and motor H, along which the nerve impulse moves from the receptor to the working organ. It does not consist of two Hs, but there are one or more intercalary Hs.

REFLECTOR VEGETATIVE ARC– includes three groups of N. The bodies of sensitive N are located in the SM nodes and CN nodes. The bodies of the intercalary (second) Ns lie in the vegetative centers of the GM and SM, their processes emerge as part of the anterior roots and roots of the CN, reaching the vegetative nodes, where they end. The bodies of the third N are located in the vegetative nodes, their axons reach the working organs.

Reflex arc of the somatic nervous system on the way from the central nervous system to skeletal muscle is not interrupted anywhere, unlike the reflex arc of the autonomic nervous system, which, on the way from the central nervous system to the innervated organ, is necessarily interrupted with the formation of a synapse - the autonomic ganglion.

White connecting branches: formed by the axons of central sympathetic nerves, i.e. they are preganglionic fibers, they are myelinated. They leave the SC as part of the anterior roots of the SMN and go to the nearest node of the sympathetic trunk.

Gray branches: formed by postganglionic fibers, which are axons of the H nodes of the sympathetic trunk. Most lack myelin sheath.

Ticket number 50

1.Sphenoid bone: its parts, processes, holes, their purposes .

Sphenoid bone,os sphenoidale, located in the center of the base of the skull. It participates in the formation of the lateral walls of the cranial vault, as well as the cavities and fossae of the cerebral and facial parts of the skull. The sphenoid bone has a complex shape and consists of a body from which 3 pairs of processes extend: large wings, small wings and pterygoid processes.

Body,corpus The sphenoid bone has the shape of an irregular cube. Inside it there is a cavity - the sphenoid sinus, sinus sphenoidalis. There are 6 surfaces in the body: the upper, or cerebral; posterior, fused in adults with the basilar (main) part of the occipital bone; the front one, which passes without sharp boundaries into the lower one, and two lateral ones.

Small wing, ala minor, It is a paired plate extending from each side of the body of the sphenoid bone with two roots. Between the latter is the visual channel, canalis opticus, for the passage of the optic nerve from the orbit. The anterior edges of the lesser wings are serrated; the orbital parts of the frontal bone and the cribriform plate of the ethmoid bone are connected to them. The posterior edges of the small wings are free and smooth. On the medial side of each wing there is an anterior inclined process, processus clinoideus anterior. The dura mater of the brain grows to the anterior as well as to the posterior inclined processes.

The lesser wing has an upper surface facing the cranial cavity, and a lower one, participating in the formation of the upper wall of the orbit. The space between the lesser and greater wings is the superior orbital fissure, fissura orbitalis superior. The oculomotor, lateral and abducens nerves (III, IV, VI pairs of cranial nerves) and the optic nerve - I branch of the trigeminal nerve (V pair) pass through it from the cranial cavity to the orbit.

Big wing, ala major, paired, begins with a wide base from the lateral surface of the body of the sphenoid bone (Fig. 32). At the very base, each wing has three holes. Above the others and in front there is a round hole, foramen rotundum, through which the second branch of the trigeminal nerve passes, in the middle of the wing there is the foramen ovale, foramen ovale, for the third branch of the trigeminal nerve. Foramen spinosum, foramen spinosum, smaller in size, located in the area of ​​the posterior corner of the large wing. Through this opening, the middle meningeal artery enters the cranial cavity.

The large wing has four surfaces: medullary, orbital, maxillary and temporal. On the surface of the brain fades cerebralis, finger-shaped impressions are well defined, impressidnes digitatae, and arterial grooves, sulci arteriosi. orbital surface, fades orbitalis,- quadrangular smooth plate; part of the lateral wall of the orbit. maxillary surface, fades maxillaris, occupies a triangular area between the orbital surface above and the base of the pterygoid process below. On this surface, facing the pterygopalatine fossa, a round opening opens. Temporal surface, fades tempordlis, the most extensive. infratemporal crest, crista infratemporalis, divides it into two parts. Top part larger in size, located almost vertically, part of the wall of the temporal fossa. Bottom part located almost horizontally, forms the upper wall of the infratemporal fossa.

pterygoid process,processus pterygoideus, paired, departs from the body of the sphenoid bone at the beginning of the large wing and is directed vertically downward. The medial plate of the process faces the nasal cavity, the lateral plate faces the infratemporal fossa. The base of the process is pierced from front to back by a narrow pterygoid canal, canalis pterygoideus, in which blood vessels and nerves pass. The anterior opening of this canal opens into the pterygopalatine fossa, the posterior one - on the outer base of the skull near the spine of the sphenoid bone, splna ossis sphenoidalis. The plates of the pterygoid process are distinguished: medial, lamina medlis, and lateral, lamina lateralis. The anterior plates are fused. Posteriorly, the plates of the pterygoid process diverge, forming the pterygoid fossa, fossa pterygoidea. At the bottom, both plates are separated by a pterygoid notch, incisura pterygoidea. The medial plate of the pterygoid process is somewhat narrower and longer than the lateral one and below passes into the pterygoid hook, Hamulus pterygoideus.

2.Chewing muscles, their development, functions, blood supply, innervation. Chewing muscle, t. masseter, is divided into two parts: superficial (larger) and deep (smaller). Surface partbegins a thick tendon from the zygomatic process of the maxilla and the anterior two-thirds of the zygomatic arch; bunches of it are attached to the masticatory tuberosity of the lower jaw. Deep part muscles begins from the back third of the lower edge and the entire inner surface zygomatic arch. Its bundles run almost vertically from top to bottom and are attached to the lateral surface of the coronoid process of the mandible to its base. Function: raises the lower jaw, the superficial part of the muscle is also involved in moving the lower jaw forward. Innervation: n. trigeminus. Blood supply: a. masseterica, a. transversa faciei.

Temporalis muscle, n. temporalis, begins from the entire surface of the temporal fossa, with the exception of a small area belonging to the zygomatic bone; from the inner surface of the temporal fascia. The muscle bundles continue into a thick tendon, which attached to the coronoid process of the mandible. Function: raises the lower jaw. The posterior muscle bundles pull the lower jaw forward backwards. Innervation: n. trigeminus. Blood supply: ah. temporales profunda anterior et superficialis.

Medial pterygoid muscle, t. pterygoideus medialis, begins in the pterygoid fossa of the same process of the sphenoid bone.

The muscle bundles continue into a highly developed tendon plate, which attached to the pterygoid tuberosity on the inner surface of the angle of the lower jaw. Function: raises the lower jaw, pushes the lower jaw forward. Innervation: n. trigeminus. Blood supply: a. maxillaris, a. facialis.

Lateral pterygoid muscle, t. pterygoideus lateralis, begins two heads - upper and lower. The upper head begins on the maxillary surface and from the infratemporal crest of the greater wing of the sphenoid bone, the lower head begins from the outer surface of the lateral plate of the pterygoid process of the same bone. Bundles of both heads of muscle are attached to the anterior surface of the neck of the lower jaw, the articular capsule of the temporomandibular joint and to the articular disc. Function: with bilateral contraction of the muscle, the lower jaw moves forward. The muscle pulls forward the joint capsule and articular disc of the temporomandibular joint; with unilateral contraction, it shifts the lower jaw to the opposite side. Innervation: n. trigeminus. Blood supply: a. maxillaris, a. facialis.

Chewing fascia, fascia masseterica covers the muscle of the same name, firmly merging with its superficial bundles. At the top it is attached to the lateral surface of the zygomatic bone and zygomatic arch, in front it passes into the buccal-pharyngeal fascia, and at the back it is fused with the capsule of the parotid gland.

temporal fascia, fascia temporalis, It is represented by a dense fibrous plate that covers the temporal muscle and closely fuses with it. It begins on the lateral surface of the skull from the temporal line and the tendon helmet. Above the zygomatic arch, the temporal fascia is divided into two plates - superficial and deep.

superficial plate, lamina superficialis, is attached to the lateral surface of the zygomatic arch, and the deep plate, lamina profunda,- to its medial surface. Between these plates there is a small amount of fatty tissue, blood vessels and nerves pass through.

Buccopharyngeal fascia, fascia buccopharyngea, covers the buccal muscle and continues to the lateral wall of the pharynx; relatively poorly developed. A compacted section of this fascia, stretched between the pterygoid hook of the sphenoid bone above and the mandible below, forms the pterygomandibular suture.

3.Accessory apparatus of the eye: muscles of the eyeball, conjunctiva, eyelids, lacrimal apparatus, their blood supply, innervation.

Muscles of the eyeball - 6 striated muscles: 4 rectus muscles - superior, inferior, lateral and medial, and two obliques - superior and inferior.

M levator muscle upper eyelid, t. levator palpebrae superioris. R It is located in the orbit above the superior rectus muscle of the eyeball, and ends in the thickness of the upper eyelid. The rectus muscles rotate the eyeball around the vertical and horizontal axes.

Lateral and medial rectus muscles, vol. recti lateralis et medialis, turn the eyeball outward and inward around the vertical axis, the pupil rotates.

Superior and inferior rectus muscles, vol. recti superior et inferior, rotate the eyeball around the transverse axis. The pupil, under the action of the superior rectus muscle, is directed upward and somewhat outward, and when the inferior rectus muscle operates, it is directed downward and inward.

superior oblique muscle,t. obliquus superior, lies in the superomedial part of the orbit between the superior and medial rectus muscles, turns the eyeball and pupil downward and laterally.

inferior oblique muscle,t. obliquus inferior, starts from the orbital surface of the upper jaw near the opening of the nasolacrimal canal, on the lower wall of the orbit, is directed between it and the inferior rectus muscle obliquely upward and backward, turns the eyeball upward and laterally.

Eyelids. Upper eyelid, palpebra superior, And lower eyelid, palpebra inferior, - formations that lie in front of the eyeball and cover it from above and below, and when the eyelids close, completely covering it.

The anterior surface of the eyelid, facies anterior palpebra, is convex, covered with thin skin with short vellus hair, sebaceous and sweat glands. The posterior surface of the eyelid, facies posterior palpebrae, faces the eyeball, concave. This surface of the eyelid is covered conjunctiva, tunica conjuctiva.

Conjunctiva, tunica conjunctiva, connective tissue membrane. It is distinguished conjunctiva of the eyelids, tunica conjunativa palpebrarum, covering the inside of the eyelids, and conjunctiva of the eyeball, tunica conjunctiva bulbaris, which on the cornea is represented by a thin epithelial cover. . The entire space lying in front of the eyeball, limited by the conjunctiva, is called conjunctival sac, saccus conjunctivae

Lacrimal apparatus, apparatus lacrimalis, includes the lacrimal gland with its excretory canaliculi, opening into the conjunctival sac, and lacrimal ducts. lacrimal gland,glandula lacrimalis,- a complex alveolar-tubular gland, lies in the fossa of the same name in the lateral corner, at the upper wall of the orbit. Excretory canaliculi of the lacrimal gland, ducxuli excretorii open into the conjunctival sac in the lateral part of the superior fornix of the conjunctiva.

Blood supply: Branches of the ophthalmic artery, which is a branch of the internal carotid artery. Venous blood flows through the ophthalmic veins into the cavernous sinus. Supplies the retina with blood central retinal artery, a. centralis retinae, Two arterial circles: big,circulus arteriosus iridis major, at the ciliary edge of the iris and small,circulus arteridsus iridis minor, at the pupillary edge. The sclera is supplied with blood by the posterior short ciliary arteries.

Eyelids and conjunctiva - from the medial and lateral arteries of the eyelids, anastomoses between which form the arch of the upper eyelid and the arch of the lower eyelid, and anterior conjunctival arteries in the thickness of the eyelids. The veins of the same name drain into the ophthalmic and facial veins. Directed to the lacrimal gland lacrimal artery, a. lacrimalis.

Innervation: Sensitive innervation comes from the first branch of the trigeminal nerve - the optic nerve. From its branch, the nasociliary nerve, long ciliary nerves extend to the eyeball. The lower eyelid is innervated by the infraorbital nerve, which is a branch of the second branch of the trigeminal nerve. The superior, inferior, medial rectus, inferior oblique muscles of the eye and the muscle that lifts the upper eyelid receive motor innervation from the oculomotor nerve, the lateral rectus - from the abducens nerve, the superior oblique - from the trochlear nerve.

4. Extrapyramidal system, its nuclei and main pathways. Formation of motor automatism.

The extrapyramidal system is a set of structures of the brain involved in controlling movements, maintaining muscle tone and poses, bypassing the pyramid system. Extrapyramidal pathways are formed by descending projection nerve fibers of origin not related to giant pyramidal cells (Betz cells). These nerve fibers provide connections between the motor neurons of the subcortical structures (cerebellum, basal ganglia, brain stem) of the brain with all parts of the nervous system located distally.

The extrapyramidal system consists of the following brain structures: basal ganglia, red nucleus, interstitial nucleus, tectum, substantia nigra, RF of the pons and medulla oblongata, vestibular complex nuclei, cerebellum, premotor cortex, striatum.

Red nuclear spinal tract

1. Medial tract, tractus mediate.
2. Spinalis muscle, i.e. spinalis. It is attached to the spinous processes and consists of three parts. Rice. B.
3. The spinalis muscle of the chest, i.e. spinalis thoracis. H: spinous processes T11 - L2. P: spinous processes T 1 - 11. F: extends the thoracic spine. Rice. IN.
4. The spinalis muscle of the neck, i.e. spinalis servicis. N: spinous processes Sb - T7. P: spinous processes C2 - 4. F: extends the cervical spine. Rice. IN.
5. Spinalis capitis muscle, nuspinalis capitis. It starts from the spinous processes of the upper thoracic and lower cervical vertebrae. Fickle component The semispinalis capitis muscle is an additional point of its origin.
6. Interspinous muscles, vol. interspinales. Unlike the spinous muscles, they connect only two adjacent spinous processes. F: straighten the corresponding parts of the spine. Rice. V, G.
7. Interspinous muscles of the neck, vol. interspinales cervicis. Usually lie on both sides of the bifurcated spinous process of the cervical vertebrae. Rice. G.
8. Interspinous muscles of the chest, vol. interspinales thoracis. Usually absent. Rice. IN.
9. Interspinous muscles of the lumbar region, vol. interspinales lumborum. Horyu are especially developed. Rice. IN.
10. Transverse spinous muscles, vol. transversospinales. Represented by the nine muscles listed below. Rice. A B C.
11. Semispinalis muscle, so semispinalis. The most superficial of the transverse spinous muscles. It spans four to six vertebrae and consists of three parts. Rice. A, B.
12. The semispinalis muscle of the chest, so semispinalis thoracis. H: transverse processes of the six lower thoracic vertebrae. P: spinous processes C b - T 6. F: extends the spine. Rice. A.
13. The semispinalis muscle of the neck, i.e. semispinalis cervicis. H: transverse processes of T1 - b. P: spinous processes C2 - 5. F: extends the spine. Rice. A.
14. The semispinalis capitis muscle, i.e. semispinalis capitis. H: transverse processes of C4 - Tb. P: squama of the occipital bone between the superior and inferior nuchal lines. F: extension of the head or its rotation in different directions depending on starting position. Rice. A.
15. Multifidus muscles, vol. multifidi. They spread over two to four vertebrae and lie on the sides of the spinous processes. F: rotate the spinal column around the longitudinal axis, participate in its extension and tilt to the side. Rice. B.
16. Rotator muscles, vol. rotators. The deepest layer of the transverse spinalis muscle. Comprises short fibers, which have a transverse direction of travel, resulting in rotation of the spine. They end on the overlying or subsequent vertebra. Rice. A, B.
17. Neck Rotators, vol. rotatores cervicis. H: inferior articular process. P: arch or base of the spinous process of the cervical vertebrae. Rice. A.
18. Rotator muscles of the chest, vol. rotatores thoracis. H: transverse processes of the thoracic vertebrae. P: spinous processes. Rice. A, V.
19. Low back rotator muscles, vol. rotatores lumborum. H: mastoid process of the lumbar vertebrae. P: bases of the spinous processes. Rice. A, V.
20. The thoracolumbar fascia, fascia thoracolumbalis. Covers the muscle that straightens the spine; the superficial layer starts from the spinous vertebrae, the deep layer starts from the transverse processes of the lumbar vertebrae. At the lateral edge of the muscle, both leaves are united into one. Start from the fascia: latissimus muscle back, serratus posterior muscle, transverse muscle belly. Rice. V, E.
21. Nuchal fascia, fascia nuchae (nuchalis). Continuation of the superficial layer of the cervical fascia. Covers the autochtomous muscles of the neck.
22. Muscles of the head, musculi capitis.
23. Suboccipital muscles, vol. suboccipitales. Represented by the muscles listed below.
24. The anterior rectus capitis muscle, i.e. rectus capitis anterior. H: lateral mass of the atlas. P: basilar part of the occipital bone. F: tilts his head forward. Inn.: anterior branches of the spinal nerves. Rice. D.
25. The large posterior rectus capitis muscle, i.e. rectus capitis posterior major. H: spinous process of the axial vertebra. P: middle of the lower nuchal line. F: Turns his face in the direction of contraction. He throws his head back and tilts it to the side. Inn.: suboccipital nerve. Rice. G.
26. The small posterior rectus capitis muscle, i.e. rectus capitis posterior minor. H: posterior tubercle of the atlas. P: medial third of the inferior nuchal line. F: throws back his head. Inn.: suboccipital nerve. Rice. G.

The anterior rectus capitis muscle (m. rectus capitis anterior) (Fig. 98) with bilateral contraction tilts the head forward, with unilateral contraction it tilts the head in its direction. The muscle begins at the transverse process and lateral mass of the first cervical vertebra, and is attached to the lower surface of the basilar occipital bone.

The lateral rectus capitis muscle (m. rectus capitis lateralis) (Fig. 98) tilts the head forward with bilateral contraction, and in its direction with unilateral contraction. The origin of the muscle is located on the transverse process of the first cervical vertebra, and the attachment point is on the lateral occipital bone.

The long muscle of the head (m. longus cspitis) (Fig. 97, 98) tilts the head and cervical spine forward, and also participates in the rotation of the head. The muscle begins at the anterior tubercles of the transverse processes of the III–VI cervical vertebrae and is attached to the lower surface of the main part of the occipital bone.

The long neck muscle (m. longus coli) (Fig. 97, 98, 100), contracting, tilts the neck to its side and forward. The muscle includes two parts: upper (lateral) and lower (medial). The starting point of the upper part is located on the transverse processes of the IV–VI cervical vertebrae, and the attachment point is on the anterior tubercle of the I cervical vertebra. The starting point of the lower part is the bodies of the three upper thoracic vertebrae and the three lower cervical vertebrae, the attachment point is the bodies of the II–IV cervical vertebrae and the transverse processes of the V–VII cervical vertebrae.

Lateral muscles

The anterior scalene muscle (m. scalenus anterior) (Fig. 96, 98, 100, 105) with bilateral contraction tilts the cervical spine forward, and with unilateral contraction - in its direction. When the spine is in a fixed position, the muscle raises the first rib. The muscle begins from the anterior tubercles of the III–VI cervical vertebrae, and the site of its attachment is the tubercle of the anterior scalene muscle of the 1st rib.

The middle scalenus muscle (m. scalenus medius) (Fig. 96, 98, 100, 105) when contracted, tilts the neck forward, and when the neck is in a fixed position, it raises the first rib. The origin of the muscle is located on the anterior tubercle of the six lower cervical vertebrae, and the attachment point is on the upper surface of the first rib.

The posterior scalene muscle (m. scalenus posterior) (Fig. 96, 98, 100) raises the second rib and, with the chest in a fixed position, bends the cervical spine forward. The muscle begins on the posterior tubercles of the IV–VI cervical vertebrae and attaches to the outer surface of the II rib.

Fascia of the neck

The fascia of the neck (fascia cervicalis) (Fig. 99) consists of three plates and has a complex structure due to the large number of muscles and organs. The space between the fascia of the neck and the organs of the neck is filled with fatty tissue and loose connective tissue.

The superficial plate (lamina superficialis) (Fig. 99, 100) is a continuation of the fascia of the chest and back. It forms a vagina for the submandibular gland and for the suprahyoid and sternocleidomastoid muscles of the neck. In the back of the neck, the fascia envelops the trapezius muscle, reaching the occipital protuberance and the superior nuchal line. The suprasternal interaponeurotic space (spatium interaponeuroticum suprasternale) is formed above the jugular notch of the manubrium of the sternum (Fig. 99, 100).

Rice. 99. Fascia of the neck (side view):

1 - chewing fascia; 2 - thyroid gland; 3 - fascia of the neck; 4 - sternocleidomastoid muscle; 5 - pretracheal plate; 6 - suprasternal interaponeurotic space; 7 - trapezius muscle; 8 - surface plate; 9 - subcutaneous muscle of the neck

Rice. 100. Muscles and fascia of the neck (cross section):

1 - suprasternal interaponeurotic space; 2 - previsceral space; 3 - sternohyoid muscle; 4 - surface plate; 5 - sternothyroid muscle; 6 - pretracheal plate; 7 - trachea; 8 - scapular-hyoid muscle; 9 - subcutaneous muscle of the neck; 10 - esophagus; 11 - long muscle of the neck; 12 - sternocleidomastoid muscle; 13 - anterior scalene muscle; 14 - middle scalene muscle and posterior scalene muscle; 15 - semispinalis dorsi muscle; 16 - muscle that lifts the scapula; 17 - splenius muscle of the head and splenius muscle of the neck; 18 - trapezius muscle

The prevertebral plate (lamina prevertebralis) begins at the base of the skull, descends, covers the prevertebral muscles of the neck, and also passes to the scalene muscles. Between the prevertebral plate and the organs of the neck is the retrovisceral space (spatium retroviscerale).

The pretracheal plate (lamina pretrachealis) (Fig. 99, 100) begins in the region of the clavicle and the manubrium of the sternum and forms a sheath for the sublingual muscles. Between the pretracheal plate and the organs of the neck is the previsceral space (spatium previscerale) (Fig. 100).