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General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

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Page 1: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks
Page 2: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

General anatomy of skeletal muscle

its innervation and blood supply

General anatomy of spinal nerve

Miloš Grim

Institute of Anatomy

First Faculty of Medicine,

Charles University

Winter semester 2017/2018

Page 3: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

General Anatomy of Skeletal Muscle(final exam questions) Origin and development of muscles,

molecular mechanisms

General features of striated muscle, its auxiliary structures

(motor end plate, motor unit, muscle spindle, Golgi tendon organ),

motor and proprioceptive innervation

Attachments of skeletal muscles – origin, insertion

Muscle fibres, myofibrils, sarcomeres

Naming of muscles

Shape and fibre architecture, pennation

The endomysial and perimysial sheaths

The interface between muscle and connective tissue

Myofibrilar proteins

Sliding filament mechanism of contraction

Tendons, Aponeuroses

Synovial sheaths and bursae

Fascia, intermuscular septa, osteofibrous spaces

Page 4: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

How to study skeletal muscles: identification, muscle groups,

innervation, function, origo, insertion,

position (scheme, tables), osteofascial

spaces (compartments),

transverse sections of limb segments,

dissection

Page 5: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

R.S.Snell: Clinical Anatomy. Lippincott Williams Wilkins

Page 6: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Attachments of skeletal muscles – origin, insertion,

endomysial and perimysial sheaths, fascia

Page 7: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

tendons, aponeuroses, neuro-vascular hilum (motor point)

Page 8: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks
Page 9: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Naming of Muscles

Shape:

deltoid (= triangular), quadratus (= square), rhomboid

(= diamond-shaped)

teres (= round), gracilis (= slender), rectus (= straight),

lumbrical (= worm-like)

Size : major, minor, longus (= long), brevis (= short),

latissimus (= broadest), longissimus (= longest)

Number of Heads or Bellies:

biceps (= 2 heads), triceps (= 3 heads), quadriceps (= 4 heads)

digastric (= 2 bellies), biventer (= 2 bellies),

Position:

anterior, posterior, interosseous (= between bones)

supraspinatus (= above spine of scapula),

infraspinatus (= below spine),

dorsi (= of the back), abdominis (= of the abdomen)

pectoralis (= of the chest), brachii (= of the arm)

femoris (= of the thigh), oris (= of the mouth)

Page 10: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Naming of Muscles

Depth:

superficialis (= superficial), profundus (= deep),

externus (or externi), internus (or interni)

Attachment:

sternocleidomastoid

(from sternum and clavicle to mastoid process)

coracobrachialis (from the coracoid process to the arm)

Action:

extensor, flexor, abductor, adductor,

levator (= lifter), depressor,

supinator, pronator, constrictor, dilator

Page 11: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Fascia, intermuscular septum, osteofibrous spaces

Page 12: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Osteofasciál

spaces of

the upper limb

Page 13: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks
Page 14: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Fibrous and synovial sheaths,

synovial bursa

Auxiliary structures of muscles

Page 15: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Retinaculum musculorum extensorum

m. extensor hallucis longus (Vesalius, 1555)

Page 16: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks
Page 17: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

muscle fibre,

myofibril,

sarcomere

sarcoplasmic

reticulum,

T-tubules,

triads

mitochondria,

sarcolemma,

basal lamina

Satellite cell

Page 18: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

http://fig.cox.miami.edu/~cmallery/150/neuro/muscle.htm

striated muscle fibres, sarkomere

Page 19: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks
Page 20: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Innervation of skeletal muscle

Neurovascular hilum

Blood supply

Motor innervation

Alfa motoneurons: slow and fast,

gamma motoneurons,

motor end-plate, ACh

motor unit, zone of motor end-plates,

polyneural innervation, segmental

innervation

Sensory (proprioceptive) innervation

muscle spindle, Golgi tendon organ,

proprioceptive reflexes

Page 21: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Innervation of skeletal muscle: motoneurons, motor units, motor

end- plates, acetylcholine, proprioceptive neurons,

muscle spindles, Golgi tendon organs

Page 22: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

vizualization of motor end plates

Page 23: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

visualization of motor end plates and axons,

acetylcholinesterase in subneural apparatus

Page 24: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

synaptic vesicles containing acetylcholine

(neurotransmitter) in axon terminal of motor end-plate;

curare blocks the transmission

Page 25: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Muscle spindle

Golgi tendon organ

Elektromyography (EMG)

Page 26: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

A young women with sensory neuropathy of unknown

origin who completely lost proprioceptive sensation:

She could not stand without watching her feet,

she could not held anything in her hands, and they

wandered around without her awareness…

„Something awful´s happened, I can´t feel my body.

I feel weird-disembodied“, she said, and „I may lose

my arms. I think they´re one place and I find they´re

another“.

After having proprioception explained, she said:

„This proprioception is like the eyes of the body,

the way the body sees itself. And if it goes, as it´s gone

with me, it´s like the body is blind…so I have

to watch it - be its eyes. Right?“ (Dr. O.Sacks, neurologist)

Page 27: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

pennation of muscles

arrangement of parallel

running muscle fibres

Page 28: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

myo-tendinous junction

Page 29: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Terms related to muscle functionIsotonic and isometric contraction, reciprocal

innervation, synergists, antagonists, resting tension,

postural muscles, electromyography,

denervation atrophy

Muscle activity controls motor systems of CNS

according to information from mechanoreceptors and

proprioceptors and according to motivation

processed by the limbic system

Page 30: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Posture, isometric contraction

Page 31: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Motion, isotonic contraction

Page 32: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Fibre Types of Skeletal Muscle• Type I fibres are slow-contracting and fatigue-resistant

• Type IIA fibres are fast-contracting and fatigue-resistant

• Type IIX (B) fibres are fast-contracting and susceptible

to fatigue

myosin ATPase, dehydrogenase, glycogen phosphorylase

Type I - SO Type IIa - FOG Type IIx - FG

Page 33: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Capillaries of skeletal muscle

FG IIx FOG IIa SO I

Page 34: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

FG IIx FOG IIa SO I

Page 35: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks
Page 36: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

A gene for speed? The evolution and function of a-actinin-3

Summary

The a-actinins are an ancient family of actin-binding proteins that play

structural and regulatory roles in cytoskeletal organisation and muscle

contraction. Alfa-actinin-3 is the most-highly specialised of the four

mammalian a-actinins, with its expression restricted largely to fast

glycolytic fibres in skeletal muscle. Intriguingly, a significant proportion (

18%) of the human population is totally deficient in a-actinin-3 due to

homozygosity for a premature stop codon polymorphism (R577X) in the

ACTN3 gene. Recent work in our laboratory has revealed a strong

association between R577X genotype and performance in a variety of

athletic endeavours. We are currently exploring the function and

evolutionary history of the ACTN3 gene and other a-actinin family

members. The a-actinin family provides a fascinating case study in

molecular evolution, illustrating phenomena such as functional redundancy

in duplicate genes, the evolution of protein function, and the action of

natural selection during recent h uman evolution. BioEssays 26:786–795,

2004. ß 2004 Wiley Periodicals, Inc.

Page 37: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

DG MacArthur and KN North:

BioEssays 26:786–795, 2004

Only the R allele allows the synthesis of alpha actinin 3, a protein that is

predominantly present in FG (IIx) muscle fibers responsible for rapid and intense

muscle contraction

Page 38: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Development and Differentiation

of Skeletal MuscleMyogenesis,

Myogenic Determination Factors

Myf-5, myogenin, MyoD and Myf-6 (herculin)

Myostatin

Growth of Skeletal Muscle

Hypertrophy, not hyperplasia

Anabolic Steroids

Regeneration of Skeletal MuscleSatellite cells

Page 39: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Langman´s Medical Embryology

Paraxial mesoderm: somites, somatopleura, splanchnopleura

Page 40: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Histochem Cell Biol (2012) 138:187–199

Fate of somites

Page 41: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

HH 25

MyoD

Page 42: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Epaxial and hypaxial musculature and its innervation

from dorsal and ventral branches of spinal nerves

Page 43: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Myogenese - diferenciace svalového vlákna

myoD

myf-5

mrf-4

Myogenin

myostatin

Page 44: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Mutation of myostatine gene resulting in overproduction of myogenic cells

Page 45: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Segmental

pattern

of muscle

innervation

Page 46: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

The origin of the muscles of the limb

Page 47: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

C DK HH 22

Page 48: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Migration of

myogenic cells into

limb primordium

Grim M: Z. Anat-EntwGesch 132:260-71,1970

Page 49: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Neural crest cells in embryonic chimeras

of Japanese quail and white Leghorn chicken

QCPN

Page 50: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Colonization

of the limb bud

(myogenic cells,

Schwann cells,

angioblasts,

ingrowing

Axons)

Page 51: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Ventral and dorsal muscle blastema in limb primordium

Desmin

Morfogenesis of limb muscles

Page 52: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Morfogenesis of limb muscles

Page 53: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Regeneration of skeletal muscle

Satellite cells are resident myogenic progenitors

in postnatal skeletal muscle involved in muscle

postnatal growth and adult regenerative capacity

Page 54: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Activation of satellite cells in muscle regeneration

Page 55: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Fate of the free muscle graft in the rat

1.day

3. day

5. day

7. day

30. day

60. day Intact muscle

Page 56: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

General anatomy of spinal nerves

Regeneration of peripheral nerve

Page 57: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Spinal nerve

rootlets, anterior root - motor root,

posterior root - sensory root , spinal ganglion,

trunk of the spinal nerve (mixed nerve),

anterior ramus, posterior ramus

Spinal nerves: C 1-8, T 1-12, L 1-5, S 1-5, Co

Page 58: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Kandel et al:

Principles of neural

science,

2000 McGraw-Hill

Segmental innervation - areae radiculares (dermatomes)

Page 59: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Spinal cord and spinal

nerves of the newborn

Brachial plexus,

Lumbosacral plexus,

Page 60: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Development of segmental innervation of limbs

Page 61: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Neural tube- basal plate, alar plate, sulcus limitans,

somatomotoric zone, visceromotric zone,

viscerosensitive zone, somatosensitive zone,

Spinal ganglion, anterior root, posterior root

Development of the spinal nerve

Page 62: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Nerve graft bridging the partial defect, suture

of perineurium without tension, wavy course of axons

in the peripheral nerve can not be eliminated

peripheral nerve, endoneurium, perineurium,

perineural epithelium, epineurium, denervation atrophy

Page 63: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Regeneration of interrupted axon

Page 64: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

General terms of angiology

Page 65: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Terms

of general angiology

Vascular development,

blood vessels,

structure of arteries, veins,

capillaries,

lymphatic vessel,

collateral circulation

collateral vessels,

arteriovenous anastomosis,

venous plexuses,

hepatic portal vein

Page 66: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Venous valves

Page 67: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Terms of general anatomy of lymphatic systemLymph, lymph node, lymph tissue in the organs, main

lymphatic trunks, lymphatic vessels and ducts

Page 68: General anatomy of skeletal muscle - Univerzita Karlovaanat.lf1.cuni.cz/souhrny/alekzs0401.pdf · General anatomy of skeletal muscle its innervation and blood supply ... curare blocks

Literature and sources of illustrations used:

Mescher: Junqueira´s Basic Histology 12th Edit., 2010

Sadler: Langman´s Medical Embryology, 11th Edit. 2009

Gilroy, MacPherson, Schuenke, Schulte, Schumacher: Atlas of

Anatomy, Thieme 3 ed. 2016

Platzer: Color Atlas and Textbook of Human Anatomy –

Vol.1 Locomotor System, Thieme 2008

Kahle, Frotscher: Color Atlas and Textbook of Human Anatomy – Vol.

3 Nervous System and Sensory Organs, Thieme 2010

Stingl, Grim, Druga: Regional Anatomy, 2012

Netter: Atlas of Human Anatomy, Icon 2003

Sobotta: Atlas of Human Anatomy Vol.1+2, Williams and Wilkins 2000

Snell: Clinical Anatomy by systems, Lippincott Williams and Wilkins

Grim M, Naňka O, Helekal I: Atlas of Human Anatomy I, II , 2014,

2017

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Beware of muscle atrophy from inactivity

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