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Questions and Answers
What is the origin of the Gracilis muscle?
Which muscle primarily adducts and flexes the hip?
What action does the Gastrocnemius perform?
Where does the Pectineus muscle insert?
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Which nerve supplies the Adductor Minimus muscle?
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What is the referral pain location for the Soleus muscle?
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Which of the following muscles inserts at the posterior surface of the calcaneus via the Achilles tendon?
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What is the action of the Plantaris muscle?
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What is the origin of the Flexor Digitorum Superficialis?
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Which muscle is primarily responsible for flexing the thumb?
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Where does the Flexor Digitorum Profundus insert?
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Which nerve supplies the Flexor Pollicis Longus muscle?
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What action is performed by the Pronator Teres?
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Which muscle can refer pain to the palmar side of the wrist and fingers?
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Which nerve innervates the Flexor Digitorum Superficialis?
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Which origin corresponds to the Palmaris Longus muscle?
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What is the origin of the Biceps Brachii long head?
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Which action is NOT performed by the Pectoralis Major?
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Where does the Brachialis muscle insert?
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What is the main nerve supply for the Biceps Brachii?
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Which muscle's trigger point referral pain extends to the lateral side of the elbow and down the forearm to the thumb?
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Which origin is shared by both the Brachioradialis and Extensor Carpi Radialis Longus?
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What is the main action of the Brachialis muscle?
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What is the trigger point referral pain for the Pectoralis Major?
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Which muscle primarily extends the big toe and dorsiflexes the foot?
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What is the main action of the Flexor Hallucis Longus?
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Which nerve supplies the Extensor Hallucis Longus muscle?
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Where does the Flexor Digitorum Longus insert?
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What pain referral area is associated with the Flexor Digitorum Longus?
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Which muscle is responsible for the extension and abduction of the wrist?
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What is the trigger point referral pain location for the Extensor Carpi Ulnaris?
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Which nerve supplies the Extensor Digitorum?
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Which of the following muscles is responsible for extending the little finger?
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Which muscle originates at the lateral epicondyle of the humerus and extends the index finger?
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The Flexor Carpi Radialis has its origin at which location?
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Which of the following actions does the Flexor Carpi Ulnaris perform?
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Which muscle inserts at the extensor expansions of the medial four digits?
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What is the nerve supply for the Flexor Carpi Ulnaris?
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Which muscle's main action is to extend and abduct the wrist?
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What is the nerve supply for the Brachialis muscle?
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Which muscle's primary action includes both flexing the elbow and supinating the forearm?
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What is the main referral pain location for the Brachioradialis muscle?
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What is the origin of the Short head of the Biceps Brachii?
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Which of the following muscles extends the humerus from a flexed position?
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Which muscle's insertion is at the base of the second metacarpal?
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Which trigger point referral pain extends to the anterior elbow and down to the base of the thumb?
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Which muscle primarily adducts and medially rotates the humerus?
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What is the primary action of the gluteus medius muscle?
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Which nerve supplies the adductor longus muscle?
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What is the insertion point for the gluteus minimus muscle?
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Which action is NOT performed by the adductor magnus?
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Where does the gluteus maximus muscle primarily refer pain?
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What is the main nerve supply for the gluteus medius?
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Which muscle primarily adducts and medially rotates the hip?
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Which of the following is the origin of the adductor brevis?
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What type of pain can be referred from the gluteus minimus?
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Which part of the adductor magnus is responsible for extending the hip?
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What is the main action of the posterior scalene muscle?
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Which nerve innervates the masseter muscle?
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What is the referral pain location for the temporalis muscle?
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What is the origin of the rectus femoris muscle?
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Which of the following muscles primarily elevates the mandible?
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What is the main action of the quadriceps femoris group?
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What nerve supplies the upper portion of the scalene muscles?
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Where does the vastus lateralis muscle insert?
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Which muscle is responsible for closing the jaw?
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What is the trigger point referral pain for the rectus femoris muscle?
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Which muscle is responsible for flexing the distal phalanges at the distal interphalangeal joints?
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What is the nerve supply for the medial part of the Flexor Digitorum Profundus?
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Which muscle's trigger point referral pain is noted to affect the forearm and wrist, potentially impacting the thumb and index finger?
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Which muscle acts on the middle phalanges at the proximal interphalangeal joints?
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What is the main action of the Palmaris Longus muscle?
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Which of the following muscles originates from both the medial epicondyle of the humerus and the coronoid process of the ulna?
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Which insertion corresponds to the Flexor Digitorum Superficialis?
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What is the common referral pain area for both Flexor Digitorum Profundus and Flexor Digitorum Superficialis muscles?
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Which muscle has its origin at the inferior ramus of the pubis?
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What action is primarily performed by the Gracilis muscle?
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Which nerve primarily supplies the Pectineus muscle?
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Which of the following muscles is responsible for weakly assisting in plantarflexion of the foot?
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Where does the Gastrocnemius muscle insert?
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Which structure can refer pain to the back of the knee and calf?
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What main action is associated with the Soleus muscle?
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Which muscle originates from the lateral supracondylar line of the femur?
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Which muscle is innervated by the obturator nerve?
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Which trigger point referral pain is associated with the Gracilis muscle?
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What is the primary action of the Tibialis Anterior muscle?
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Which nerve supplies the Peroneus Longus muscle?
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Where does the Tibialis Posterior muscle insert?
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What common area does trigger point referral pain from the Extensor Digitorum Longus affect?
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Which muscle's main action is to unlock the knee?
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Which muscle elevates the scapula?
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Which muscle's primary action includes retracting the scapula?
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What is the nerve supply for the Rhomboid Minor?
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Which of the following muscles stabilizes the scapula by drawing it inferiorly?
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Which muscle originates from the external occipital protuberance?
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What action does the Latissimus Dorsi primarily perform?
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Which of the following is a referral pain location for the Latissimus Dorsi?
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What is the main action of the Rhomboid Major?
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What is the common nerve supply for the Rhomboid Major and Minor?
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Which muscle rotates the scapula to depress the glenoid cavity?
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Which muscle elevates the first rib and flexes the neck?
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Which muscle's trigger point referral pain can extend down the arm to the thumb?
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What is the main action of the Temporalis muscle?
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Which nerve supplies the masseter muscle?
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Where does the rectus femoris muscle insert?
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Which action does the posterior scalene NOT perform?
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What is the nerve supply for the quadriceps femoris group?
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Pain referral from which muscle can extend to the temples and side of the head?
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Which muscle primarily extends the knee?
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Which muscle is associated with pain referral to the upper chest and shoulder?
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What is the main action of the Tibialis Posterior muscle?
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Which nerve supplies the Peroneus Longus muscle?
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What is the referral pain location for the Extensor Digitorum Longus muscle?
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Which muscle originates at the head and upper two-thirds of the lateral surface of the fibula?
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Which of the following muscles is primarily responsible for unlocking the knee joint?
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Which muscle primarily extends the little finger?
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What is the primary nerve supply for the Extensor Carpi Ulnaris muscle?
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Which muscle's action includes both flexing and abducting the wrist?
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From which location does the Flexor Carpi Ulnaris originate?
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What is the referred pain location for the Extensor Carpi Ulnaris?
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Which muscle is responsible for extending the index finger?
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Which muscle extends and adducts the wrist?
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Which nerve supplies the Extensor Digitorum?
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Which muscle's main action includes both adduction and medial rotation of the humerus?
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What action is primarily performed by the posterior deltoid?
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Which of the following muscles originates from the acromion of the scapula?
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What is the nerve supply for the Teres Minor?
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Which muscle is responsible for abducting the arm during the first 15 degrees?
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Pain from the Teres Minor can be referred to which area?
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Which deltoid muscle primarily contributes to flexing and medially rotating the arm?
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Which muscle assists in holding the head of the humerus in the glenoid cavity?
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What is the main action of the Infraspinatus muscle?
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Which muscle's trigger point referral pain extends to the anterior shoulder and down the lateral arm?
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What is the primary nerve supply for the gluteus maximus muscle?
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Which action is performed by the gluteus medius muscle?
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What is the common referral pain area for the gluteus minimus?
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The adductor part of the adductor magnus muscle is primarily responsible for which action?
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Which of the following muscles does NOT share a common nerve supply?
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From which anatomical location does the adductor longus muscle originate?
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Which muscle primarily extends and laterally rotates the hip?
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The adductor brevis muscle has its insertion where?
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What is the trigger point referral pain location for the adductor longus muscle?
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Which of the following muscles originates between the anterior and inferior gluteal lines?
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What action is primarily performed by the upper fibers of the trapezius muscle?
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Which nerve is responsible for the innervation of the latissimus dorsi muscle?
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Which muscle is responsible for stabilizing the scapula by drawing it inferiorly and anteriorly against the thoracic wall?
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What is the origin of the rhomboid major muscle?
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Which of the following actions does NOT involve the rotator function of the scapula?
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What pain referral area is primarily associated with the levator scapulae muscle?
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Which muscle is responsible for the medial rotation of the humerus?
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Which of the following statements about the rhomboid muscles is true?
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What is the primary anatomical distinction between rhomboid major and rhomboid minor?
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What action does the middle fibers of the trapezius perform?
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Study Notes
Pectoralis Major
- Origin: Medial half of the clavicle (clavicular head) and sternum and upper six costal cartilages (sternocostal head).
- Insertion: Lateral lip of the bicipital groove of the humerus.
- Main Action: Adducts and medially rotates the humerus; clavicular head flexes, and sternocostal head extends the humerus from flexed position.
- Nerve Supply: Medial and lateral pectoral nerves (C5-C8, T1).
- Trigger Point Referral Pain: Anterior shoulder, inner arm to elbow, and sometimes to chest.
Biceps Brachii
- Origin: Short head from coracoid process, long head from supraglenoid tubercle of the scapula.
- Insertion: Radial tuberosity and bicipital aponeurosis.
- Main Action: Flexes elbow, supinates forearm, and flexes shoulder (long head).
- Nerve Supply: Musculocutaneous nerve (C5, C6).
- Trigger Point Referral Pain: Anterior shoulder and front of arm, sometimes extending to forearm.
Forearm Group
Brachialis
- Origin: Distal half of the anterior surface of the humerus.
- Insertion: Coronoid process and tuberosity of the ulna.
- Main Action: Flexes the elbow.
- Nerve Supply: Musculocutaneous nerve (C5, C6) and radial nerve (C7).
- Trigger Point Referral Pain: Anterior elbow and base of the thumb.
Brachioradialis
- Origin: Lateral supracondylar ridge of the humerus.
- Insertion: Styloid process of the radius.
- Main Action: Flexes the elbow, especially in mid-pronation.
- Nerve Supply: Radial nerve (C5, C6, C7).
- Trigger Point Referral Pain: Lateral side of elbow and forearm to the thumb.
Extensor Carpi Radialis Longus
- Origin: Lateral supracondylar ridge of the humerus.
- Insertion: Base of the second metacarpal.
- Main Action: Extends and abducts the wrist.
- Nerve Supply: Radial nerve (C6, C7).
- Trigger Point Referral Pain: Lateral elbow and forearm.
Lower Leg Group
Gastrocnemius
- Origin: Medial head from medial condyle of femur, lateral head from lateral condyle of femur.
- Insertion: Posterior surface of calcaneus via Achilles tendon.
- Main Action: Plantarflexes foot at ankle and flexes knee.
- Nerve Supply: Tibial nerve (S1, S2).
- Trigger Point Referral Pain: Calf and back of the knee.
Soleus
- Origin: Posterior surface of head of fibula and soleal line of tibia.
- Insertion: Posterior surface of calcaneus via Achilles tendon.
- Main Action: Plantarflexes the foot at the ankle.
- Nerve Supply: Tibial nerve (S1, S2).
- Trigger Point Referral Pain: Calf, heel, and sometimes sole of the foot.
Additional Muscles
Flexor Digitorum Superficialis
- Origin: Medial epicondyle of humerus and coronoid process of ulna (humeroulnar head), anterior surface of radius (radial head).
- Insertion: Middle phalanges of the medial four digits.
- Main Action: Flexes middle phalanges at proximal interphalangeal joints.
- Nerve Supply: Median nerve (C7, C8, T1).
- Trigger Point Referral Pain: Palmar side of wrist and fingers.
Flexor Pollicis Longus
- Origin: Anterior surface of the radius and interosseous membrane.
- Insertion: Base of distal phalanx of the thumb.
- Main Action: Flexes the thumb.
- Nerve Supply: Anterior interosseous branch of median nerve (C8, T1).
- Trigger Point Referral Pain: Thumb and thenar eminence.
Pronator Teres
- Origin: Humeral head from medial epicondyle of humerus, ulnar head from coronoid process of ulna.
- Insertion: Lateral surface of the radius.
- Main Action: Pronates forearm and assists in flexion of the elbow.
- Nerve Supply: Median nerve (C6, C7).
- Trigger Point Referral Pain: Forearm and wrist, sometimes thumb and index finger.
Trigger Point Referral Pain
- Pain is often referred to the anterior shoulder, chest, and inner arm, indicating muscle tension or trigger points.
Pectoralis Major
- Origin: Clavicular head originates from the medial half of the clavicle; sternocostal head from the sternum and upper six costal cartilages.
- Insertion: Lateral lip of the bicipital groove of the humerus.
- Main Action: Adducts and medially rotates the humerus; the clavicular head flexes and the sternocostal head extends the humerus.
- Nerve Supply: Medial and lateral pectoral nerves (C5-C8, T1).
- Trigger Point Referral Pain: Felt in the anterior shoulder, inner arm to the elbow, and sometimes the chest.
Biceps Brachii
- Origin: Short head from the coracoid process; long head from the supraglenoid tubercle of the scapula.
- Insertion: Radial tuberosity and bicipital aponeurosis.
- Main Action: Flexes the elbow, supinates the forearm, and flexes the shoulder (long head).
- Nerve Supply: Musculocutaneous nerve (C5, C6).
- Trigger Point Referral Pain: Felt in the anterior shoulder and down the front of the arm.
Forearm Group Muscles
Brachialis
- Origin: Distal half of the anterior surface of the humerus.
- Insertion: Coronoid process and tuberosity of the ulna.
- Main Action: Flexes the elbow.
- Nerve Supply: Musculocutaneous nerve (C5, C6) and radial nerve (C7).
- Trigger Point Referral Pain: Can refer pain to the anterior elbow and base of the thumb.
Brachioradialis
- Origin: Lateral supracondylar ridge of the humerus.
- Insertion: Styloid process of the radius.
- Main Action: Flexes the elbow in a mid-pronated position.
- Nerve Supply: Radial nerve (C5, C6, C7).
- Trigger Point Referral Pain: Refers pain to the lateral elbow and down the forearm to the thumb.
Extensor Carpi Radialis Longus
- Origin: Lateral supracondylar ridge of the humerus.
- Insertion: Base of the second metacarpal.
- Main Action: Extends and abducts the wrist.
- Nerve Supply: Radial nerve (C6, C7).
- Trigger Point Referral Pain: Refers pain to the lateral elbow and forearm.
Extensor Digitorum
- Origin: Lateral epicondyle of the humerus.
- Insertion: Extensor expansions of the medial four digits.
- Main Action: Extends fingers and wrist.
- Nerve Supply: Posterior interosseous nerve (C7, C8).
- Trigger Point Referral Pain: Can refer pain to the back of the hand and forearm.
Extensor Digiti Minimi
- Origin: Lateral epicondyle of the humerus.
- Insertion: Extensor expansion of the fifth digit.
- Main Action: Extends the little finger.
- Nerve Supply: Posterior interosseous nerve (C7, C8).
- Trigger Point Referral Pain: Refers pain to the back of the hand and forearm.
Extensor Carpi Ulnaris
- Origin: Lateral epicondyle of the humerus and posterior border of the ulna.
- Insertion: Base of the fifth metacarpal.
- Main Action: Extends and adducts the wrist.
- Nerve Supply: Posterior interosseous nerve (C7, C8).
- Trigger Point Referral Pain: Refers to ulnar side of the forearm and wrist.
Forearm Flexors
Flexor Carpi Radialis
- Origin: Medial epicondyle of the humerus.
- Insertion: Base of the second and third metacarpals.
- Main Action: Flexes and abducts the wrist.
- Nerve Supply: Median nerve (C6, C7).
- Trigger Point Referral Pain: Can refer pain to the palmar side of the wrist and forearm.
Flexor Carpi Ulnaris
- Origin: Humeral head from medial epicondyle, ulnar head from olecranon and posterior border of the ulna.
- Insertion: Pisiform, hook of the hamate, base of the fifth metacarpal.
- Main Action: Flexes and adducts the wrist.
- Nerve Supply: Ulnar nerve (C7, C8).
- Trigger Point Referral Pain: Can refer pain to the upper chest, shoulder, and down the arm to the thumb.
Masseter
- Origin: Superficial part from zygomatic process of the maxilla; deep part from posterior third of the zygomatic arch.
- Insertion: Angle and ramus of the mandible.
- Main Action: Elevates the mandible (closes the jaw).
- Nerve Supply: Mandibular nerve (V3 branch of the trigeminal nerve).
- Trigger Point Referral Pain: Pain refers to the jaw, teeth, above the eye, and ear.
Temporalis
- Origin: Temporal fossa and fascia.
- Insertion: Coronoid process and anterior border of the ramus of the mandible.
- Main Action: Elevates and retracts the mandible (closes the jaw).
- Nerve Supply: Mandibular nerve (V3 branch of the trigeminal nerve).
- Trigger Point Referral Pain: Pain can be referred to the temples, teeth, eyebrow area, and side of the head.
Quadriceps Femoris Group
Rectus Femoris
- Origin: Anterior inferior iliac spine (AIIS) and ilium above the acetabulum.
- Insertion: Patella and tibial tuberosity via the patellar ligament.
- Main Action: Extends the knee and flexes the hip.
- Nerve Supply: Femoral nerve (L2, L3, L4).
- Trigger Point Referral Pain: Can refer pain to the front of the thigh and knee.
Vastus Lateralis
- Origin: Greater trochanter and lateral lip of the linea aspera.
- Insertion: Iliotibial tract (IT band) and gluteal tuberosity of the femur.
- Main Action: Extends and laterally rotates the hip.
- Nerve Supply: Inferior gluteal nerve (L5, S1, S2).
- Trigger Point Referral Pain: Pain can refer to the buttocks, sacrum, and lateral thigh.
Gluteus Medius
- Origin: External surface of the ilium between the anterior and posterior gluteal lines.
- Insertion: Lateral surface of the greater trochanter of the femur.
- Main Action: Abducts and medially rotates the hip.
- Nerve Supply: Superior gluteal nerve (L4, L5, S1).
- Trigger Point Referral Pain: Pain may refer to the lateral hip and lower back.
Adductor Muscles
Adductor Longus
- Origin: Body of the pubis.
- Insertion: Middle third of the linea aspera of the femur.
- Main Action: Adducts and medially rotates the hip.
- Nerve Supply: Obturator nerve (L2, L3, L4).
- Trigger Point Referral Pain: Can refer pain to the medial thigh and groin.
Adductor Brevis
- Origin: Body and inferior ramus of the pubis.
- Insertion: Pectineal line and proximal part of the linea aspera of the femur.
- Main Action: Adducts and medially rotates the hip.
- Nerve Supply: Obturator nerve (L2, L3, L4).
- Trigger Point Referral Pain: Can refer to the medial thigh and groin.
Adductor Magnus
- Origin: Inferior ramus of the pubis, ischial ramus, and ischial tuberosity.
- Insertion: Linea aspera and adductor tubercle of the femur.
- Main Action: Adductor part adducts and medially rotates the hip; hamstring part extends the hip.
- Nerve Supply: Obturator nerve (L2, L3, L4) and tibial part of sciatic nerve (L4).
Flexor and Extensor Muscles of the Lower Leg
Extensor Hallucis Longus
- Origin: Middle part of the anterior surface of the fibula and interosseous membrane.
- Insertion: Base of the distal phalan
Muscular Anatomy and Referral Pain
Flexor Digitorum Superficialis
- Origin: Humeroulnar head from medial epicondyle of the humerus, radial head from anterior surface of the radius.
- Insertion: Middle phalanges of the medial four digits.
- Main Action: Flexes middle phalanges at proximal interphalangeal joints.
- Nerve Supply: Median nerve (C7, C8, T1).
- Trigger Point Referral Pain: Pain can be felt on the palmar side of the wrist and fingers.
Flexor Digitorum Profundus
- Origin: Anterior and medial surfaces of the ulna and interosseous membrane.
- Insertion: Distal phalanges of the medial four digits.
- Main Action: Flexes distal phalanges at distal interphalangeal joints.
- Nerve Supply: Medial part - ulnar nerve (C8, T1); Lateral part - anterior interosseous branch of median nerve (C8, T1).
- Trigger Point Referral Pain: Pain can be experienced on the palmar side of the wrist and fingers.
Flexor Pollicis Longus
- Origin: Anterior surface of the radius and interosseous membrane.
- Insertion: Base of the distal phalanx of the thumb.
- Main Action: Flexes the thumb.
- Nerve Supply: Anterior interosseous branch of the median nerve (C8, T1).
- Trigger Point Referral Pain: Pain may radiate to the thumb and thenar eminence.
Palmaris Longus
- Origin: Medial epicondyle of the humerus.
- Insertion: Palmar aponeurosis and flexor retinaculum.
- Main Action: Flexes the wrist and tenses the palmar aponeurosis.
- Nerve Supply: Median nerve (C7, C8).
- Trigger Point Referral Pain: Pain can be referred to the palmar side of the wrist and forearm.
Pronator Teres
- Origin: Humeral head from medial epicondyle of the humerus; ulnar head from coronoid process of the ulna.
- Insertion: Lateral surface of the radius.
- Main Action: Pronates the forearm and assists in elbow flexion.
- Nerve Supply: Median nerve (C6, C7).
- Trigger Point Referral Pain: Pain can be referred to the forearm and wrist, sometimes including the thumb and index finger.
Back Muscles Overview
Trapezius
- Origin: External occipital protuberance, nuchal ligament, spinous processes of C7-T12.
- Insertion: Lateral third of the clavicle, acromion, and spine of the scapula.
- Main Action: Elevates, retracts, and rotates the scapula.
- Nerve Supply: Accessory nerve (CN XI), cervical spinal nerves (C3 and C4).
- Trigger Point Referral Pain: Pain can be felt in the neck, shoulders, temple, and jaw.
Latissimus Dorsi
- Origin: Spinous processes of T7-T12, thoracolumbar fascia, iliac crest, inferior three or four ribs.
- Insertion: Floor of the intertubercular groove of the humerus.
- Main Action: Extends, adducts, and medially rotates the humerus, raises body during climbing.
- Nerve Supply: Thoracodorsal nerve (C6-C8).
Rhomboid Major
- Origin: Spinous processes of T2-T5.
- Insertion: Medial border of the scapula from spine to inferior angle.
- Main Action: Retracts and rotates the scapula to depress the glenoid cavity.
- Nerve Supply: Dorsal scapular nerve (C4, C5).
- Trigger Point Referral Pain: Pain may be referred to the medial border of the scapula and upper back.
Rhomboid Minor
- Origin: Spinous processes of C7-T1.
- Insertion: Medial border of the scapula at spine level.
- Main Action: Similar to rhomboid major.
- Nerve Supply: Dorsal scapular nerve (C4, C5).
- Trigger Point Referral Pain: Pain can be referred to the medial border of the scapula and upper back.
Levator Scapulae
- Origin: Transverse processes of C1-C4.
- Insertion: Medial border of scapula between superior angle and spine.
- Main Action: Elevates the scapula and rotates to depress the glenoid cavity.
- Nerve Supply: Dorsal scapular nerve (C5), cervical nerves (C3, C4).
- Trigger Point Referral Pain: Pain may radiate to the medial border of the scapula, neck, and shoulder.
Pectoralis Minor
- Origin: Anterior surfaces of ribs 3-5.
- Insertion: Coracoid process of the scapula.
- Main Action: Stabilizes scapula by drawing it inferiorly and anteriorly.
- Nerve Supply: Medial pectoral nerve (C8, T1).
- Trigger Point Referral Pain: Pain can be experienced in the upper chest, shoulder, and down the arm to the thumb.
Muscles of Upper and Lower Leg
Quadriceps Femoris Group
-
Rectus Femoris:
- Origin: Anterior inferior iliac spine (AIIS), ilium above acetabulum.
- Insertion: Patella and tibial tuberosity via patellar ligament.
- Main Action: Extends knee and flexes hip.
- Nerve Supply: Femoral nerve (L2, L3, L4).
- Trigger Point Referral Pain: Pain can be felt in the front of the thigh and knee.
-
Vastus Lateralis:
- Origin: Greater trochanter and lateral lip of linea aspera.
- Trigger Point Referral Pain: Pain may be referred to the medial thigh and groin.
Adductor Minimus
- Origin: Inferior ramus of the pubis.
- Insertion: Proximal part of the linea aspera of the femur.
- Main Action: Adducts and medially rotates the hip.
- Nerve Supply: Obturator nerve (L2, L3, L4).
- Trigger Point Referral Pain: Pain can be referred to the medial thigh and groin.
Pectineus
- Origin: Superior ramus of the pubis.
- Insertion: Pectineal line of the femur.
- Main Action: Adducts and flexes the hip.
- Nerve Supply: Femoral nerve (L2, L3) and occasionally obturator nerve (L2, L3).
- Trigger Point Referral Pain: Pain may radiate to the groin and upper medial thigh.
Gracilis
- Origin: Body and inferior ramus of the pubis.
- Insertion: Medial surface of the tibia (pes anserinus).
- Main Action: Adducts the hip and flexes the knee.
Lower Leg Muscles
Gastrocnemius
- Origin: Medial head from medial condyle of the femur; lateral head from lateral condyle of the femur.
- Insertion: Posterior surface of the calcaneus via Achilles tendon.
- Main Action: Plantarflexes foot at ankle and flexes the knee.
- Nerve Supply: Tibial nerve (S1, S2).
- Trigger Point Referral Pain: Pain can be referred to the calf and back of the knee.
Soleus
- Origin: Posterior surface of the head of the fibula, soleal line of the tibia.
- Insertion: Posterior surface of the calcaneus via Achilles tendon.
- Main Action: Primarily plantarflexes the foot.
- Nerve Supply: Tibial nerve (S1, S2).
- Trigger Point Referral Pain: Pain can radiate to the calf, heel, and sometimes the sole of the foot.
Plantaris
- Origin: Lateral supracondylar line of the femur.
- Insertion: Posterior surface of the calcaneus via Achilles tendon.
- Main Action: Weakly assists in plantarflexion of the foot and flexion of the knee.
- Nerve Supply: Tibial nerve (S1, S2).
- Trigger Point Referral Pain: Pain may refer to the back of the knee and calf.
Popliteus
- Origin: Lateral condyle of the femur, lateral meniscus.
- Insertion: Posterior surface of the tibia above the soleal line.
- Main Action: Medially rotates tibia to unlock the knee and flexes
Forearm Extensors
- Extensor Carpi Radialis Longus: Extends and abducts the wrist; supplied by the radial nerve (C6, C7). Pain may refer to the lateral elbow and forearm.
- Extensor Digitorum: Extends the fingers and wrist; innervated by the posterior interosseous nerve (C7, C8). Referral pain occurs in the back of the hand and forearm.
- Extensor Digiti Minimi: Specifically extends the little finger; also supplied by the posterior interosseous nerve (C7, C8). Referral pain is similar to that of the extensor digitorum.
- Extensor Carpi Ulnaris: Extends and adducts the wrist; innervated by the posterior interosseous nerve (C7, C8). Pain may refer to the ulnar side of the forearm and wrist.
- Extensor Indicis: Extends the index finger; supplied by the posterior interosseous nerve (C7, C8). Referral pain can be noted in the back of the hand and forearm.
Forearm Flexors
- Flexor Carpi Radialis: Flexes and abducts the wrist; innervated by the median nerve (C6, C7). Referral pain can occur on the palmar side of the wrist and forearm.
- Flexor Carpi Ulnaris: Flexes and adducts the wrist; innervated by the ulnar nerve (C7, C8). Pain may refer to the ulnar side of the wrist and forearm.
Shoulder Muscles
- Anterior Deltoid: Flexes and medially rotates the arm; innervated by the axillary nerve (C5, C6). Referral pain may be felt in the lateral shoulder and upper arm.
- Medial Deltoid: Abducts the arm; also supplied by the axillary nerve (C5, C6). Referral pain is similar to the anterior deltoid.
- Posterior Deltoid: Extends and laterally rotates the arm; innervated by the axillary nerve (C5, C6). Pain may be referred to the lateral shoulder and upper arm.
- Teres Major: Adducts and medially rotates the humerus; innervated by the lower subscapular nerve (C5, C6). Referral pain can be felt in the lateral shoulder.
- Teres Minor: Laterally rotates and assists in adduction of the arm; innervated by the axillary nerve (C5, C6). Pain may refer to the posterior shoulder and down the lateral arm.
- Subscapularis: Medially rotates the arm and stabilizes the shoulder; innervated by upper and lower subscapular nerves (C5, C6, C7). Pain can be referred to the posterior shoulder and down the back of the arm.
- Supraspinatus: Abducts the arm in the first 15 degrees; innervated by the suprascapular nerve (C5, C6). Referral pain can occur in the lateral shoulder.
- Infraspinatus: Laterally rotates the arm; also supplied by the suprascapular nerve (C5, C6). Pain may refer to the anterior shoulder and down the lateral arm.
Back Muscles
- Trapezius: Elevates, retracts, and rotates the scapula; innervated by accessory nerve (CN XI) and cervical spinal nerves (C3, C4). Pain may refer to the neck, shoulders, and even the temple.
- Latissimus Dorsi: Extends, adducts, and medially rotates the humerus; supplied by the thoracodorsal nerve (C6-C8). Referral pain often occurs in the lower back.
- Rhomboid Major and Minor: Retract and rotate the scapula; both innervated by the dorsal scapular nerve (C4, C5). Pain may refer to the medial border of the scapula and upper back.
- Levator Scapulae: Elevates the scapula; innervated by the dorsal scapular nerve (C5) and cervical nerves (C3, C4). Pain may refer to the neck and medial border of the scapula.
Hip Muscles
- Gluteus Maximus: Extends and laterally rotates the hip; innervated by the inferior gluteal nerve (L5, S1, S2). Pain can refer to the buttocks and lateral thigh.
- Gluteus Medius: Abducts and medially rotates the hip; supplied by the superior gluteal nerve (L4, L5, S1). Pain may refer to the lateral hip.
- Gluteus Minimus: Similar actions as gluteus medius; innervated by the superior gluteal nerve (L4, L5, S1). Referral pain can occur in the lateral hip and leg.
Adductor Muscles
- Adductor Longus: Adducts and medially rotates the hip; supplied by the obturator nerve (L2, L3, L4). Pain may refer to the medial thigh and groin.
- Adductor Brevis: Functions similarly to adductor longus; innervated by the obturator nerve (L2, L3, L4). Referral pain occurs in the medial thigh and groin.
- Adductor Magnus: Has both adductor and hamstring parts; the adductor part is innervated by the obturator nerve, while the hamstring part is supplied by the tibial part of the sciatic nerve. Pain can refer to the medial thigh.
Lower Leg Muscles
- Peroneus Longus and Brevis: Both everts and plantarflex the foot; innervated by the superficial fibular nerve (L5, S1, S2). Pain may refer to the lateral leg and foot or lateral foot and ankle respectively.
- Tibialis Anterior: Dorsiflexes and inverts the foot; supplied by the deep fibular nerve (L4, L5). Pain may refer to the front of the ankle and big toe.
- Tibialis Posterior: Plantarflexes and inverts the foot; innervated by the tibial nerve (L4, L5). Pain may refer to the arch of the foot and back of the ankle.
- Extensor Digitorum Longus: Extends toes and dorsiflexes the foot; innervated by the deep fibular nerve (L5, S1). Pain can be referred to the top of the foot and toes.
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Description
This quiz covers the anatomy and physiology of the Pectoralis Major muscle, including its origin, insertion, and main actions. Test your knowledge on trigger point referral pain and how it affects regions like the shoulder, chest, and arm.