MSK Palpation exam study guide 3.docx

I’m Muscles Origin Insertion Action Innervation Erector spinae muscles (as a group): Arises by a broad tendon from the posterior part of the iliac crest, posterior surface of the sacrum, sacro-iliac ligaments, sacral and inferior lumbar spinous processes, and supraspinatous ligament Longissi...

I’m Muscles Origin Insertion Action Innervation Erector spinae muscles (as a group): Arises by a broad tendon from the posterior part of the iliac crest, posterior surface of the sacrum, sacro-iliac ligaments, sacral and inferior lumbar spinous processes, and supraspinatous ligament Longissimus: transverse processes in thoracic and cervical regions and to mastoid process of temporal bone Iliocostalis: angles of lower ribs, and cervical transverse processes Spinalis: spinous processes in the upper thoracis region and to cranium Acting bilaterally: extend vertebral column and head (eccentric contraction during flextion) Acting unilaterally: laterally flexes vertebral column Posterior Rami of spinal nerves Sternocleidomastoid: Medial 1/3 of clavicle Manubrium of sternum Mastoid process of temporal bone Lateral ½ of superior nuchal line of occipital bone Unilateral contraction: -Lateral flexion of head & neck -Contralateral rotation of head & neck Bilateral contraction: -Ext. Of head & upper neck -Flex. Of the lower neck -Elevation of sternum and clavicle (during forced inhalation) Spinal Accessory nerve Scalene Group: Anterior: TVP’s of C3-C6 Middle & Posterior: POsterior tubercles of TVP’s C5-C7 Anterior: 1st rib Middle: superior surface of 1st rib; posterior groove for subclavian artery Posterior: External border of 2nd rib Anterior: Flexes neck laterally; elevates 1st rib during forced inspiration Middle: Flexes neck laterally; elevates 1st rib during forced inspiration Posterior: Flexes neck laterally; elevates 2nd rib during forced inspiration Ventral Rami Temporalis: Temporal fossa and fascia -Coronoid process -Anterior border of ramus of mandible mastication Mandibular nerve Masseter: Zygomatic arch Lateral surface of ramus of mandible Elevation of jaw bone/bringing teeth together Mandibular nerve Rectus Abdominis: Pubic crest & symphysis pubis Xiphoid process Cartilages of ribs 5,6,7 Stabilizes the pelvis during walking, and depresses the ribs Intercostal nerves (T6-T12) External abdominal Oblique Muscle: External surfaces of lower 8 ribs -linea alba -pubic tubercle -Anterior half of iliac crest Flexes the trunk Assists in forced expiration Rotation of the trunk Intercostal nerves (T7-T12) Rhomboid Major & Minor: Major: SP’s of T2-T5 Minor: SP’s of C7 & T1 Major: Medial border of scapula inferior to spine Minor: Medial border of scapula at the root of the spine Elevates and adducts the scapula Rotates scapula downwards Stabilizes scapula Dorsal scapular Trapezius: External occipital protuberance, nuchal ligament, SP’s of T1-T12 Lateral 1/3 of clavicle, medial acromial margin, superior crest of spine of scapula, lateral apex of medial end of scapular spine Draws scapula medially, extension of head and neck Accessory nerve Latissimus Dorsi: Spinous process T7-L5 Crests of illium & sacrum Lowers four ribs (thoracolumbnar fascia) Floor of the inter-tubercular groove of the humerus Adducts and internally rotates the arm Thoracodorsal nerve Serratus Anterior: Upper nine ribs Anterior surface of medial border of scapula Protracts scapula, assists in upward rotation, stabilizes the scapula Long thoracic nerve (C5,6,7) Pectoralis Major: Clavicular head: medial half of clavicle Sternocostal head: sternum Cartilages of 1st to 7th ribs Lateral lip of intertubercular (bicipital) groove of humerus Adducts and medially rotates the humerus Lateral pectoral nerve Deltoid: Lateral clavicle Acromion Spine of scapula Deltoid tuberosity Abduction Stabilization of glenohumeral joint Axillary Subscapularis: Subscapular fossa Lesser tubercle of humerus Internally rotates the arm Upper and lower subscapularis nerve Supraspinatus: Supraspinatus fossa Greater tubercle of humerus Abduction of arm, stabilization of humerus in glenohumeral joint Suprascapular nerve Infraspinatus: Infraspinatus fossa Greater tubercle of humerus External rotation of humerus Suprascapular nerve Teres Major: Inferior lateral border of scapula Medial lip of intertubercular (bicipital) sulcus (groove) of humerus Adduction of the humerus Internal rotation of the humerus Upper and lower subscapular nerve Teres Minor: The superior lateral border of scapula Greater tubercle of humerus Rotate the arm laterally (externally) Axillary Biceps Brachii: Coracoid process of scapula Supraglenoid tubercle of scapula Radial tuberosity & fascia of forearm via bicipital aponeurosis Flexion of arm Musculocutaneous nerve Triceps Brachii: -Infraglenoid tubercle -lateral, posterior humerus (superior to radial groove) -Posterior surface of humerus (inferior to radial groove Olecranon process of ulna Extension of arm Radial nerve Pronator teres: Common flexor tendon (Medial condylar ridge) Middle of the lateral surface of the radius Pronation of forearm Weak elbow flexion Median nerve Flexor carpi radialis: Common flexor tendon (medial epicondyle of humerus) Base of 2nd and 3rd metacarpals Flexion of wrist/hand Flexion of froearm Radial deviation Median nerve Flexor Carpi ulnaris: Humoral head: Common flexor tendon (medial epicondyle) Ulnar head: olecranon process of ulna, posterior border of ulna Base of 5th metacarpal Hook of hamate Pisiform Ulnar deviation Wrist flexion Ulnar Nerve Flexor digitorum superficialis: Humero-ulnar head: common flexor tendon (medial epidcondyle) -Coronoid process of ulna Base of middle phalanges of fingers 2-5 Metacarpophalangeal and proximal interphalangeal joint 2-5: finger flexion Median Nerve Extensor carpi radialis longus: Distal 1/3 of the supracondylar ridge of the humerus Base of 2nd metacarpal Extension of wrist Radial deviation Weak elbow flexion Radial Nerve Brachioradialis: Distal humerus Distal Radius Flex of elbow in mid pronation “beer drinking muscle” Radial Nerve Extensor digitorum: Common extensor tendon (lateral epicondyle) Distal & middle phalanges of fingers 2-5 via dorsal digital expansion Finger 2-5 extension Posterior interosseous nerve (extension of radial nerve) Abductor pollicis longus: Middle of posterior surface of radius, ulna and interosseous membrane Base of 1st metacarpal Abd. Of thumb Ext. Of thumb Hand ext. at radiocarpal J. Post interosseous N. (extension of radial nerve) Abductor pollicis brevis: Flexor retinaculum Tubercle of scaphoid Tubercle of trapezius Lateral side of base of proximal phalanx of the thumb Abduction of the thumb Median nerve Flexor pollicis brevis: Flexor retinaculum Trapezius Lateral side of base of proximal phalanx Flexion & medial rotation of the thumb Median nerve Dorsal Interossei: Adjacent sides of metacarpals Base of proximal phalanges and dorsal digital expansion of fingers (2,3,4) Abduction of fingers 2-4 Ulnar nerve Tensor Fascia Lata: Posterior ASIS ITB Medial rotation Abduction Flexion (All at hip joint) Superior gluteal nerve Sartorius: Anterior superior iliac spine (ASIS) Proximal part of medial surface of shaft of tibia (forms pes anserine tendon) Flexion of thigh Abduction of thing Lateral rotation of thigh Flex of leg Med rotation of leg @ knee Femoral nerve Biceps femoris: Ischial tuberosity Linea aspera of the femur Head of the fibula @ hip: thigh extension, external rotation @knee: leg flexion, leg external rotation, stabilizes pelvis Sciatic nerve Semitendinosus: Ischial tuberosity Proximal end of the tibia via pens anserine @ hip: extension, internal rotation, stabilizes pelvis @knee: flexion, internal rotation Sciatic nerve Rectus femoris: Anterior: AIIS Posterior head: Groove above the brim of acetabulum Base of patella via quadriceps tendon & tibial tuberosity via patellar ligament Ext of leg Flex of thigh Femoral nerve Vastus Medialis: Intertrochanteric line Medial lip of linea aspera Medial supracondylar line Medial border of patella via the qudriceps tendon & tibial tuberosity via patellar ligament Ext. Of leg Femoral Adductor muscles (as a group): Pectineus: Pectineal line of pubis Adductor longus: Anterior surface of pubis Adductor brevis: body & inferior ramus of pubis Adductor Magnus (4th hamstring): Ischiopubic ramus, ischial tuberosity Gracilis: body of pubis, inferior ramus of pubis Pectineus: Pectineal line of femur Adductor longus: Middle part of linea aspera Adductor brevis: Proximal 1/3 of linea aspera of femur Adductor magnus: Linea aspera, gluteal tuberosity, medial supracondylar line, adductor tubercle Gracilis: Proximal part of medial surface of shaft of tibia (pes anserine) Pectineus: @hip add. & flex. Adductor longus: @hip Add., flex, lat. rotation Adductor brevis: @ hip add, flex, lat rotation Adductor magnus: add, flex, ext, lat. Rotation Gracilis: add, flex of thigh, flex of leg, med. rotation Pectineus: Femoral N. Adductor Longus: Obturator N. Adductor brevis: Obturator N. Adductor magnus: Anterior head; Obturator N. Posterior head; Tibial N. Gracilis: Obturator N. Gastrocnemius: Medial condyle of femur Lateral condyle of femur Achilles tendon Plantar flex of foot Flex of leg Tibial nerve Joint: Type of joint: Actions: Shoulder: Synovial joint (ball & socket) Flexion Extension Medial/Lateral rotation Abduction Adduction circumduction Elbow: Synovial hinge joint Flexion extension Radiocarpal (wrist): Condyloid synovial Joint Flexion Extension Abduction Adduction First carpometacarpal: Saddle joint Flexion Extension Abduction adduction Metcarpophalangeal: Condyloid Joint Flexion Extension Abduction Adduction Proximal interphalangeal: synovial Hinge joint Flexion Extension Distal Interphalangeal: Synovial hinge joint Flexion extension Hip: Synovial ball & socket joint Flexion Extension Medial/Lateral rotation Abduction Adduction circumduction Knee: Hinge joint Flexion Extension