Upper Extremity Muscle Table.pdf

Robert Frysztak, PhD. Structure of the Human Body Loyola University Chicago Stritch School of Medicine UPPER EXTREMITY MUSCLE TABLE MUSCLE PROXIMAL ATTACHMENT (ORIGIN) DISTAL ATTACHMENT (INSERTION) Flexor carpi radialis Medial epicondyle of humerus Flexor carpi ulnaris Humeral head: medial epicondyl...

Robert Frysztak, PhD. Structure of the Human Body Loyola University Chicago Stritch School of Medicine UPPER EXTREMITY MUSCLE TABLE MUSCLE PROXIMAL ATTACHMENT (ORIGIN) DISTAL ATTACHMENT (INSERTION) Flexor carpi radialis Medial epicondyle of humerus Flexor carpi ulnaris Humeral head: medial epicondyle of Pisiform bone, hook of hamate, base Ulnar nerve humerus Ulnar head: olecranon and of 5th metacarpal posterior border of ulna Flexor digitorum profundus Flexor digitorum superficialis Flexor pollicis longus Medial and anterior surface of proximal 3/4 of ulna and interosseous membrane Humero‐ulnar head: medial epicondyle of humerus and coronoid process of ulna Radial head: superior half of anterior radius Anterior surface of radius and interosseous membrane Palmaris longus Medial epicondyle of humerus Pronator quadratus Distal fourth of anterior ulna Pronator teres Anconeus Biceps brachii Brachialis Coracobrachialis Triceps brachii Abductor digiti minimi Abductor pollicis brevis Adductor pollicis Dorsal interosseous muscles Two heads: medial epicondyle of humerus and coronoid process of ulna Posterior surface of lateral epicondyle of humerus Long head: supraglenoid tubercle of scapula Short head: tip of coracoid process of scapula Distal half of anterior surface of humerus Tip of coracoid process of scapula Long head: infraglenoid tubercle of scapula Lateral head: upper half of posterior humerus Medial head: distal 2/3 of medial and posterior humerus Pisiform bone and tendon of flexor carpi ulnaris Flexor retinaculum, tubercles of scaphoid and trapezium Oblique head : bases of 2nd and 3rd metacarpals and capitate and adjacent bones Transverse head: anterior surface of 3rd metacarpal Adjacent sides of two metacarpal bones Base of 2nd metacarpal INNERVATION Palmar base of distal phalanges of medial four digits Median nerve Medial part: ulnar nerve Lateral part: median nerve Bodies of middle phalanges of medial Median nerve four digits Palmar base of distal phalanx of thumb Distal half of flexor retinaculum and palmar aponeurosis MAIN ACTIONS MUSCLE GROUP Flexes and abducts hand at wrist Radial artery Anterior forearm Flexes and adducts hand at wrist Posterior ulnar recurrent artery Anterior forearm Flexes distal phalanges of medial four Anterior interosseous artery, digits, assists with flexion of hand at muscular branches of ulnar artery wrist Anterior forearm Flexes middle and proximal phalanges of medial four digits, flexes Ulnar and radial arteries hand at wrist Anterior forearm Median nerve (anterior interosseous) Flexes phalanges of thumb Median nerve BLOOD SUPPLY Flexes hand at wrist and tenses palmar aponeurosis Anterior interosseous artery Anterior forearm Posterior ulnar recurrent artery Anterior forearm Anterior interosseous artery Anterior forearm Distal fourth of anterior radius Median nerve (anterior interosseous) Pronates forearm Midway along lateral surface of radius Median nerve Pronates forearm and assists with elbow flexion Anterior ulnar recurrent artery Anterior forearm Lateral surface of olecranon and posterior proximal ulna Radial nerve (C5–T1) Assists triceps in extending elbow, abducts ulna in pronation Deep brachial artery Arm Radial tuberosity, fascia of forearm via bicipital aponeurosis Musculocutaneous nerve (C5,C6) Flexes and supinates forearm at elbow Muscular branches of brachial artery Arm Musculocutaneous nerve and radial nerve (C7) Flexes forearm at elbow Radial recurrent artery, muscular branches of brachial artery Musculocutaneous nerve Flexes and adducts arm at shoulder Muscular branches of brachial artery Arm Radial nerve Extends forearm at elbow; long head stabilizes head of abducted humerus Branch of profunda brachii artery and extends and adducts arm at shoulder Arm Ulnar nerve (deep branch) Abducts little finger Deep palmar branch of ulnar artery Hand Median nerve (recurrent branch) Abducts thumb Superficial palmar branch of radial artery Hand Ulnar nerve (deep branch) Adducts thumb Deep palmar arch Hand Abduct digits from axial line of hand (3rd digit); flex digits at Deep palmar arch metacarpophalangeal joint and extend interphalangeal joints Hand Coronoid process and tuberosity of ulna Middle third of medial surface of humerus Posterior surface of olecranon process of ulna Medial side of base of proximal phalanx of little finger (5th digit) Lateral side of base of proximal phalanx of thumb Medial side of base of proximal phalanx of thumb Base of proximal phalanges, extensor Ulnar nerve (deep branch) expansion of digits 2–4 Arm 07/16/2015 Robert Frysztak, PhD. Structure of the Human Body Loyola University Chicago Stritch School of Medicine MUSCLE Flexor digiti minimi brevis Flexor pollicis brevis PROXIMAL ATTACHMENT (ORIGIN) Flexor retinaculum and hook of hamate bone Flexor retinaculum and tubercle of trapezium DISTAL ATTACHMENT (INSERTION) Medial side of base of proximal phalanx of little finger Lateral side of base of proximal phalanx of thumb INNERVATION Deep palmar branch of ulnar artery Hand Median nerve (recurrent branch) Flexes proximal phalanx of thumb Superficial palmar branch of radial artery Hand Superficial and deep palmar arches Hand Superficial and deep palmar arches Hand Deep palmar branch of ulnar artery Hand Superficial palmar branch of radial artery Hand Deep palmar arch Hand Lateral sides of extensor expansion of Median nerve (digital branches) digits 2 and 3 Lumbrical, third and fourth Medial three tendons of flexor digitorum profundus Lateral sides of extensor expansion of Ulnar nerve (deep branch) digits 4 and 5 Opponens pollicis Palmar interosseous muscles Palmaris brevis Pectoralis major Pectoralis minor Abductor pollicis longus Brachioradialis Extensor carpi radialis brevis Extensor carpi radialis longus Extensor carpi ulnaris Sides of metacarpals 2, 4, and 5 Palmar aponeurosis and flexor retinaculum Sternal half of clavicle, sternum to 7th rib, cartilages of true ribs, aponeurosis of external oblique muscle Palmar surface of 5th metacarpal Ulnar nerve (deep branch) Lateral side of 1st metacarpal Median nerve (recurrent branch) Bases of proximal phalanx and extensor expansion of digits 2, 4, and Ulnar nerve (deep branch) 5 Skin of medial border of palm Superficial palmar branch of ulnar nerve Lateral lip of intertubercular sulcus of Medial and lateral pectoral nerves humerus Outer surface of upper margin of ribs Coracoid process of scapula 3–5 Posterior surface of ulna, radius, and Base of 1st metacarpal interosseous membrane Proximal 2/3 of lateral supracondylar Lateral side of distal end of radius ridge of humerus Dorsal base of 3rd metacarpal and Lateral epicondyle of humerus slip to 2nd metacarpal Distal third of lateral supracondylar Dorsal base of 2nd metacarpal and ridge of humerus slip to 3rd metacarpal Lateral epicondyle of humerus and Dorsal base of 5th metacarpal posterior border of ulna Medial pectoral nerve Radial nerve (posterior interosseous) Radial nerve Extend digits at interphalangeal joints, flex metacarpophalangeal joints Extend digits at interphalangeal joints, flex metacarpophalangeal joints Draws 5th metacarpal anteriorly and rotates it to face thumb Draws 1st metacarpal forward and rotates it medially Adducts digits toward axial line of hand (3rd digit); flexes digits at metacarpophalngeal joint and extends interphalangeal joints Deepens hollow of hand, assists grip Superficial palmar arch Lowers lateral angle of scapula and protracts scapula Abducts and extends thumb at carpometacarpal joint Weak flexion of forearm when forearm is midpronated Radial artery, radial recurrent artery Posterior forearm Radial nerve (posterior interosseous) Extends and adducts hand at wrist Posterior interosseous artery Posterior forearm Posterior interosseous artery Posterior forearm Posterior interosseous artery Posterior forearm Posterior interosseous artery Posterior forearm Posterior interosseous artery Posterior forearm Posterior interosseous artery Posterior forearm Radial recurrent artery, posterior interosseous arteries Posterior forearm Extensor expansions of medial four digits Extends medial four digits, assists in wrist extension Extends 2nd digit and helps extend Radial nerve (posterior interosseous) hand at wrist Extends proximal phalanx of thumb Radial nerve (posterior interosseous) at carpometacarpal joint Extends distal phalanx of thumb at Radial nerve (posterior interosseous) interphalangeal and metacarpophalangeal joints Posterior surface of middle third of ulna, interosseous membrane Dorsal base of distal phalanx of thumb Supinator Lateral epicondyle of humerus, supinator crest of ulna Lateral, posterior, and anterior surfaces of proximal third of radius Posterior forearm Extends and abducts hand at wrist Lateral epicondyle of humerus Extensor pollicis longus Radial recurrent artery Radial nerve Extensor digitorum Dorsal base of proximal phalanx of thumb Posterior forearm Radial artery, radial recurrent artery Posterior forearm Radial nerve (posterior interosseous) Extends 5th digit Extensor pollicis brevis Posterior interosseous artery Extends and abducts hand at wrist Extensor expansion of 5th digit Extensor expansion of 2nd digit Pectoral branch of thoraco‐acromial and intercostal lateral thoracic Pectoral region/axilla arteries Radial nerve (deep branch) Lateral epicondyle of humerus Extensor indicis Hand Pectoral branch of thoraco‐acromial Flexes and adducts arm, rotates arm artery, perforating branches of Pectoral region/ axilla medially internal thoracic artery Extensor digiti minimi Posterior surface of ulna and interosseous membrane Posterior surface of radius and interosseous membrane MUSCLE GROUP Flexes proximal phalanx of little finger Lateral two tendons of flexor digitorum profundus Flexor retinaculum and hook of hamate bone Flexor retinaculum and tubercle of trapezium BLOOD SUPPLY Ulnar nerve (deep branch) Lumbrical, first and second Opponens digiti minimi MAIN ACTIONS Radial nerve (posterior interosseous) Radial nerve (deep branch) Supinates forearm 07/16/2015 Robert Frysztak, PhD. Structure of the Human Body Loyola University Chicago Stritch School of Medicine MUSCLE PROXIMAL ATTACHMENT (ORIGIN) DISTAL ATTACHMENT (INSERTION) INNERVATION MAIN ACTIONS BLOOD SUPPLY MUSCLE GROUP Deltoid Lateral third of anterior clavicle, lateral acromion, inferior edge of spine of scapula Deltoid tuberosity of humerus Axillary nerve Clavicular part : flexes and medially rotates arm Acromial part: abducts arm beyond initial 15 degrees done by supraspinatus Spinal part: extends and laterally rotates arm Infraspinatus Infraspinous fossa of scapula and deep fascia Middle facet of greater tubercle of humerus Suprascapular nerve Lateral rotation of arm (with teres minor) Suprascapular artery Shoulder Thoracodorsal nerve Extends, adducts, and medially rotates humerus at shoulder Thoracodorsal artery, dorsal perforating branches of 9th, 10th, and 11th posterior intercostal, subcostal, and first three lumbar arteries Shoulder Long thoracic nerve Protracts and rotates scapula and holds it against thoracic wall Lateral thoracic artery Shoulder Nerve to subclavius Anchors and depresses clavicle Clavicular branch of thoraco‐acromial Shoulder artery Latissimus dorsi Spinous processes of T7–L5 vertebrae, thoracolumbar fascia, iliac Intertubercular sulcus of humerus crest, last 3 ribs Serratus anterior Lateral surfaces of upper 8–9 ribs Subclavius Upper border of 1st rib and its cartilage Subscapularis Supraspinatus Teres major Teres minor Levator scapulae Rhomboid major Rhomboid minor Trapezius Costal surface of medial border of scapula Inferior surface of middle third of clavicle Posterior circumflex humeral artery, deltoid branch of thoraco‐acromial Shoulder artery Medially rotates arm at shoulder and Subscapular artery, lateral thoracic Upper and lower subscapular nerves adducts it, helps hold humeral head artery in glenoid cavity Supraspinous fossa of scapula and Initiates arm abduction, acts with Superior facet of greater tubercle of Suprascapular artery Suprascapular nerve rotator cuff muscles deep fascia humerus Posterior surface of inferior angle of Medial lip of intertubercular sulcus of Lower subscapular nerve Adducts and medially rotates arm Circumflex scapular artery scapula humerus Inferior facet of greater tubercle of Upper 2/3 of posterior surface of Axillary nerve Laterally rotates arm Circumflex scapular artery lateral border of scapula humerus Dorsal scapular artery, transverse Posterior tubercles of transverse Medial border of scapula from Ventral rami of C3–C4 and dorsal Elevates scapula medially, inferiorly cervical artery, ascending cervical processes of C1–C4 superior angle to spine scapular nerve rotates glenoid cavity artery Dorsal scapular OR deep branch of transverse cervical artery, dorsal Fixes scapula to thoracic wall and Spinous processes of T2–T5 Medial border of scapula below base perforating branches of the upper Dorsal scapular nerve retracts and rotates it to depress vertebrae of spine of scapula glenoid cavity five or six posterior intercostal arteries artery Dorsal scapular artery OR deep branch of transverse cervical artery, Fixes scapula to thoracic wall and Ligamentum nuchae, spines of C7 Medial border of scapula at spine of Dorsal scapular nerve retracts and rotates it to depress dorsal perforating branches of the and T1 vertebrae scapula glenoid cavity upper five or six posterior intercostal arteries Superior nuchal line, external Transverse cervical artery, dorsal Elevates, retracts, and rotates Lateral third of clavicle, acromion, occipital protuberance, nuchal Accessory nerve (cranial nerve XI) perforating branches of posterior scapula; lower fibers depress scapula and spine of scapula ligament, spinous processes of intercostal arteries C7–T12 Subscapular fossa Lesser tubercle of humerus Shoulder Shoulder Shoulder Shoulder Superficial back Superficial back Superficial back Superficial back 07/16/2015