Anatomy of Upper Limbs and Neck Flashcards
Origin: spinous processes of C7-T3
Insertion: ribs 2-5
Action: assists with inhalation
Serratus Posterior Superior
Origin: Spinous processes of C7-T3
Insertion: mastoid process
Action: Acting unilaterally, produce ipsilateral flexion and slight rotation of head; extend head when acting bilaterally
Splenius Capitis
Origin: Spinous processes of T3-T6
Insertion: Transverse processes of C1-C3/4
Action: Acting unilaterally, produce ipsilateral flexion and slight rotation of head; extend head when acting bilaterally
Splenius Cervicis
Origin: Transverse processes of C4-T5
Insertion: Between superior & inferior nuchal line of occiput
Action: Extends vertebral column and head
Semispinalis Capitis
Origin: common tendon (thorcolumbar fascia) that attaches to the posterior surface of the sacrum, iliac crest, spinous processes of the lumbar and last 2 thoracic vertebrae
Insertion: Various attachments at posterior ribs, spinous and transverse processes of thoracic and cervical vert, and mastoid process.
A: Laterally flex vertebral column to same side (unilaterally); extends vertebral column (bilaterally)
Erector Spinae group
Subscapularis, supraspinatus, and infraspinatus fossa attachments; Superior and Inferior angles; Lateral and Medial borders; Glenoid Cavity; Supraglenoid and Infraglenoid tubercles
Scapula
Boney prominence that lays inferior to the anterior scapular curvature
Coracoid Process
Boney prominence that lays inferior to the lateral end of the clavicular curvature
Coracoid Process
Acromial (lateral) end, Sternal (medial) end
Clavicle
Bone: greater tubercle, lesser tubercle, attachment to the glenoid fossa, deltoid tuberosity
Humerus
Action: extend head & neck(bilaterally); laterally flex head and neck to same side; rotate head and neck
Origin: External protuberance, medial one third portion of superior nuchal line of occiput, spinous process of C7, ligamentum nuchae
Insertion: Posterior border of lateral third of clavicle
Trapezius (Upper Fibers)
Action: adduct, stabilize scapula
Origin: spinous process of the C7-T3
Insertion: the acromion
Trapezius (Middle Fibers)
Action: depress scapula; downwardly rotate scapula
Origin: spinous process of the T4–T12
Insertion: spine of scapula
Trapezius (Lower Fibers)
Action: extend, adduct and medially rotate shoulder
Origin: inferior angle of scapula, spinous processes of last 6 thoracic vert, last 3-4 ribs, thoracolumbar fascia and posterior iliac crest
Insertion: intertubercle groove of humerus
Latissimus Dorsi
Action: extend, adduct and medially rotate shoulder
Origin: inferior angle & lower 1/3 of lateral border of scapula
Insertion: crest of lesser tubercle of humerus
Teres Major
Action: extend elbow (all heads), extend and adduct shoulder (long head)
Origin: infraglenoid tubercle of scapula (long head), posterior surface of proximal half of humerus (lat. head), posterior surface of distal half of humerus (medial head)
Insertion: Olecranon process of ulna
Triceps Brachii
Action: flex, adduct shoulder
Origin: coracoid process of scapula
Insertion: medial surface of mid-humeral shaft
Coracobrachialis
Main Ligaments of the Shoulder
Coraco-clavicular ligament Acromio-clavicular ligament Coraco-acromial ligament Coraco-humeral ligament Gleno-humeral joint
Action: abduct shoulder (all fibers); flex, medially rotate, horizontally adduct shoulder (anterior fibers); extend, laterally rotate, horizontally abduct shoulder
Origin: lateral 1/3 of clavicle, acromion, and spine of scapula
Insertion: deltoid tuberosity
Deltoid
Action: laterally rotate, adduct shoulder; stabilize head of humerus in glenoid cavity
Origin: infraspinatus fossa of scapula
Insertion: greater tubercle of humerus
Infraspinatus
Action: flex both elbow and shoulder; spinate forearm
Origin: coracoid process of scapula (short head); supraglenoid tubercle of scapula (long head)
Insertion: radial tuberosity
Biceps brachii
Action: Laterally rotate, adduct shoulder; stabilize humerus in glenoid cavity
Origin: upper 2/3rds of lateral border of scapula
Insertion: greater tubercle of humerus
Teres Minor
Action: Adduct, elevate and downwardly rotate scapula
Origin: spinous process of T2-T5
Insertion: Medial border of scapula between the spine of scapula and inferior angle
Rhomboid Major
Action: adduct, elevate and downwardly rotate scapula
Origin: Spinous process of C7-T1
Insertion: upper portion of medial border of scapula, across from spine of scapula
Rhomboid Minor
Action: Unilaterally - elevate, downwardly rotate scapula; lat. flex head and neck; rotate head and neck to same side
Bilaterally - extend head and neck
Origin: transverse process of C1-C4
Insertion: medial border of scapula, between superior angle and superior portion of spine of scapula
Levator Scapula
Action: abduct, upwardly rotate, depress scapula; hold the medial border of scapula against rib cage
Origin: external surfaces of upper 8 or 9 ribs
Insertion: anterior surface of medial border of scapula
Serratus Anterior
Action: abduct shoulder; stabilize head of humerus in glenoid cavity
Origin: supraspinatus fossa of scapula
Insertion: greater tubercle of humerus
Supraspinatus
Action: adduct, medially rotate shoulder (all fibers); assist to elevate thorax during forced inhalation (all); flex & horizontally adduct shoulder (upper fibers); extend shoulder (lower fibers)
Origin: medial half of clavicle, sternum and cartilage of 1st through 6th ribs
Insertion: crest of greater tubercle of humerus
Pectoralis Major
Action: depress, abduct, downwardly rotate scapula; assist to elevate thorax during forced inhalation
Origin: 3rd, 4th, and 5th ribs
Insertion: medial surface of coracoid process of scapula
Pectoralis Minor
Action:
Unilaterally - laterally flex head & neck to same side; rotate head & neck to opposite side
Bilaterally - elevate ribs during inhalation; flex head & neck (anterior only)
Origin:
Transverse processes of C3-C7 (anterior), C2-C7 (middle), C6-C7 (posterior)
Insertion: first rib (anterior and middle), second rib (posterior)
Scalenes
Action: laterally flex head & neck to same side, rotate head & neck to opposite side (unilaterally); flex neck (bilaterally)
Origin: sternal head - top of manubrium
clavicular head - medial 1/3 of
clavicle
Insertion: mastoid process and lateral portion of superior nuchal line of occiput
Sternocleidomastoid (SCM)
Bones of the wrist
Scaphoid, lunate, triquetrum, pisiform, hamate, capitate, trapezoid, trapezium
Action: abduct, extend thumb; abduct wrist
Origin: posterior surface of radius and ulna; interosseous membrane
Insertion: base of 1st MC
Abductor Pollicis Longus
Action: extend thumb (IP joint); extend thumb (MCP & CMC Jt )
Origin: posterior surface of ulna and interosseous membrane
Insertion: base of distal phalanx of thumb
Extensor Pollicis Longus
Action: abduct thumb
Origin: flexor retinaculum, trapezium and scaphoid tubercles
Insertion: bones of proximal phalanx of thumb
Abductor Pollicis Brevis
Action: adduct thumb
Origin: capitate, 2nd and 3rd MC
Insertion: base of proximal phalanx of thumb
Adductor Pollicis
Action: extend 2nd through 5th fingers at IP joints; flex 2nd through 5th fingers at MCP joints
Origin: tendon of the flexor digitorum profundus
Insertion: extensor aponeurosis on dorsal surfaces of phalanges
Lumbricals of the Hand
Action: adduct thumb, 2nd, 4th and 5th fingers toward 3rd finger
Origin: base of 1st 2nd, 4th and 5th MCs
Insertion: base of proximal phalanx of the related finger and the extensor aponeurosis
Palmar Interossei
Action: abduct 2nd, 3rd and 4th fingers at MC joints
Origin: adjacent sides of all MCs
Insertion: base of proximal phalanx of 2nd-4th fingers and the extensor aponeurosis
Dorsal Interossei
Action: abduct 5th finger (MCP joint); assist in opposition of 5th finger toward thumb
Origin: pisiform & tendon of FCU
Insertion: base of proximal phalanx of 5th finger, ulnar surface
Abductor Digiti Minimi
Boney Landmarks of the Forearm: Ulna
Olecranon process, shaft, styloid process and head
Boney Landmarks of the Forearm: Radius
Head, shaft, styloid process
Action: flex elbow
Origin: distal half of anterior surface of humerus
Insertion: tuberosity and coronoid process of ulna
Brachialis
Action: flex elbow
Origin: distal half of anterior surface of humerus
Insertion: tuberosity and coronoid process of ulna
Brachialis
Action: flex elbow; assist in pronating and supinating forearm
Origin: proximal 2/3rds of lateral supracondylar ridge of humerus
Insertion: styloid process of radius
Brachioradialis
Action: extend, abduct wrist; assist to flex elbow
Origin: distal 1/3rd of lateral supracondylar ridge of humerus
Insertion: base of 2nd MC
Extensor Carpi Radialis Longus
Action: extend, abduct wrist; assist to flex elbow
Origin: common extensor tendon from lateral epicondyle of humerus
Insertion: base of 3rd MC
Extensor Carpi Radialis Brevis
Action: extend, abduct wrist
Origin: common extensor tendon from the lateral epicondyle of humerus
Insertion: base of 5th MC
Extensor Carpi Ulnaris
Action: extend 2nd through 5th fingers; assist to extend wrist
Origin: common extensor tendon from lateral epicondyle of humerus
Insertion: base of middle and distal phalanges of 2nd through 5th fingers
Extensor Digitorum
Action: flex, abduct wrist; flex elbow (assist)
Origin: common flex tendon from medial epicondyle
Insertion: base of 2nd & 3rd MCs
Flexor Carpi Radialis
Action: tense the palmar fascia, flex wrist, flex elbow (assist)
Origin: common flexor tendon from medial epicondyle of humerus
Insertion: flexor retinaculum and palmar aponeurosis
Palmaris Longus
Action: flex 2nd through 5th fingers; flex wrist
Origin: common flexor tendon from medial epicondyle, ulnar collateral ligament, coronoid process of ulna, interosseous membrane and proximal shaft of radius
Insertion: sides of middle phalanges of 2nd through 5th fingers
Flexor Digitorum Superficialis
Action: flex wrist; flex elbow (assist)
Origin:
medial epicondyle,
posterior surface of the proximal ulna
Insertion: pisiform, hook of hamate and base of 5th MC
Flexor Carpi Ulnaris
Action: flex 2nd through 5th fingers
Origin: anterior & medial surfaces of proximal three quarters of ulna
Insertion: bases of distal phalanges, palmar surface of 2nd - 5th fingers
Flexor Digitorum Profundus
Action: pronate forearm; flex elbow (assist)
Origin: medial epicondyle of humerus and coronoid process of ulna
Insertion: middle of lateral surface of radius
Pronator Teres
Action: pronate forearm
Origin: medial anterior surface of distal ulna
Insertion: lateral anterior surface of distal radius
Pronator Quadratus
Action: supinate forearm
Origin: lateral epicondyle, radial collateral ligament, annular ligament, and supinator crest of ulna
Insertion: anterior lateral of proximal 1/3rd of radial shaft
Supinator
C4, C5, C6, C7 dermatomes
Clavicle, Lateral Deltoid, Thumb, Middle Finger
C8 and T1 dermatomes
Pinky and Medial side of forearm to base of pinky
C1, C2, C3, C4 Myotomes
Neck flexion, neck extension, neck side flexion, shoulder elevation
C5 C6, C7, C8, T1 Myotomes
Shoulder abduction, elbow flexion, elbow extension, finger flexion, finger abduction/adduction
Maitland’s Mobilization Grading Technique
Grade I
Small amplitude movement at beginning of the available range
Maitland’s Mobilization Grading Technique
Grade II
Large amplitude movement at within middle (just past) of available range
Maitland’s Mobilization Grading Technique
Grade III
Large amplitude movement that moves within/into stiffness or resistance
Maitland’s Mobilization Grading Technique
Grade IV
Small amplitude movement stretching into / /slightly past stiffness or resistance
Oxford Muscle Strength Scale (0-2/5)
0/5 - no contraction
1/5 - visible/palpable muscle contraction; no movement
2/5 - movement with gravity eliminated
Oxford Muscle Strength Scale (3-5/5)
3/5 - Movement against gravity only
4/5 - Movement with some resistance
5/5 - Movement with full resistence
Time Frame of Stages of Healing (Bleeding)
First 0-6 hours
Time Frame of Stages of Healing (Inflammation)
Occurs 1-2 hours after injury … peaks at 1-3 days … can last for a couple weeks
Time Frame of Stages of Healing (Proliferation)
Starts within 24-48 hours … peaks at around 2-3 weeks … can last up to 4-6 months
Time Frame of Stages of Healing (Remodeling)
Usually starts around 2-3 weeks after injury and could take as long as a few months or years depending on severity
5 D’s
Dizziness (light headedness, vertigo) Diplopia (visual problems) Drop Attacks (sudden weakness in face or limbs) Dysarthria (speech disorder) Dysphagia (swallowing problems)
3 N’s
Nausea (possibly with vomiting)
Numbness
Nystagmus (spontaneous, involuntary rhythmic side to side, up and down or circular movement of the eyes)
Red Flags
Severe Pain, Worsening or Constant pain, Night pain - disturbed sleep, Significant unexplained weight loss, Pins and Needles, Trauma, Severe injury, Numbness in arms or legs
Yellow Flags
Pessimistic Attitude toward pain and recovery
Excessive fear of movement and activity
Previous experiences
Work-related issues
Emotional problems (depression, anxiety)
Generalized pain (headache, fatigue, dizziness)
Desire for passive treatments; little desire to be proactive
Overprotective Family
Social withdrawal, lack of support
