Anatomy Practical - Arm Flashcards
Pectoralis Major
A: Humeral Horizontal adduction and Internal Rotation
O: Clavicular Head: Medial half of clavicle
Sternal Head: Sternum
I: Upper shaft of humerus
Palp: Clavicular head: Patient’s arm in shoulder flexion. Patient holds medially while OT pushes laterally on the arm
Pectoralis Minor
A: Draws scapula anteriorly against thoracic wall
O: Ribs 3, 4, 5 and fascia of corresponding intercostal spaces
I: Coracoid Process
Palp: Patient standing, OT at patient’s side
Place patient’s arm behind back in IR, Lift away. Palpate anteriorly over tendon & Muscle, deep to pec major
Serratus Anterior
A: Prevents scapular winging, scapular protraction & downward rotation
O: Ribs 1-8
I: Superior, Medial and inferior boarder of scapula
Palp: Patient Standing, OT facing
Patient extends arm, 90 degrees or so, making a fist. Patient hold fist while OT applies resistance on fist. Palpate lateral ribs
Anterior Deltoid
A: Shoulder flexion, Horizontal Adduction
O: Lateral third of clavicle
I: Deltoid Tubercle
Palp: Patient raise arm to 90 degrees flexion. Palpate anterior shoulder above deltoid tubercle. Patient holds as you provide resistance downward
Middle Deltoid
A: Shoulder abduction
O: Acromion
I: Deltoid Tubercle
Palp: Patient raise arm to 50-70 degrees ABDUCTION. Palpate lateral shoulder above the deltoid tubercle, providing resistance downward
Posterior Deltoid
A: Shoulder extension & horizontal abduction
O: Spine of Scapula
I: Deltoid Tubercle
Palp: Patient raises arm in 40 to 50 degrees EXTENSION. Palpate posterior shoulder above deltoid tubercle. Patient holds as you provide resistance
Upper Trapezius
A: Scapular Elevation
O: Occipital protuberance
I: Lateral third of clavicle, spine of scapula
Palp: Standing. Patient elevates shoulders. Palp hand over space between occiput and acromion. Patient hold as you resist by applying pressure over acromion
Middle Trapezius
A: Scapular retraction
O: Spinous process of C7-T4
I: Acromion & spine of scapula
Palp: Patient prone. Arm dangling off mat 90 deg abduction. Palp hands b/w vertebral column & spine of scapula. Patient lift elbow away from the mat
Lower Trapezius
A: Scapular depression & adduction
O: Spinous process of T5-T12
I: Spine of Scapula
Palp: Patient prone on mat with arms in full flexion - superman. Palpate lower medial aspect of spine of scapula with fingers pointing diagonally downward toward vertebral column
Rhomboids
A: Scapular retraction/adduction & downward rotation (opposite SA)
O: C7-T5
I: Upper medial boarder of scapula
Palp: Patient sitting. Patient place hand on small of back, palm facing outward. Palp hand b/w medial boarder of scapula and spine. Ask patient to lift hand away from back as you provide resistance at the forearm
Supraspinatus
A: First 15 degrees of shoulder abduction
O: Supraspinatus fossa of scapula
I: Greater tubercle
Palp: Patient standing, OT facing patient’s back
Place hand over supraspinatus fossa. Patient’s shoulder in 20-30 degrees abduction & provide resistance to abduction with hand placed just above the elbow.
Infraspinatus & Teres Minor (Together)
A: External rotation
O: Infraspinatus fossa
I: Greater tubercle
Palp: Patient standing. Ask to bend over at the hip, dangling arm. Palp fingers just into the axilla and along the anterior boarder of scapula. Ask patient to quickly rotate thumb outward (ER)
Subscapularis
A: Internal rotation
O: Subscapular fossa
I: Lesser tubercle
Palp: Patient standing. Ask to bend over at the hip, dangling arm. Palp fingers just into the axilla and along the anterior boarder of scapula. Ask patient to quickly rotate thumb inward (IR)
Teres Major
A: Shoulder internal rotation & adduction
O: Inferior angle of scapula
I: Intertubercular groove
Palp: Same as lats, but palpate from scapula to humerus
Latissimus Dorsi
A: Internal rotation, adduction, & extension of flexed arm
O: Spinous processes of lower six thoracic and all lumbar and sacral vertebrae, posterior part of iliac crest, lower 3-4 ribs, & inferior angle of the scapula
I: bicipital groove
Palp: Patient standing, OT facing
Patient rest the pinky side of a fist on your opposite shoulder with their arm straight. Palp hand in posterior fold of axilla. Ask patient to push down
Coracobrachialis
A: Adduction & flexion of shoulder
O: Coracoid process
I: Medial aspect of midshaft of humerus
Palp: Patient standing.
Extend straight arm to about 45 degrees abduction. Palp fingers in armpit area. Patient resist adduction
Biceps Brachii
A: Elbow flexion, forearm supination, & shoulder flexion
O: Short head: Coracoid process, Long head: supraglenoid tuberosity.
I: Radius
Palp: Patient in 50 degrees or so of flexion. Apply resistance on forearm and palp
Brachialis
A: Elbow flexion
O: Anterior humerus
I: Upper anterior ulna
Palp: Patient in 50 degrees elbow flexion with palm down. Patient hold while OT applies resistance to upper forearm. Palp fingers are on either side of biceps brachii
Brachioradialis
A: Elbow flexion
O: Lateral humerus about 2 to 3 inches above joint
I: Distal lateral end of radius above radial styloid
Palp: Ask patient to push up with a fist against the underside of a table or against your resistance. Palp hand is on top of forearm on proximal third.
Ulnar Nerve
Located in two places:
In the cubital tunnel b/w medial epicondyle and olecranon aka funny bone. In Guyon’s canal at wrist’s volar (palmar) surface b/w the hook of hamate & pisiform bones.
Two very common sites for impingement. Cubital Tunnel Syndrome, and Guyon’s Canal Syndrome
Triceps Brachii
A: Elbow extension
O: Long head: Infraglenoid tubercle of scapula
Lateral head: Upper half of posterior humerus
Medial head: Lower half of posterior humerus
I: Olecranon
Palp: Patient standing, table at waist height. Ask patient to dip down while supporting w/their hands and stop midrange. Palp posterior upper arm in the distal third.
Pronator Teres
A: Pronation & aids elbow flexion
O: Medial epicondyle
I: Middle of lateral radius
Palp: Patient sitting with elbow in flexion. OT place palp on volar side proximal third of radius. Place other thumb on patients volar distal radius and two fingers on dorsal distal ulna. Resist pronation
Supinator
A: Supination
O: Lateral humeral epicondyle
I: Lateral side of proximal third of radius
Palp: Fingers over dorsum of radial head. Ask patient to rotate arm into supination
