Humerus and Elbow Flashcards
Coracobrachialis:
O: apex of the coracoid process of scapula
I: medial surface of middle of shaft of humerus
A: flexes and adducts the shoulder joint
N: musculocutaneous nerve (C6, C7)
Muscle Testing - Coracobrachialis
Patient: sitting or supine
Fixation: none
Test: shoulder flexion in lateral rotation, with elbow flexed and forearm supinated
Pressure: against anteromedial surface of the lower ⅓ of the humerus
Biceps Brachii:
O: short head: apex of coracoid process of scapula
O: long head: supraglenoid tubercle of the scapula
I: tuberosity of the radius and aponeurosis of biceps brachii
A: flexes the elbow joint, supinates the forearm, flexes the shoulder joint
N: musculocutaneous nerve (C5, C6)
Muscle Testing - Biceps Brachii (with Brachialis):
Patient: supine or sitting
Fixation: examiner places one hand under the elbow to cushion
Test: elbow flexion with forearm in supination
Pressure: against the lower forearm
Brachialis:
O: distal ½ of anterior surface of humerus, both medial & lateral intermuscular septa
I: tuberosity and coronoid process of ulna
A: flexes the elbow joint
N: musculocutaneous nerve (C5, C6)
Muscle Testing - Biceps Brachii (with Brachialis):
Patient: supine or sitting
Fixation: examiner places one hand under the elbow to cushion
Test: elbow flexion with forearm in supination
Pressure: against the lower forearm
Triceps Brachii:
O: Long head: infraglenoid tubercle of scapula
O: Lateral head: lateral & posterior surface of proximal ½ of body of humerus & lateral intermuscular septum
O: Medial head: distal 2/3 of the medial & posterior surfaces of the humerus below the radial groove & medial intermuscular septum
I: posterior surface of the olecranon process of the ulna & antebrachial fascia
A: extends the elbow joint, long head aids in adduction & extension of shoulder joint
N: radial nerve (C6, C7, C8, T1)
Muscle Testing - Triceps Brachii
(with Anconeus):
Patient: supine
Fixation: shoulder at 90 degrees of flexion with arm supported
Test: extension of the elbow joint
Pressure: against the forearm
Pronator Teres:
O: Humeral head: above the medial epicondyle of humerus & the common flexor tendon
O: Ulnar head: medial side of the coronoid process of the ulna
I: middle of the lateral surface of the radius
A: pronates the forearm, assists in flexion at the elbow joint
N: median nerve (C6, C7)
Muscle Testing - Pronator Teres (with Quadratus):
Patient: supine or sitting
Fixation: elbow held against the patient’s side
Test: pronation of the forearm, with elbow partially flexed
Pressure: at lower forearm, above the wrist
Flexor Carpi Radialis:
O: common flexor tendon at medial epicondyle of humerus
I: base of the 2nd metacarpal bone and a slip at the base of the 3rd metacarpal bone
A: flexes and abducts the wrist, assists in pronation of the forearm and flexion of the elbow joint
N: median nerve (C6, C7, C8)
Muscle Testing - Flexor Carpi Radialis:
Patient: sitting or supine
Fixation: forearm is slightly less than full supination and rests on table or supported by examiner
Test: flexion of the wrists towards the radial side
Pressure: against the thenar eminence
Flexor Carpi Ulnaris:
O: Humeral head: common flexor tendon at medial epicondyle of humerus
O: Ulnar Head: aponeurosis from medial margin of olecranon, proximal 2/3 of posterior border of the ulna
I: pisiform bone, ligaments, hamate bone, and 5th metacarpal bone
A: flexes & adducts the wrist, assists in flexion of the elbow
N: ulnar nerve (C7, C8, T1)
Muscle Testing - Flexor Carpi Ulnaris:
Patient: sitting or supine
Fixation: forearm in full supination and resting on the table or supported by examiner
Test: flexion of the wrist toward the ulnar side
Pressure: against the hypothenar eminence
Palmaris Longus:
O: common flexor tendon from medial epicondyle of humerus
I: flexor retinaculum and palmar aponeurosis
A: tenses the palm, flexes the wrist, assists in flexion at the elbow
N: median nerve (C6, C7, C8, T1)
Muscle Testing - Palmaris Longus:
Patient: sitting or supine
Fixation: forearm rests on table in supination
Test: tensing the palmar fascia by strongly cupping the palm of the hand with flexion of the wrist
Pressure: against the thenar and hypothenar eminence
Flexor Digitorum Superficialis:
O: Humeral head: common flexor tendon at medial epicondyle of humerus
O: Ulnar head: medial side of the coronoid process
O: Radial head: oblique line of the radiusI: by four tendons into the sides of the middle phalanges of the 2-5 digits
A: Flexes the interphalangeal joints of 2-5 digits, assists in flexion of metacarpophalangeal joint & flexion of wrist
N: median nerve (C7, C8, T1)
Muscle Testing - Flexor Digitorum Superficialis:
Patient: sitting or supine
Fixation: examiner stabilizes the metacarpophalangeal joint, wrist in neutral
Test: flexion of proximal interphalangeal joint with distal interphalangeal joints extended (2-5 only) each finger tested.
Pressure: against the palmar surface of the middle phalanx
Flexor Pollicis Longus:
O: anterior surface of body of radius below tuberosity, interosseous membrane, medial border of coronoid process of ulna, medial epicondyle of humerus
I: base of the distal phalanx of the thumb, palmar surface
A: flexes the interphalangeal joint of thumb, flexes metacarpophalangeal and carpometacarpal joints, flexes the wrist
N: median nerve (C6, C7, C8, T1)
Muscle Testing - Flexor Pollicis Longus:
Patient: sitting or supine
Fixation: hand rests on table, examiner stabilizes metacarpal bone and proximal phalanx of the thumb in extension.
Test: flexion of the interphalangeal joint of the thumb
Pressure: against the palmar surface of the distal phalanx
Brachioradialis:
O: proximal 2/3 of lateral supracondylar ridge of humerus
I: lateral side of base of styloid process of radius
A: flexes the elbow joint, assists in pronation/supination
N: radial nerve (C5, C6)
Muscle Testing - Brachioradialis:
Patient: supine or sitting
Fixation: examiner places one hand under the elbow to cushion
Test: flexion of the elbow, with forearm in neutral
Pressure: against the lower forearm
Extensor Carpi Radialis Longus:
O: distal 1/3 of lateral supracondylar ridge of humerus
I: dorsal surface of base of 2ne metacarpal bone, radial side
A: extends & abducts the wrist, flexes elbow
N: radial nerve (C5, C6, C7, C8)
Muscle Testing - Extensor Carpi Radialis Longus (with Brevis):
Patient: sitting, elbow in 30 degrees of zero extension
Fixation: forearm slightly less than full pronation and resting on table
Test: extension of wrist toward radial side
Pressure: against the dorsum of the hand, along the 2nd and 3rd metacarpal bones
Extensor Carpi Radialis Brevis:
O: common extensor tendon at lateral epicondyle of humerus, radial collateral ligament of elbow
I: dorsal surface of base of the 3rd metacarpal bone
A: extends & and aids in abduction the wrist
N: radial nerve (C6, C7, C8)
Muscle Testing - Extensor Carpi Radialis Brevis:
Patient: sitting, elbow fully flexed
Fixation: forearm is slightly less than full pronation and resting on table
Test: extension of wrist towards the radial side
Pressure: against the dorsum of the hand, along the 2nd and 3rd metacarpal bones
Extensor Digitorum (communis):
O: common extensor tendon from lateral epicondyle of humerus
I: by four tendons to the 2-5th digits, dividing into 1 medial & 2 lateral bands
A: extends metacarpophalangeal & interphalangeal.
N: radial nerve (C6, C7, C8
Muscle Testing - Extensor Digitorum:
Patient: sitting or supine
Fixation: examiner stabilizes the wrist avoiding full extension
Test: extension of the metacarpophalangeal joints of the 2-5 digits with the interphalangeal joints relaxed
Pressure: against the dorsal surfaces of the proximal phalanges
Extensor Digiti Minimi:
O: common extensor tendon of lateral epicondyle of humerus
I: into extensor expansion of little finger with extensor digitorum tendon
A: extends metacarpophalangeal (MCP) joint & interphalangeal (IP) joint of little finger
N: radial nerve (C6, C7, C8)