Module 4C: Upper Appendicular Muscles Flashcards
what are the appendicular muscles?
muscles that move and attach to the limb
if some appendicular muscles can attach to the axial skeleton, why are they called appendicular muscles?
because they have a direct impact on the appendicular skeletal movement
- so they are grouped with the appendicular muscles
why can the scapula move freely over the thoracis wall?
because there is no ligament attachment to the thorax
what are three movements of the scapula?
- elevation and depression (up and down)
- protraction(adduction) and retraction(abduction) (left and right)
- upward and downward rotation (moving arm up and down) (clockwise and counter-clockwise)
what is the point of reference for upward and downward rotation of the scapula?
the glenoid cavity
- if it points up, it is an upward rotation and if it points down, it is a downward rotation
what is the trapezius?
a shoulder girdle muscle
- looks like a diamond on the back
- has three fibers (superior, middle and inferior)
what is the origin of the trapezius?
- nuchal ligament (ligamentum nuchae)
- spines of thoracic vertebrae
- occipital bone
- ALL THREE, NOT JUST ONE
what is the insertion of the trapezius?
- clavicle (out front)
- acromion process (laterally)
- spine of scapula (back)
what is the action of the trapezius?
- elevate scapula
- adduction/retraction of scapula
- upward rotation of scapula, depression
- shoulder shrug (combination of elevation and adduction of the scapula)
where is the most action of the trapezius?
the scapula
which muscle primarily elevates the scapula?
the levator scapulae
what is the origin of the levator scapulae?
C1-C4 transverse processes
where does most of the back muscles attach to?
spinous processes
what is the insertion of the levator scapulae?
superior angle of scapula
- located superiorly to the spine of the scapula
what is the action of the levator scapulae?
- scapula elevation (if you pull up or contract this muscle, you will pull up on the scapula, causing elevation)
- on ONE side, it will do a clockwise rotation which depresses the glenoid fossa (if you pull up on this medial side, the lateral side will go down(occurs when lowering the arm)
-* elevates medial border of scapula - shoulder shrug with trapezius; downward rotation of scapula
the levator scapulae works with the trapezius muscle for which movement?
the shrug movement
- they both have elevation in common
is the rhomboid minor superior to the rhomboid major?
yes
what is the origin of the rhomboid minor and major?
the spinous processes of C7-T5
what is the insertion of the rhomboid minor and major?
medial border of scapula
- insert lower than the levator scapula
what is the actions of the rhomboid minor and major?
- retraction of scapula
- elevation of scapula
- downward rotation of scapula
what muscle is superficial to the ribs directly and to the intercostal muscles?
the serratus anterior
what is the origin of the serratus anterior?
the lateral surface of ribs 1-9
what is the insertion of the serratus anterior?
- the medial border of scapula, anterior surface
how does the serratus anterior start and then move?
starts deep and moves more superficially
why is the serratus anterior called serratus?
because the bumpy origin points look like a serrated knife
what are the actions of the serratus anterior?
- abduction/protraction of scapula
- upward rotation of scapula
why is the serratus anterior called the boxers muscle?
because of its function of scapular protraction at the abduction of the scapula
- boxers are able to get more reach with their fist due to the protraction of the scapula which allows the glenoid fossa to move to a point that is more forward
what is a cause of scapula winging?
an insufficient serratus anterior and strength endurance and/or function
- scapula winging can effect the ability to lift, pull and push heavy objects and consequently impacts the ability to carry out many activities of daily living
- may cause pain, limits shoulder elevation because you are limited in the upward rotation of the scapula
is the pectoralis minor generally deep or superficial?
deep
what is the origin of the pectoralis minor?
- outer surface of ribs 2-5
what is the insertion of the pectoralis minor?
coracoid process of scapula
what is the actions of the pectoralis minor?
weak shoulder protraction (serratus anterior is prime mover)
- pulls scapula forward
- synergist to serratus interior
how many heads does the deltoid have?
three
1. spinal (posterior) head
2. acromial (lateral) head
3. clavicular (anterior) head
what is the origin of the deltoid spinal (posterior) head?
the spine of scapula
what is the insertion of the deltoid spinal (posterior) head?
deltoid tuberosity of humerus
what are the actions of the deltoid spinal (posterior) head?
- extension of humerus
- lateral rotation of humerus
- abduction of humerus
what is the origin of the deltoid acromial (lateral) head?
acromion of the scapula
what is the insertion of the deltoid acromial (lateral) head?
the deltoid tuberosity of humerus
what is the action of the deltoid acromial (lateral) head?
abduction of arm at shoulder
what is the origin of the deltoid clavicular (anterior) head?
clavicle
what is the insertion of the deltoid clavicular (anterior) head?
deltoid tuberosity of humerus
what is the actions of the deltoid clavicular (anterior) head?
- flexion of humerus
- medial rotation of humerus
- abduction of humerus
what is the most superficial muscle of the anterior thorax?
the pectoralis major
what is the origin of the pectoralis major?
- medial clavicle
- costal cartilage of ribs 1-6
what is the insertion of the pectoralis major?
bicipital (intertubercular) groove of humerus
what is the actions of the pectoralis major?
- flexion of arm at shoulder
- extension of flexed arm
- medial rotation of humerus
- adduction of humerus
- horizontal flexion of arm
- movement of humerus because of where it inserts
which view can we see the latissimus dorsi?
the posterior view
what is the origin of the latissimus dorsi?
- posterior sacrum
- lumbar vertebrae
- lower thoracic vertebrae
what is the insertion of the latissimus dorsi?
- bicipital (intertubercular) groove of humerus
what are the actions of the latissimus dorsi?
- extension of arm at shoulder
- medial rotation of humerus
- adduction of humerus
how many muscles are in the rotator cuff?
four
what muscles of the rotator cuff can be seen anteriorly?
- supraspinatus
- subscapularis
what muscles of the rotator cuff can be seen posteriorly?
- supraspinatus
- infraspinatus
- teres minor
what does all the rotator cuff muscles connect the scapula to? what do they function to do?
the humerus
- all function to stabilize the shoulder joint during movement of the joint in addition to their individual actions
what is the origin of the supraspinatus?
supraspinous fossa of scapula
what is the insertion of the supraspinatus?
greater tubercle of humerus
what is the action of the supraspinatus?
- provide strength and stability to shoulder joint
- initiates arm abduction (then deltoid takes over)
what runs underneath the spine of the scapula and the acromion process?
the supraspinous fossa of the scapula
when there is damage to the rotator cuff, typically which muscle is the first that is damaged and/or torn?
supraspinatus muscle
what is the origin of the infraspinatus muscle?
infraspinous fossa of scapula
what is the insertion of the infraspinatus muscle?
greater tubercle of humerus
what is the action of the infraspinatus muscle?
- provides strength to posterior component of shoulder joint
- lateral rotation of humerus
what is the origin of the teres minor?
lateral border of scapula
what is the insertion of the teres minor?
greater tubercle of humerus, below infraspinatus
what are the actions of the teres minor?
- provides posterior support to shoulder joint
- lateral rotation of humerus
- adduction of humerus
what view is the subscapularis seen in?
the anterior deep view
what is the origin of the subscapularis muscle?
subscapular fossa of scapula
what is the insertion of the subscapularis muscle?
lesser tubercle of humerus
what are the actions of the subscapularis muscle?
- provides strength to shoulder joint capsule
- medial rotation of humerus (because of its anterior position)
- adduction of humerus
which is the largest rotator cuff muscle?
subscapularis
is the teres major a rotator cuff muscle?
no
where does the teres major run from?
the lateral border by the inferior angle of the scapula to to up under the arm through the armpit to the front to attach to the bicipital (intertubercular) groove of humerus
what muscle is teres major a synergist to?
the latissimus dorsi
what is the origin of the teres major?
- lateral border of scapula
what is the distal attachment of the teres major?
- bicipital groove of humerus
what are the actions of the teres major?
- medial rotation of arm
- extension of arm
is the teres major capable of stabilizing the shoulder joint
no, it is incapable
what does brachii mean?
arm
what does biceps mean?
two heads
what is the two origins of the biceps brachii?
long head: supraglenoid tubercle of scapula
short head: coracoid process of scapula
what is the insertion of the biceps brachii?
radial tuberosity
what is the action of the biceps brachii?
- elbow flexion (when forearm is supinated) (MAIN ACTION)
- elbow supination
- flexion of the shoulder
why is the long head of the biceps brachii called the long head?
because it has a longer tendon
- because it has to travel over the top of the head of the humerus to get to its attachment point
how many heads does the triceps brachii have?
three heads
- long
- medial
- lateral
what is the three origins of the triceps brachii?
- long head: infraglenoid tubercle of scapula
- medial head: posterior/medial aspect of humerus (medial/inferior to spiral line)
- lateral head: posterior/lateral aspect of humerus (lateral/superior to spiral line)
what is the insertion of the triceps brachii?
olecranon process of ulna
what are the actions of the triceps brachii?
- extension of elbow
- extension of arm at shoulder (long head only)
what muscle is the major contributor to arm extension?
posterior deltoid
what is the only muscle for elbow extension?
the triceps brachii
- its large with multiple heads so we don’t need more
- usually to return from a flexed to a straight arm
which muscle is an antagonist to the arm flexors?
the triceps brachii
what is the origin of the coracobrachialis?
coracoid process of scapula
- runs underneath the biceps brachii
what is the insertion of the coracobrachialis?
medial side of shaft of humerus (about the level of the deltoid tuberosity)
what is the action of the coracobrachialis?
flex the arm at the shoulder
what is the origin of the brachialis?
anterior shaft of humerus
(does not cross the shoulder joint)
what is the insertion of the brachialis?
- coronoid process of ulna
- ulnar tuberosity (just below the elbow joint)
what is the action of the brachialis?
- elbow flexion
where is the brachialis muscle in regards to the biceps brachii?
deep
- also has a wider end than the biceps brachii
if the beginning of the muscles name starts with “brachi”, what does this mean?
muscle is coming off of the arm
what is the origin of the brachioradialis?
- shaft of humerus, just above lateral epicondyle
what is the insertion of the brachioradialis?
- styloid process of radius
what is the action of the brachioradialis?
elbow flexion (in partial supination)
which muscle is also called your handshaking, beer, water or drinking muscle?
the brachioradialis
which exercise targets the brachioradialis?
the hammer curl
the anterior aspect of your forearm is primarily for what?
wrist/digit flexion
the posterior aspect of your forearm is primarily for what?
wrist/digit extensors
how many muscles are in the superficial anterior compartment of the forearm muscles?
four muscles
- they all have a common origin on the medial epicondyle of humerus
- they are all synergists for elbow flexion (weak)
- all cross the elbow
how many muscles are in the intermediate anterior compartment of the forearm muscles?
one
how many muscles are in the deep anterior compartment of the forearm muscles?
three
- they all do not cross the elbow joint
what are the four anterior superficial forearm muscles?
(in order of lateral to medial)
1. pronator teres
2. flexor carpi radialis
3. palmaris longus
4. flexor carpi ulnaris
what is the origin of the pronator teres forearm muscle?
medial epicondyle of the humerus
what is the insertion of the pronator teres forearm muscle?
lateral surface of radius
- about the same level as the supinator muscle
what is the action of the pronator teres forearm muscle?
- pronates forearm
- elbow flexion
what is the origin of the flexor carpi radialis forearm muscle?
medial epicondyle of the humerus
what is the insertion of the flexor carpi radialis forearm muscle?
base of 2nd and 3rd metacarpals
what is the action of the flexor carpi radialis forearm muscle?
flex and abduct wrist (or hand), elbow flexion
what is the origin of the palmaris longus forearm muscle?
medial epicondyle of the humerus
what is the insertion of the palmaris longus forearm muscle?
palmar aponeurosis
- passes OVER the flexor retinaculum
what is the action of the palmaris longus forearm muscle?
flex wrist; elbow flexion
what is the origin of the flexor carpi ulnaris forearm muscle?
- medial epicondyle of the humerus
- upper part of ulna
what is the insertion of the flexor carpi ulnaris forearm muscle?
pisiform, base of 5th metacarpal
what is the action of the flexor carpi ulnaris forearm muscle?
flex and adduct wrist, elbow flexion
what does “teres” mean?
round-shaped muscle
what is the flexor retinaculum for?
its a tight band of connective tissue moving from medial to lateral across the carpal bones that helps prevent bowing of the tendons as it performs action at the wrist
what is the palmer aponeurosis?
layers of tendon and fascia cover the palm of the hand
- helps to protect the vessels and layers of tendon and muscles in the palm of the hand
what is the intermediate anterior forearm muscle?
flexor digitorum superficialis
what is the origin of the flexor digitorum superficialis?
- medial epicondyle of humerus
- coronoid process of ulna
- shaft of radius
how many heads are there for the flexor digitorum superficialis?
two heads
what is the insertion of the flexor digitorum superficialis?
middle phalanges of digits 2-5
- when it inserts, it has this snake tongue-like attachment
what are the actions of the flexor digitorum superficialis?
- proximal interphalangeal joints: flexion
- metacarpophalangeal joints: flexion
- wrist: flexion
- elbow: flexion (weak)
FLEXES EVERY JOINT IT CROSSES
what are the three anterior deep forearm muscles?
- flexor digitorum profundus (FDP)
- flexor pollicis longus (FPL)
- pronator quadratus (PQ)
what does profundus mean?
deep
what does pollicis mean?
thumb
what does quadratus mean?
square
what is the origin of the flexor digitorum profundus anterior deep forearm muscle?
- upper anterior ulna
- interosseus membrane
what is the insertion of the flexor digitorum profundus anterior deep forearm muscle?
distal phalanges (digits 2-5)
- runs under the flexor retinaculum at the wrist and right to the tip of the finger of digits 2-5
what is the action of the flexor digitorum profundus anterior deep forearm muscle?
- flexion of distal interphalangeal joints
- flexion of metacarpophalangeal joints
- wrist flexion
what is the origin of the flexor pollicis longus anterior deep forearm muscle?
- anterior shaft of radius
- interosseus membrane
what is the insertion of the flexor pollicis longus anterior deep forearm muscle?
distal phalanx of thumb
- runs under the flexor retinaculum at the wrist and right to the tip of the finger of digit 1
what are the actions of the flexor pollicis longus anterior deep forearm muscle?
- flexion of carpal metacarpal joints
- flexion of metacarpophalangeal joints
- interphalangeal joint of the first digit
- wrist flexion
what is the origin of the pronator quadratus anterior deep forearm muscle?
distal ulna on the medial side
what is the insertion of the pronator quadratus anterior deep forearm muscle?
distal radius on the lateral side
what is the action of the pronator quadratus anterior deep forearm muscle?
forearm pronation
- when it contracts it pulls its assertion of the radius towards the origin on the ulna which will turn the palm of the hand down or over
if you were to make a fist and flex everything in your hand, which muscles would be hard at work?
- flexor digitorum profundus
- flexor pollicis longus
what is the common origin for the posterior superficial forearm muscles?
common extensor origin on:
- lateral epicondyle of humerus
what are the two groups of posterior forearm muscles and how many are there?
- superficial group (4 muscles)
- deep group (6 muscles)
what are the four posterior superficial forearm muscles?
in order from lateral to medial
1. extensor carpi radialis longus (very long tendon)
2. extensor carpi radialis brevis
3. extensor digitorum
4. extensor carpi ulnaris
what is the origin of the extensor carpi radialis longus posterior superficial forearm muscle?
- above lateral epicondyle of humerus
what does “brevis” mean?
short
what is the action of the extensor digitorum?
- extend the digits
- there is a split of the tendon that goes right to the distal phalanx
what is the insertion of the extensor carpi radialis longus posterior superficial forearm muscle?
base of second metacarpal
what is the origin of the extensor carpi radialis brevis posterior superficial forearm muscle?
lateral epicondyle of humerus
what is the origin of the extensor carpi ulnaris posterior superficial forearm muscle?
lateral epicondyle of humerus
what is the origin of the extensor digitorum posterior superficial forearm muscle?
lateral epicondyle of humerus
what is the insertion of the extensor carpi radialis brevis posterior superficial forearm muscle?
base of third metacarpal
what is the insertion of the extensor carpi ulnaris posterior superficial forearm muscle?
base of fifth metacarpal
what is the insertion of the extensor digitorum posterior superficial forearm muscle?
distal phalanx of digits 2-5 via extensor expansion
what is the action of the extensor carpi radialis longus posterior superficial forearm muscle?
- extension of wrist and elbow
- abducts wrist (bc they have tendons on the radial side)
what is the action of the extensor carpi radialis brevis posterior superficial forearm muscle?
- extension of wrist and elbow
- abducts wrist (bc they have tendons on the radial side)
what is the action of the extensor digitorum posterior superficial forearm muscle?
- extension of wrist and elbow
- finger extension (digits 2-5)
what is the action of the extensor carpi ulnaris posterior superficial forearm muscle?
- extension of wrist and elbow
- adducts wrist (or hand)
what are the six deep posterior forearm muscles?
- supinator
- anconeus
- abductor pollicis longus
- extensor pollicis longus
- extensor pollicis brevis
- extensor indicis
what is the origin of the supinator posterior deep forearm muscle?
- lateral epicondyle of humerus
- posterior radial notch of ulna
what is the origin of the anconeus posterior deep forearm muscle?
- lateral epicondyle of humerus
what is the origin of the abductor pollicis longus posterior deep forearm muscle?
- posterior surface of radius and ulna
- interosseous membrane
what is the origin of the extensor pollicis longus posterior deep forearm muscle?
- posterior surface of ulna
- interosseous membrane
what is the origin of the extensor pollicis brevis posterior deep forearm muscle?
- posterior surface of radius
- interosseous membrane
what is the origin of the extensor indicis posterior deep forearm muscle?
- posterior surface of ulna
- interosseous membrane
what is the insertion of the supinator posterior deep forearm muscle?
- anterolateral radius, distal to radial tuberosity
what is the insertion of the anconeus posterior deep forearm muscle?
olecranon
what is the insertion of the abductor pollicis longus posterior deep forearm muscle?
first metacarpal
what is the insertion of the extensor pollicis longus posterior deep forearm muscle?
distal phalanx of thumb
what is the insertion of the extensor pollicis brevis posterior deep forearm muscle?
proximal phalanx of thumb
- hence it is shorter than the extensor pollicis longus
what is the insertion of the extensor indicis posterior deep forearm muscle?
distal phalanx of digit 2 (via extensor expansion)
we wouldnt be able to extend digit 2 independently if we didn’t have which muscle?
extensor indicis
- allows us to point at people
what is the action of the supinator posterior deep forearm muscle?
- forearm supination
- elbow extension
(synergist to the biceps brachii muscle)
what is the action of the anconeus posterior deep forearm muscle?
- elbow extension
(synergist to triceps brachii)
what is the action of the abductor pollicis longus posterior deep forearm muscle?
- wrist extension
- thumb abduction
what is the action of the extensor pollicis longus posterior deep forearm muscle?
- metacarpophalangeal and interphalangeal extension of thumb
- wrist extension
what is the action of the extensor pollicis brevis posterior deep forearm muscle?
- metacarpophalangeal extension of thumb
- wrist extension
no interphalangeal extension of thumb because it inserts at proximal phalanx so it doesn’t cross those joints
what is the action of the extensor indicis posterior deep forearm muscle?
- interphalangeal extension of 2nd digit
- wrist extension
why isn’t interphalangeal extension of the thumb an action of the extensor pollicis brevis?
because it inserts at proximal phalanx so it does not cross those joints
the intrinsic muscles that are contained entirely in the hand are responsible for what?
mainly precision movements with the fingers and the thumb
where do the extrinsic hand muscles originate?
in the forearm
where do the extrinsic hand muscles insert?
in the hand
what is the function of the extrinsic hand muscles?
- function in forceful gripping with the hand
the thenar muscle group (thenar eminence) is made up of what?
three muscles at the base of the thumb on the palm side
1. opponens pollicis
2. abductor pollicis brevis
3. flexor pollicis brevis
which muscle group allows the thumb to oppose other digits?
the thenar muscle group
(touching tip of thumb to tip of other fingers)
– ALSO permits flexion and abduction of the thumb
the hypothenar muscle group (hypothenar eminence) is made up of what?
three muscles on the pinky side of the hand
1. opponens digiti minimi
2. abductor digiti minimi
3. flexor digiti minimi brevis
which muscle group contributes of the movement of the fifth digit?
the hypothenar muscle group
- rotate the fifth metacarpal
which muscle group is important for grasping objects?
the hypothenar muscle group
what is the origin of the interossei (palmar and dorsal) muscles?
shafts of metacarpals
what is the insertion of the interossei (palmar and dorsal) muscles?
extensor expansion
what is the action of the interossei (palmar and dorsal) muscles?
- adduction/abduction of digits (toward and away the middle finger - there is none of the third digit)
what is the origin of the lumbricals?
tendon of flexor digitorum profundus
what is the insertion of the lumbricals?
extensor expansion (digits 2-5)
what is the action of the lumbricals?
- flexion at metacarpophalangeal joints
WHILE - extension at interphalangeal joints (digits 2-5)
- waving bye or shewing someone away
how many lumbricals do we have?
four
which muscle is a worm-like muscle that we have four of, each one associated with each finger?
lumbricals
what are the intrinsic muscles of the hand?
- thenar muscle group
- hypothenar muscle group
- interossei (palmar and dorsal) muscles
- lumbricals
