MSK I upper limb Flashcards
Deltopectoral groove location
between the deltoid and the pectoralis major
What makes the deltopectoral triangle
clavicle, deltoid and pectoralis major
Mammary gland perfusion
lateral and medial mammary artery and veins
Mammary gland innervation
lateral and anterior cutaneous branches of intercostal muscles 4-6
mammary gland lymphatic drainage
predominantly go to the axillary lymph nodes but can also go to parasternal lymph nodes
Pectoralis major origin
medial inferior border of clavicle, manubrium, sternum, costal cartilages of ribs 1-6, external abdominal oblique aponeurosis
pectoralis major insertion
lateral lip of the intertubercular groove of the humerus
pectoralis major action
adduction & medial rotation of the humerus, clavicular head flexes the humerus
pectoralis major innervation
medial pectoral nerve c8 and t1, and lateral pectoral nerve c5, c6, c7
Pectoralis minor origin
outer surface of ribs 3-5
pectoralis minor insertion
coracoid process of the scapula
pectoralis minor action
protraction and depression of the scapula , also accessory muscle for respiration
pectoralis minor innervation
medial pectoral nerve c8 t1
Subclavius origin
upper border of 1st rib and costal cartilage
Subclavius insertion
inferior surface of the clavicle
subclavius action
anchors and depresses clavicle
subclavius innervation
nerve to subclavius c5, c6
structures that penetrate the costocoracoid membrane
cephalic vein, thoracoacromial trunk, and lateral pectoral nerve
Apex of Axillary boundary aka cervicaxillary canal
between clavicle, superior scapula and the 1st rib
Medial wall of axillary boundary
border is the rib at that level and the muscles that cover those ribs
Lateral wall of axillary boundary
lateral wall of the intertubercular grove
anterior wall of the axillary boundary
pectoralis major, pectoralis minor and the clavipectoral fascia
Posterior wall of the axillary boundary
teres major, latissimus dorsi, subscapularis and scapula
base of axillary boundary
skin and axillary fascia held in place by the suspensory ligament
Brachiochephalic artery branches into
right subclavian cartery and right common carotid artery
Right subclavian artery branches into
Vertebral artery, thyrocervical trunk, and internal thoracic artery
Rotator cuff action
Rotate humerus and hold it in the glenoid during movements
Quadrangular space borders
Inferior- teres major
Lateral- surgical neck of the humerus
Medial- long head of triceps
Superior- teres minor
Triangular space borders
Inferior- teres major
lateral- long head triceps
superior- teres minor
Runs through the triangular space
circumflex scapular artery
Runs through the triangular space
circumflex scapular artery
Runs through radial groove of humerus
radial nerve and deep brachial artery
Borders of cubital fossa
superior- imaginary line between condyles, lateral- Brachioradialis, medial- pronator teres, roof- deep fascia of arm/forearm and bicpital aponeuroses, floor- brachialis and supinator
Deltoid origin
anterior- lateral 3rd of clavicle, middle- acromion, posterior- scapular spine
Deltoid insertion
deltoid tuberosity
deltoid innervation
axillary nerve c5, c6
deltoid action
anterior/clavicular- flexion of shoulder, medial rotation of humerus/arm, middle/acromion- last 85 degrees of abduction of the arm, posterior/spinous- extension of the shoulder, lateral rotation of the humerus/arm
Supraspinatus origin
supraspinous fossa
supraspinatus insertion
superior facet of greater tubercle
supraspinatus innervation
suprascapular nerve c4, c5, c6
supraspinatus action
first 15 degrees of abduction, acts with rotator cuff
infraspinatus origin
infraspinous fossa
infraspinatus insertion
middle face of greater tubercle
infraspinatus action
lateral rotation of humerus, abduction, acts with rotator cuff
subscapularis origin
subscapular fossa
subscapularis insertion
lesser tubercle of humerus
subscapularis innervation
Upper C5 and lower C6 subscapular nerves
subscapular action
medial rotation of the humerus, abduction, acts with rotator cuff
infraspinatus innervation
suprascapular nerve C5, C6
Teres minor origin
middle part of lateral border of scapula
Teres minor insertion
inferior facet of the greater tubercle
Teres minor innervation
axillary nerve c5 c6
teres minor action
lateral rotation of humerus, abduction, acts with rotator cuff
teres major origin
posterior aspect of the inferior angle of scapula
teres major insertion
medial lip of intertubercle groove
teres major innervation
lower subscapular nerve c5, c6
teres major action
adduction and medial rotation
Serratus anterior origin
medial border of the scapula
Serratus anterior insertion
external surface of ribs 1-9
Serratus anterior innervation
long thoracic nerve c5, c6, c7
Serratus anterior action
protraction of scapula, prevents winging of scapula
Biceps brachii origin
long head- supraglenoid tubercle, short head- coracoid process
Biceps brachii insertion
radial tuberosity and forearm fascia via bicipital aponeurosis
Biceps brachii innervation
musculocutaneous nerve c5, c6, c7
biceps brachii action
flexion of forearm
Triceps brachii origin
long head- infraglenoid tubercle, medial head- distal 2/3 of posteromedial humerus, lateral head- upper half of the posterior humerus
triceps brachii insertion
proximal olecranon process and forearm fascia
triceps brachii innervation
radial nerve c6, c7, c8
triceps brachi action
resist dislocation of glenohumeral joint, forearm extension
Coracobrachialis origin
coracoid process
coracobrachialis insertion
middle 3rd of the medial humeral shaft
coracobrachialis innervation
musculocutaneous nerve c5, c6, c7
coracobrachialis action
flexion and adduction of the arm at the shoulder, resists dislocation of the glenohumeral joint
brachialis origin
distal half of humeral shaft
brachialis insertion
coronoid process and ulnar tuberosity
brachialis innervation
musculocutaneous nerve c5, c6 and radial nerve c5, c7
brachialis action
flexion of forearm
anconeus origin
posterior aspect of lateral epicondyle of the humerus
anconeus insertion
posterolateral olecranon process
anconeus innervation
radial nerve c7,c8, T1
anconeus action
weak forearm extension, stabilizes elbow joint, abduction of ulna during pronation
Pronator teres origin
humeral head- medial epicondyle by common flexor tendon, ulnar head- coronoid process of the ulna
pronator teres insertion
Lateral surface of middle portion of shaft of radius
pronator teres innervation
median nerve
Pronator teres action
pronates the hand and slightly flexes the forearm
Flexor carpi radialis origin
medial epicondyle of humerus by common flexor tendon
flexor carpi radialis insertion
base of 2nd and 3rd metacarpal
Flexor carpi radialis innervation
median nerve
flexor carpi radialis action
flexes wrist, abducts hand
Palmaris longus origin
medial epicondyle of humerus by common flexor tendon
palmaris longus insertion
palmar aponeurosis
palmaris longus innervation
median nerve
palmaris longus action
flexes wrist
Flexor carpi ulnaris origin
humeral head- medial epicondyle of humerus, ulnar head- medial border of olecranon process and proximal dorsal surface of the ulna
Flexor carpi ulnaris insertion
pisiform, hamulus of the hamate and base of 5th metacarpal
flexor carpi ulnaris innervation
ulnar nerve
flexor carpi ulnaris action
flexes wrist and adducts hand
flexor digitorum superficialis origin
humeroulnar head- medial epicondyle of humerus and coronoid process of the ulna, radial head- proximal half anterior border of radius
flexor digitorum superficialis insertion
palmar aspect of middle phalanges of digits 2-5
Flexor digitorum superficialis innervation
median nerve
flexor digitorum superficialis action
flexes proximal IP joints of 2-5 and assists in flexion of the MP joints of wrist and forearm
flexor digitorum profundus origin
proximal 2/3 of the medial anterior surface of the ulnar and adjacent interosseous membrane
flexor digitorum profundus insertion
palmar surface of distal phalanges digits 2-5
flexor digitorum profundus innervation
1/2 anterior interosseous nerve, 1/2 ulnar nerve
flexor digitorum profundus action
Flexion of distal IP joints, flexion of proximal IP joints, MP joints and wrist joints
Flexor pollicis longus origin
grooved anterior surface of radius and adjacent interosseous membrane, may also attach to the medial border of the coronoid process of the ulna and the medial epicondyle of the humerus
flexor pollicis longus insertion
palmar surface, base of distal phalanx of thumb
Flexor pollicis longus innervation
anterior interosseous nerve
flexor pollicis longus action
flexes thumb
Pronator quadratus origin
distal 4th of anterior surface of the ulna
pronator quadratus insertion
distal 4th anterior surface of the radius
pronator quadratus innervation
anterior interosseous nerve
pronator quadratus action
pronates the hand
Extensor carpi radialis longus origin
lateral supracondylar ridge of humerus
extensor carpi radialis longus insertion
dorsal surface of the 2nd metacarpal
extensor carpi radialis longus innervation
radial nerve
extensor carpi radialis longus action
extends and abducts the hand
extensor carpi radialis brevis origin
lateral epicondyle of humerus
extensor carpi radialis brevis insertion
dorsal surface of base of the 3rd metacarpal
extensor carpi radialis brevis innervation
deep branch of radial nerve
extensor carpi radialis brevis action
extends and assists in abduction of the hand
Extensor digitorum origin
lateral epicondyle of the humerus
Extensor digitorum insertion
dorsal surface of the middle and distal phalanges of digits 2-5
extensor digitorum innervation
deep branch of radial nerve
extensor digitorum action
Extends digits 2-5, assists with extension of hand
extensor digiti minimi origin
lateral epicondyle of the humerus via common extensor tendon
extensor digiti minimi insertion
dorsal surface of proximal phalanx of the 5th digit
extensor digiti minimi innervation
deep branch of the radial nerve
extensor digiti minimi action
extends the 5th digit
Extensor carpi ulnaris origin
lateral epicondyle of humerus and posterior border of the ulna
extensor carpi ulnaris insertion
dorsal base of 5th metacarpal
Extensor carpi ulnaris innervation
deep branch of radial nerve
extensor carpi ulnaris action
extends and adducts the hand
abductor pollicis longus origin
middle 3rd of posterior surface of ulna, radius and interosseous membrane
abductor pollicis longus insertion
dorsolateral surface of base of the 1st metacarpal
abductor pollicis longus innervation
posterior interosseous nerve
abductor pollicis longus action
abducts the thumb and wrist, assists with extension of thumb
Extensor pollicis brevis origin
distal 3rd of posterior surface of the radius and interosseous membrane
extensor pollicis brevis insertion
dorsal surface of base of proximal phalanx of thumb
extensor pollicis brevis innervation
posterior interosseous nerve
extensor pollicis brevis action
extends proximal phalanx of thumb and 1st metacarpal
Extensor pollicis longus origin
middle 3rd of ulnar and interosseous membrane
extensor pollicis longus insertion
dorsal surface of base of distal phalax of thumb
extensor pollicis longus innervation
posterior interosseous nerve
extensor pollicis longus action
extends the thumb at the IP and MCP joints
extensor indicis origin
distal 3rd of posterior surface of the ulna and interosseous membrane
extensor indicis insertion
dorsum, base of distal phalanx of 2nd digit with extensor expansion
extensor indicis innervation
posterior interosseous nerve
extensor indicis action
extends the index finger
Supinator origin
lateral epicondyle of humerus, radial collateral ligament of elbow joint, annular ligament of radial head, supinator fossa of ulna and associated crest
Supinator insertion
lateral and anterior surface of proximal 3rd of radius
Supinator innervation
deep branch of radial nerve
supinator action
supinates the hand
brachioradialis origin
lateral supracondylar ridge of the humerus
brachioradialis insertion
lateral radius at base of
styloid process
brachioradialis innervation
radial nerve
brachioradialis action
relatively weak forearm flexion, maximal when forearm is midpronated
abductor pollicis brevis innervation
recurrent branch of median nerve
abductor pollicis brevis perfusion
superficial palmar branch of radial artery
abductor pollicis brevis action
abducts thumb
Thenar compartment muscles
abductor pollicis brevis, flexor pollicis brevis, opponens pollicis
flexor pollicis brevis perfusion
superficial palmar branch of radial artery
flexor pollicis brevis innervation
superficial head- recurrent branch of median nerve, deep head- deep branch of ulnar nerve
flexor pollicis brevis action
flexes thumb
opponens pollicis perfusion
superficial branch of radial artery
opponens pollicis innervation
recurrent branch of median nerve
Adductor compartment muscle
adductor pollicis
adductor pollicis perfusion
deep palmar arch
adductor pollicis innervation
deep branch of ulnar nerve
adductor pollicis action
adducts thumb
Hypothenar compartment muscles
Abductor digiti minimi, flexor digiti minimi brevis, opponens digiti minimi
Abductor digiti minim perfusion
deep palmar branch of ulnar artery
abductor digiti minimi innervation
deep ulnar nerve
abductor digiti minimi action
abducts 5th digit
flexor digiti minimi brevis perfusion
deep palmar branch of ulnar artery
flexor digiti minimi brevis innervation
deep branch of ulnar nerve
flexor digiti minimi brevis action
flexes proximal phalanx of 5th digit
opponens digiti minimi perfusion
deep palmar branch of ulnar artery
opponens digiti minimi innervation
deep branch of ulnar nerve
opponens digit minimi action
rotates and flexes 5th digit toward thumb
muscle superficial to hypothenar compartment
palmaris brevis
palmaris brevis perfusion
superficial palmar arch
palmaris brevis innervation
superficial branch of ulnar nerve
palmaris brevis action
assists with grip, protects ulnar artery and nerve
central compartment muscle
lumbricals
lumbricals perfusion
superficial and deep palmar arches
lumbricals innervation
1st and 2nd lumbricals- unipennate and median nerve
3rd and 4th lumbricals- bipennate and ulnar nerve
lumbricals action
extend IP joint and flex the MCP joint
interosseous compartment muscles
palmar interosseous muscles, dorsal interosseous muscles
palmar interosseous muscles perfusion
deep palmar arch
palmar interosseous muscles innervation
deep branch of ulnar nerve
palmar interosseous muscles action
adduction of digits
dorsal interosseous muscles perfusion
deep palmar arch
dorsal interosseous innervation
deep branch of ulnar nerve
dorsal interosseous action
abduction of digits 2-4
What is innervated by the median nerve before the branching of the anterior interosseous nerve
Flexor carpi radialis, palmaris longus, and flexor digitorum superficialis, pronator teres
What is innervated by the median nerve after the branching of the anterior interosseous nerve
lumbricals 1 and 2, and palmar cutaneous branch to lateral 3.5 digits
what is innervated by the anterior interosseous nerve
lateral 1/2 of flexor digitorum profundus, flexor pollicis longus, pronator quadratus
what is innervated by the recurrent median nerve
opponens pollicis, superficial head of flexor pollicis brevis, abductor pollicis brevis
Median nerve branches in the hand
recurrent branch of median nerve, common digital branches and then proper digital nerves
Ulnar nerve innervates
flexor carpi ulnaris and medial 1/2 of flexor digitorum profundus
superficial branch of ulnar nerve innervates
palmaris brevis and cutaneous sensation to the medial 1.5 digits
deep branch of the ulnar nerve innervates
deep head of flexor pollicis brevis, adductor pollicis, abductor digiti minimi, flexor digiti minimi brevis, opponens digiti minimi, 3rd and 4th lumbricals, palmar interosseous and dorsal interosseous muscles
radial nerve innnervates
triceps brachii, anconeus, brachialis, brachioradialis, extensor carpi radialis longus
superficial branch of radial nerve innervates
cutaneous sensation of posterior arm and dorsal hand
deep branch of radial nerve innervates
supinator, extensor digiti minimi, extensor digitorum, extensor carpi radialis brevis, extensor carpi ulnaris
After passing through supinator radial nerve turns into posterior interosseous nerve and innervates
abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus, and extensor indicis
Musculocutaneous nerve innervates
biceps brachii, coracobrachialis, and brachialis
Musculocutaneous nerve becomes the lateral antebrachial cutaneous nerve which innervates
cutaneous sensation to lateral forearm