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MSS > MSS09 Upper Limb Muscles > Flashcards

MSS09 Upper Limb Muscles Flashcards

1
Q

Pectoral girdle muscles

A
  • origin: Trunk
  • insertion: Scapula / Clavicle
  1. Trapezius
    - extensive origin: Head, Neck, Thoracic vertebrae
    - upper fibres (Elevate scapula)
    - middle fibres (Retract scapula)
    - lower fibres (Depress scapula)
    - insertion: U-shaped insertion along inner Lateral 1/3 of Clavicle, Acromion and Spine of scapula
  2. Levator scapulae
    - Elevate scapula
    - insertion: Medial border of Scapula
  3. Rhomboid minor
    - Retract scapula
    - insertion: Medial border of Scapula
  4. Rhomboid major
    - Retract scapula
    - insertion: Medial border of Scapula
  • **5. Serratus anterior
  • Protract + Rotates scapula
  • Holds ***Medial border of Scapula close to thoracic wall
  • insertion: Anterior/Costal surface of Medial border of scapula
  • -> Most muscle fibres converge at Inferior angle of scapula
  • Paralysis: ***Winging of scapula
  1. Pectoralis minor
    - Depress scapula
    - insertion: Coracoid process
  2. Subclavius
    - Depress scapula
    - insertion: Under surface of Clavicle
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2
Q

Rotation of scapula

A

Serratus anterior (protract: 將inferior angle擰出去) and Trapezius (upper fibres elevate, lower fibres depress) work together to rotate scapula

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3
Q

Arm/Shoulder joint muscles

A
  • origin: Axial skeleton / Pectoral girdle
  • insertion: Humerus

Lateral insertion:

  1. Deltoid
    - Abduct arm beyond ***initial 15o
    - origin: Acromion, Spine of scapula
    - insertion: Deltoid tuberosity

Anterior insertion:

  1. Latissimus dorsi
    - Adduct, Extend, ***Medially Rotate arm
    - insertion: Floor of Intertubercular (Bicipital) groove (on anterior side) of Humerus
  2. Teres major
    - Adduct, Extend, ***Medially Rotate arm
    - insertion: Medial lip of Intertubercular (Bicipital) groove of Humerus
  3. Pectoralis major
    - Adduct, ***Flex, Medially Rotate arm
    - insertion: Lateral lip of Intertubercular (Bicipital) groove of Humerus
    - 3 parts: clavicular + sternal + abdominal
  4. Coracobrachialis (將手臂舉起)
    - Flex arm / shoulder joint
    - origin: Coracoid process
    - insertion: Middle of Medial shaft of Humerus
  5. Subscapularis
    - Medial Rotate arm
    - insertion: Lesser tubercle (anterior) of Humerus

Posterior insertion:

  1. Supraspinatus
    - ***Initiate Abduction of arm
    - insertion: superior facet of Greater tubercle of Humerus
  2. Infraspinatus
    - Lateral Rotate arm
    - insertion: middle facet on posterior Greater tubercle of Humerus
  3. Teres minor
    - Lateral Rotate arm
    - insertion: inferior facet on posterior Greater tubercle of Humerus
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4
Q

***Rotator cuff

A
  1. Subscapularis
  2. Supraspinatus
  3. Infraspinatus
  4. Teres minor
  • all originate from Scapula
  • all insert into Proximal Humerus (Greater / Lesser tubercle of Humerus)
  • Maintain stability of shoulder joint
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5
Q

Intertubercular (Bicipital) groove

A

3 insertions:
Lateral lip: Pectoralis major (flex arm)
Floor: Latissimus dorsi (extend arm)
Medial: Teres major (extend arm)

Lady “D” lies between 2 majors

ALL Adduct and Medial rotate arm

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6
Q

Arm muscle

A
  • Separated by Lateral / Medial intermuscular septum

Anterior (Flexor)

  1. Coracobrachialis
    - Flex shoulder
    - do not cross elbow joint
    - origin: Coracoid process
    - insertion: Middle of Medial shaft of Humerus
  2. Brachialis
    - Flex elbow
  3. Biceps brachii
    - Flex elbow, **Strong Supination
    - insertion: Bicipital tuberosity of Radius
    - Bicipital aponeurosis
    - **    Long + Short head

Posterior (Extend elbow)

  1. Triceps brachii
    - ***Long + Lateral + Medial head
  2. Anconeus (considered part of triceps)
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7
Q

***Triangular space
Triangular interval
Quadrangular space

A 
Teres minor (上)
Teres major (下)
夾住 Triceps Long + Lateral head (中間)

Triangular space (左):

  • Teres minor + Teres major + Long head
  • ***Circumflex Scapular A+V

Triangular interval (下):

  • Teres major + Long head + Humeral shaft (Lateral)
  • ***Radial nerve + Profunda Brachii vessels
  • passageway between anterior and posterior compartments of arm + between posterior compartment of arm and axilla

Quadrangular space (中):

  • Teres minor + Teres major + Long head + Humerus Surgical neck (Lateral)
  • **Axillary nerve + **Posterior Circumflex Humeral A+V
  • -> passageway between axilla and dorsal scapular region
  • -> Hypertrophy of space / Fibrosis of muscle edges
  • -> impinge on Axillary nerve
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8
Q

Anterior group muscles of forearm (Flexor)

A
  • Anterior / Posterior group separated by:
    1. Lateral intermuscular septum
    2. Radius
    3. Ulna
    4. Interosseous membrane
  • Act primarily on wrist joint and digits (depend on insertion)

Anterior (Flexor)

  • Flex wrist, Flex digits, Pronate hand
  • Superficial, Intermediate, Deep layer

Superficial layer:

  • origin: Common Flexor Tendon from ***Medial Epicondyle of Humerus
  • ALL extend into hand EXCEPT Pronator teres
  • Lateral to Medial:
    1. Pronator teres
  • Pronation
  • insertion: Mid-shaft of Radius
  1. Flexor carpi radialis
    - Flex + ***Abduct wrist
    - insertion: Base of 2nd, 3rd Metacarpals
  2. Palmaris longus
    - Flex wrist
    - insertion: Palmar Aponeurosis, Flexor Retinaculum
    - not always present
  3. Flexor carpi ulnaris
    - Flex + ***Adduct wrist
    - insertion: Pisiform + Base of 5th Metacarpal

Intermediate layer:

  1. Flexor digitorum superficialis
    - Flex 2-5 ***PIP
    - insertion: Middle Phalanges of 2-5 digits
    (tendon: 3,4 anterior; 2,5 posterior; splits into two slips)

Deep layer:

  • origin: Radius, Ulna, Interosseous membrane
    1. Flexor pollicis longus (brevis: intrinsic muscle)
  • Flex ***IP thumb
  • insertion: Distal Phalanx of thumb
  1. Flexor digitorum profundus
    - Flex 2-5 ***DIP
    - insertion: Distal Phalanges of 2-5 digits
    - tendon 一字排開
  2. Pronator quadratus
    - Pronation
    - attach anteriorly to the distal 1/4 of the radius and ulna
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9
Q

***Carpal tunnel

A

Tendons of:

  1. Flexor carpi radialis
  2. Flexor pollicis longus
  3. Flexor digitorum superficialis
  4. Flexor digitorum profundus
  5. Median nerve
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10
Q

Posterior group muscles of forearm (Extensor)

A
  • Extend wrist, Extend digits, Supinate hand

Superficial layer:

  • origin: Common Extensor on Lateral Supracondylar Ridge + ***Lateral Epicondyle of Humerus
    1. Brachioradialis
  • ***Flex elbow (accessory flexor)
  • insertion: Distal Radius
  • anterior to elbow joint
  • action most efficient when forearm is mid-pronated
  1. Extensor carpi radialis longus
    - Extend + ***Abduct wrist
    - insertion: Dorsal of Base of 2nd Metacarapal
  2. Extensor carpi radialis brevis
    - Extend + ***Abduct wrist
    - insertion: Dorsal of Base of 3th Metacarapal
  3. Extensor carpi ulnaris
    - Extend + ***Adduct wrist
    - insertion: Dorsal of Base of 5th Metacarapal
  4. Extensor digitorum
    - Extend 2-5
    - insertion: Extensor Expansion of 2-5
    - intertendinous connections between tendons
  5. Extensor digiti minimi
    - Extend 5
    - insertion: Extensor Expansion of 5

Deep layer:

  1. Supinator
    - Supination
    - insertion: wrap around and insert on Anterior Upper 1/3 Radius
  2. Abductor pollicis longus (brevis: intrinsic muscle)
    - **Abduct **CMC thumb
    - insertion: Base of 1st Metacarpal
  3. Extensor pollicis brevis
    - Extend ***MCP thumb
    - insertion: Proximal Phalanx of Thumb
  4. Extensor pollicis longus
    - Extend ***IP thumb
    - insertion: Distal Phalanx of Thumb
  5. Extensor indicis
    - Extend 2
    - insertion: Extensor Expansion of 2
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11
Q

***Extensor expansion / dorsal digital expansion / insertion of extensor digitorum

A
  1. Tendon of Lumbrical muscles +
  2. Tendon of Interosseous muscles +
  3. Tendon of ***Extensor digitorum

—> Central band inserts at base of middle phalanx
—> Lateral band inserts at base of distal phalanx

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12
Q

***Cubital fossa

A

Lateral / Medial boundary: Brachioradialis + Pronator teres
Floor: Brachialis + Supinator
Roof / Covered by: Bicipital aponeurosis

Cubical fossa contents (***記: BMTR):

  1. ***Brachial artery —> divide into Ulnar + Radial artery
  2. ***Median nerve
  3. ***Tendon of Biceps brachii
  4. ***Radial nerve (+ deep branch)
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13
Q

Anatomical snuff box

A

Radial (anterior) border:

  • Abductor pollicis longus tendon
  • Extensor pollicis brevis tendon

Ulnar (posterior) border:
- Extensor pollicis longus tendon

***Radial artery within

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14
Q

Intrinsic muscle of hand (Thenar, Hypothenar, Lumbricals, Interossei)

A

Thenar muscles (act on thumb)

  1. Abductor pollicis brevis (median nerve, Thenar eminence)
    - insertion: Base of Proximal Phalanx
  2. Flexor pollicis brevis (median nerve, Thenar eminence)
    - insertion: Base of Proximal Phalanx
  3. Opponens pollicis (median nerve, Thenar eminence)
    - insertion: Shaft of 1st Metacarpal
  4. Adductor pollicis (***ulnar nerve)
    - insertion: Base of Proximal Phalanx

Hypothenar muscles (act on 5)

  1. Abductor digiti minimi (ulnar nerve)
    - insertion: Base of Proximal Phalanx
  2. Flexor digiti minimi (ulnar nerve)
    - insertion: Base of Proximal Phalanx
  3. Opponens digiti minimi (ulnar nerve)
    - insertion: Medial Border of 5th Metacarpal
  4. Palmaris brevis (Hypothenar eminence)
    - subcutaneous muscle; puckers the skin over the hypothenar eminence to deepen the palm of the hand

Lumbricals (act on 2-5; 4/5, 3/4: Ulnar nerve; 2/3, 1,2: Median nerve)

  • Flex MCP, Extend IP
  • insertion: Extensor Expansion —> allow Flex MCP, Extend IP
  • arise from Flexor digitorum profundus tendon
  • Sensory organs to integrate actions of digital flexors and extensors —> allow fine coordination in movement of fingers

Interosseous muscle (ulnar nerve)

  1. Dorsal interossei (***aBduction)
  2. Palmar interossei (**aDduction)
    - insertion: Base of Proximal Phalanges, Extension Expansion
    - Secondary function: Flex MCP, Extend IP (due to insertion into extensor expansion)
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15
Q

Read Slides

A

Read Slides

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