Muscle 2 Upper limb

Question 1

Upper Trapezius
Origin, insertion, action
Palpate

Answer 1

Origin- External occipital protuberance ligament in nuchae
Insertion- lateral third of clavicle/ Acromion of scapula
Action- elevation/ lateral (upward) rotation of scapula
Palpate- between curvature of neck and lateral third clavicle. Elevate scapula

Question 2

Middle Trapezius
Origin, insertion, action
Palpate

Answer 2

Origin- C7-T3 spinous processes
Insertion- spine of scapula
Action- adduction (retraction) of scapula
Palpate- palpate area medial to the vertebral border of scapula between T1–5 and root of spine during active scapular adduction.

Question 3

Lower Trapezius
Origin, insertion, action
Palpate

Answer 3

Origin- T4-T12 spinous processes
Insertion- root of spine of scapula
Action- depression lateral (upward) rotation of the scapula
Palpate-triangular area between lower thoracic vertebrae T6-12 and root of spine of scapula during depression and lateral ( upward) rotation

Question 4

Levator Scapula
Origin, insertion, action
Palpate

Answer 4

Origin- C1-4 (transverse processes)
Insertion- vertebral border of scapula from superior angle to root of spine
Action- Elevation/ medial (downward) rotation of scapula
Palpate- shrug shoulders

Question 5

Rhomboid Major
Origin, insertion, action
Palpate

Answer 5

Origin- T2-T5 (spinous processes)
Insertion- vertebral border of scapula from root of spine to inferior angle
Action- adduction (retraction)/ medial (downward) rotation of scapula
Palpate- area medial to the vertebral border of the scapula near the inferior angle during active scapular adduction and medial rotation. ( retraction and downward rotation)

Question 6

Rhomboid Minor
Origin,insertion , action
Palpate

Answer 6

Origin- C7 and T1 (spinous processes)
Insertion- root of spine of scapula
Action- adduction (retraction) medial (downward) rotation of scapula
Palpate- area medial to the vertebral

Question 7

Serratus Anterior
Origin, insertion, action
Palpate

Answer 7

Origin- lateral surface of upper 8 ribs by finger like slips
Insertion-vertebral border of scapula - anterior surface
Action- abduction (protraction)/ lateral upward rotation of scapula/stabilizes scapula against chest wall/ depression of scapula (lower fibers)/ assists forced exhalation.
Palpate- below lateral end of clavical on anterior chest wall, just inferior and medial to coracoid process of scapula, during active scapular abduction (protraction)

Question 8

Pectoralis Minor
Origin, insertion, action
Palpate

Answer 8

Origin- anterior surface of ribs 3,4, 5 near costal cartilages
Insertion- Coracoid process of scapula ( medial border of superior surface)
Action- abduction (protraction)/ depression/ medial(downward) rotation/ anterior tilt of scapula/ assist forced inhalation.
Palpate- difficult to palpate. Position arm with the hand behind the back to relax pectoralis major. Place palpating fingertip on coracoid process and lay finger just in front of the anterior border of deltoid. Palpate pectoralis minor as the hand is actively lifted away from the back during scapular abduction (protraction)

Question 9

Subclavious
Origin, insertion, action
Palpate

Answer 9

Origin- 1st rib costocartilage junction
Insertion- inferior shaft of clavicle- middle 1/3
Action- depresses clavicle/ stabilizes sternoclavicular joint
Palpate- difficult

Question 10

Pectoralis Major (clavicular) (sternocostal) heads
Origin, insertion, action
Palpate

Answer 10

(clavicular head)
origin- medial half of clavical
(Sternocostal head)
Origin- sternum/cartilages of superior 6 ribs/aponeurosis of external oblique muscle
Insertion- lateral lip of bicipital (intertubercular) groove of humerus
Action- adduction/ horizontal adduction/ medial rotation of humerus
(Clavicular head) flexion of humerus
(Sternocostal head) extension of humerus/ assists in anterior tilt of scapula
Palpate- anterior chest wall between clavicle and 6th rib during resisted adduction of the humerus at the shoulder joint.
(Clavicular head)- palpate just inferior to medical half of clavicle on anterior chest wall during rested horizontal adduction of the humerus.
(Sternocostal head) - Palpate the lower anterior border of the Avila during rested extension and horizontal adduction of the humerus from a flexed starting position.

Question 11

Latissimus Dorsi
Origin, insertion, action
Palpate

Answer 11

Origin- thoracolumbar aponeurosis/ lower 6 thoracic spinous processes/ sacrum/ Iliac crest of Ilium/ lower 3 to 4 ribs/ inferior angle of the scapula
Insertion- bicipital (intertubercular) groove of humerus
Action- extension/ medial rotation/ adduction of humerus/ medial (downward) rotation of scapula/ assists is depression of scapula
Palpate- alone the posterolateral surface of rib cage towards its insertion on the humerus during resisted extension of the humerus

Question 12

Suprasoinatus (part one of rotator cuff)
Origin, insertion, action
Palpate

Answer 12

Origin- Supraspinous fossa of scapula
Insertion- greater tubercle of humerus (superior facet)
Action- abduction/ scaption of humerus. (Half way between abduction and flexion)/ stabilization of head of humerus
Palpate- above the Spine of scapula near the acromion during the first 15 degrees of abduction of the humerus. The overlying upper trapezius can be relaxed by laterally flexing the neck prior to initiating the motion to help differentiate the Supraspinatus.

Question 13

Infrapinatus (part two of the rotator cuff)
Origin, insertion, action
Palpate

Answer 13

Origin- infraspinous fossa of scapula
Insertion- greater tubercle of humerus (middle facet)
Action- lateral rotation /extension of humerus
Palpate- below the spine of scapula during active lateral rotation of the humerus. Seated with the trunk leaning forward and arm hanging down to passively protract scapula inferior to the posterior deltoid.

Question 14

There Minor (part three of rotator cuff)
Origin, insertion, action
Palpate

Answer 14

Origin- upper 2/3 of auxiliary border of scapula
Insertion- greater tubercle of humerus (inferior facet)
action- lateral rotation/ extension of humerus
Palpate- difficult- along lateral border of scapula just inferior to the infraspinatus during active lateral rotation of the humerus.( hard to differentiate between infraspinatus

Question 15

Subcapularis (part four of rotator cuff)
Origin, insertion, action
Palpate

Answer 15

Origin- subscapular fossa of scapula
Insertion- lesser tubercle of humerus
Action- medial rotation/ adduction of humerus
Palpate- difficult- deep in the Scilla along the lateral border of costal surface of the scapula towards its insertion during medial rotation of the humerus ( hard to differentiate between lattissimus Dorsi)

Question 16

Tere Major
Origin, insertion, action
Palpate

Answer 16

Origin- inferior angle of scapula (dorsal surface)/ lower third of auxiliary border of scapula
Insertion- medial lip of bicipital Grover of humerus
Action- extension/ medial rotation/ adduction of humerus.

Question 17

Deltoids (anterior)
Origin,insertion, action
Palpate

Answer 17

Origin- lateral third clavicle
Insertion- deltoid tuberosity of humerus
Action- flexion/ horizontal adduction/ medial rotation of humerus
Palpate- anterior surface of upper arm in shoulder area just below acromion during horizontal adduction of the humerus

Question 18

Deltoids (middle)
Origin, insertion, action
Palpate

Answer 18

Origin- acromion of scapula- lateral surface
Insertion- deltoid tuberosity of humerus
Action- abduction of humerus to 90 degrees
Palpate- lateral surface of the upper arm in the shoulder area just below the acromion during adduction of the humerus

Question 19

Deltoids (posterior)
Origin, insertion, action
Palpate

Answer 19

Origin- spine of scapula
Insertion- deltoid tuberosity of humerus
Action- Extension/ horizontal abduction/ lateral rotation/ scaption of humerus
Palpate- posterior surface of upper arm in shoulder area just below the acromion during horizontal abduction of the humerus

Question 20

Coracobrachilalis
Origin, insertion, action
Palpate

Answer 20

Origin- coracoid process of scapula
Insertion- middle 1/3 of medial surface of numeral shaft
Action- flexion/ adduction of humerus
Palpate- slender muscle belly on anteromedial surface of proximal humerus, medial to short head of biceps,during resisted flexion and adduction of the humerus

Question 21

Biceps brachii
Origin, insertion, action
Palpate

Answer 21

Origin- (short head) coracoid process of scapula
(Long head) supraglenoid tubercle of scapula
Insertion- tuberosity of ulna (below elbow)
Action- flexion of elbow
Palpate- on either side of the biceps tendon on anterior surface of distal humerus, just proximal to the cubital fossa, during active flexion, during active flexion of the elbow with the forearm prorated ( to relax biceps)
Palpate tendon of insertion deep in cubital fossa just medial to biceps tendon.

Question 22

Anconeus
Origin, insertion, action
Palpate

Answer 22

Origin- lateral epicondyle of humerus
Insertion- olecranon process and upper posterior surface of ulna
Action- assists extension of elbow
Palpate- ( difficult) small area just distal to elbow joint between lateral epicondyle of humerus and olecranon process of the ulna on the posterolateral surface of proximal forearm.

Question 23

Triceps Brachii ( long head)
Origin, insertion, action
Palpate

Answer 23

Origin- infraglenoid tubercle of scapula
Insertion- Olecranon process of ulna
Action- extension of humerus
Palpate- posterolateral surface of proximal humerus, just inferior to the posterior deltoid, during resisted elbow extension.

Question 24

Triceps brachii (lateral head)
Origin, insertion, action
Palpate

Answer 24

Origin- posterior humerus above spinal groove
Insertion—–
Palpate- posterolateral surface of mid humerus during resisted elbow extension.

Question 25

Triceps brachii (medal head)
Origin, insertion, action
Palpate

Answer 25

Origin- posterior humerus below spinal groove
Insertion- olecranon process of ulna
Action—
Palpate- posterior surface distal humerus, proximal to olecranon process of the ulna, on either side of triceps tendon during resisted elbow extension. It lies deep to the long and lateral heads