Shoulder/Arm/Hand Flashcards
Proximal Attachment Medial 1/3 of superior nuchal line External occipital protuberance Ligamentum nuchae Spines and supraspinous ligaments from C7 to T12 Distal Attachment Posterior border of lateral 1/3 of clavicle Acromion Scapular spine Innervation Spinal Accessory Nerve (CN XI) Ventral rami C3, C4
Trapezius
Proximal Attachment Spinous processes of T7-T12 Thoracoumbar fascia Posterior part of iliac crest Inferior 3-4 ribs Distal Attachment Floor of intertuberous sulcus of humerus Innervation Thoracodorsal nerve (C6, C7, C8)
Latissimus Dorsi
Proximal Attachment
Transverse processes of C1-C4
Distal Attachment
Medial scapular border between superior angle and end of scapular spine
Innervation
Dorsal Scapular (C5) and cervical (C3, C4)
Levator Scapulae
Proximal Attachment Lower ligamentum nuchae Spines of C7 and T1 Distal Attachment Medial end of spine of scapula Innervation Dorsal Scapular (C4, C5)
Rhomboid Minor
Proximal Attachment Spines of T2-T5 vertebrae Distal Attachment Medial border of scapula from spine to inferior angle Innervation Dorsal Scapular (C4, C5)
Rhomboid Major
Proximal Attachment Lateral 1/3 clavicle Acromion Spine of scapula Distal Attachment Deltoid Tuberosity Innervation Axillary Nerve (C5, C6)
Deltoid
Proximal Attachment Inferior scapular angle Distal Attachment Medial lip of intertubercular sulcus Innervation Lower Subscapular Nerve (C5, C6)-posterior cord
Teres Major
Proximal Attachment Suprascapular fossa Distal Attachment Superior facet of greater tubercle of humerus Innervation Suprascapular Nerve (C4, C5, C6)
Supraspinatus
Proximal Attachment
Inferior scapular fossa
Distal Attachment
Medial facet of greater tubercle of humerus
Innervation
Suprascapular Nerve (C5, C6)- Lateral Cord
Infraspinatus
Proximal Attachment Upper 2/3 of lateral border of scapula Distal Attachment Inferior facet of greater tubercle of humerus Innervation Axillary Nerve (C5, C6)
Teres Minor
Proximal Attachment Subscapular fossa Distal Attachment Lesser tubercle of humerus Innervation Upper and Lower subscapular nerves (C5, C6, C7) – Posterior cord
Subscapularis
Proximal Attachment Medial half of clavicle Sternum Upper six costal cartilages Distal Attachment lateral lip of intertubercular sulcus Innervation medial and lateral pectoral nerves (C5, C6- clavicular and C6, C7, C8, T1-sternal)
Pectoralis Major
Proximal Attachment Ribs 3-5 Distal Attachment Coracoid process Innervation Medial pectoral nerves (C5, C6, C7, C8, T1)
Pectoralis Minor
Proximal Attachment Rib 1 Distal Attachment Inferior clavicle Innervation Nerve to subclavius (C5, C6)
Subclavius
Proximal Attachment
Lateral regions of ribs 1-8
Distal Attachment
Anterior surface of medial border of scapula
Innervation
Long Thoracic Nerve (C5, C6, C7)- Roots of nerves
Serratus Anterior
Origin
Lateral epicondyle of humerus, radial collateral and annular ligaments, supinator fossa and crest of ulna
Insertion
Lateral, posterior and anterior surfaces of proximal 1/3 of radius
Action
Supinates forearm (i.e., rotates radius to turn palm anteriorly)
Innervation
Deep branch of radial nerve (C5 and C6)
Arterial Supply
Recurrent interosseous artery
Supinator
Origin Medial epicondyle of humerus and coronoid process of ulna Insertion Middle of lateral surface of radius Action Pronates and flexes forearm (at elbow) Innervation Median nerve (C6 and C7) Arterial Supply Ulnar artery, anterior recurrent ulnar artery
Pronator Teres
Origin Distal 1/4 of anterior surface of ulna Insertion Distal 1/4 of anterior surface of radius Anterior interosseous artery Pronates forearm; deep fibers bind radius and ulna together Innervation Anterior interosseous nerve from median nerve (C8 and T1) Arterial Supply
Pronator Quadratus
Origin Medial epicondyle of humerus Insertion Base of 2nd metacarpal Action Flexes and radial flexion (at wrist) Innervation Median nerve (C6 and C7) (C6, C7) Arterial Supply Ulnar artery
Flexor Carpi Radialis
Origin Medial epicondyle of humerus Insertion Distal half of flexor retinaculum and palmar aponeurosis Action Flexes hand (at wrist) and tightens palmar aponeurosis Innervation Median nerve (C7 and C8) (C7, C8) Arterial Supply Ulnar artery
Palmaris Longus
Origin Humeral head: medial epicondyle of humerus; Ulnar head: olecranon and posterior border of ulna Insertion Pisiform bone, hook of hamate bone, and 5th metacarpal bone Action Flexes and ulnar flexion (at wrist) Innervation Ulnar nerve (C7 and C8) (C7, C8) Arterial Supply Ulnar artery
Flexor Carpi Ulnaris
Origin
Humeroulnar head: medial epicondyle of humerus, ulnar collateral ligament, and coronoid process of ulna; Radial head: superior half of anterior border of radius
Insertion
Bodies of middle phalanges of digits 2 - 5
Action
Flexes middle phalanges at proximal interphalangeal joints of medial four digits; acting more strongly, it also flexes proximal phalanges at metacarpophalangeal joints and hand
Innervation
Median nerve (C7, C8 and T1) (C7, C8, T1)
Flexor Digitorum Superficialis
Origin
Proximal 3/4 of medial and anterior surfaces of ulna and interosseous membrane
Insertion
Base of the distal phalanx of digits 2 - 5
Action
Flexes distal phalanges at distal interphalangeal joints of medial four digits; assists with flexion of hand
Innervation
Medial part: ulnar nerve (C8 and T1); Lateral part: anterior interosseous branch of median nerve (C8 and T1) (C8, T1)
Flexor Digitorum Profundus
Origin Anterior surface of radius and adjacent interosseous membrane Insertion Base of distal phalanx of thumb Action Flexes phalanges of 1st digit (thumb) Innervation Anterior interosseous nerve from median nerve (C8 and T1) (C8, T1)
Flexor Pollicis Longus
Origin
Flexor retinaculum and tubercles of scaphoid and trapezium
Insertion
Lateral side of base of proximal phalanx of thumb
Action
Flexes and abducts thumb
Innervation
Recurrent branch of median nerve (C8 and T1) (C8, T1)
Abductor Pollicis Brevis
Origin Proximal 2/3 of lateral supracondyle ridge of humerus Insertion Lateral surface of distal end of radius Action Flexes forearm Innervation Radial nerve (C5, C6 and C7) (C5, C6, C7)
Brachioradialis
Origin Lateral epicondyle of humerus Insertion Base of 3rd metacarpal Action Extend and abduct hand at wrist joint Radial deviation Innervation Deep branch of radial nerve (C7 and C8) (C7, C8)
Extensor Carpi Radialis Brevis
Origin Lateral supracondyle ridge of humerus Insertion Base of 2nd metacarpal Action Extend and abduct hand at wrist joint Innervation Radial nerve (C6 and C7) (C7, C6)
Extensor Carpi Radialis Longus
Origin
Lateral epicondyle of humerus
Insertion
Extensor expansions of medial four digits
Action
Extends medial four digits at metacarpophalangeal joints; Extends hand at wrist joint
Innervation
Posterior interosseous nerve (C7 and C8), the continuation of the deep branch of the radial nerve (C7, C8)
Extensor Digitorum
Origin
Lateral epicondyle of humerus and posterior border of ulna
Insertion
Base of 5th metacarpal
Action
Extends and adducts hand at wrist joint. Ulnar deviation
Innervation
Posterior interosseous nerve (C7 and C8), the continuation of the deep branch of the radial nerve (C7, C8)
Extensor Carpi Ulnaris
Origin Lateral epicondyle of humerus Insertion Extensor expansion of 5th digit Action Extends 5th digit at metacarpophalangeal and interphalangeal joints Innervation Posterior interosseous nerve (C7 and C8), the continuation of the deep branch of the radial nerve (C7, C8)
Extensor Digiti Minimi
Origin
Posterior surface of ulna and interosseous membrane
Insertion
Extensor expansion of 2nd digit (medial phalanx)
Action
Extends 2nd digit and helps to extend hand
Innervation
Posterior interosseous nerve (C7 and C8), the continuation of the deep branch of the radial nerve (C7, C8)
Extensor Indices
Origin
Posterior surfaces of radius and interosseous membrane
Insertion
Base of proximal phalanx of thumb
Action
Extends proximal phalanx of thumb at carpometacarpal joint
Innervation
Posterior interosseous nerve (C7 and C8), the continuation of the deep branch of the radial nerve (C7, C8)
Extensor Pollicis Brevis
Origin
Posterior surface of middle 1/3 of ulna and interosseous membrane
Insertion
Base of distal phalanx of thumb
Action
Extends distal phalanx of thumb at carpometacarpal and interphalangeal joints
Innervation
Posterior interosseous nerve (C7 and C8), the continuation of the deep branch of the radial nerve (C7, C8)
Extensor Pollicis Longus
Origin
Flexor retinaculum and tubercles of scaphoid and trapezium
Insertion
Lateral side of base of proximal phalanx of thumb
Action
Abducts thumb and helps oppose it
Innervation
Recurrent branch of median nerve (C8 and T1) (C8, T1)
Abductor Pollicis Brevis
Origin
Flexor retinaculum and tubercles of scaphoid and trapezium
Insertion
Lateral side of 1st metacarpal
Action
Draws 1st metacarpal laterally to oppose thumb toward center of palm and rotates it medially
Innervation
Recurrent branch of median nerve (C8 and T1) (C8, T1)
Opponens Pollicis
Origin
Flexor retinaculum and tubercles of scaphoid and trapezium
Insertion
Lateral side of base of proximal phalanx of thumb
Action
Flexes thumb
Innervation
Recurrent branch of median nerve (C8 and T1) (C8, T1)
Flexor Pollicis Brevis
Origin Pisiform Insertion Medial side of base of proximal phalanx of little finger Action Abducts little (5th) finger Innervation Deep branch of ulnar nerve (C8 and T1) (C8, T1)
Abductor Digiti Minimi
Origin
Hook of hamate and flexor retinaculum
Insertion
Medial side of base of proximal phalanx of little finger
Action
Flexes proximal phalanx of little (5th) finger
Innervation
Deep branch of ulnar nerve (C8 and T1) (C8, T1)
Flexor Digiti Minimi
Origin Hook of hamate and flexor retinaculum Insertion Medial border of 5th metacarpal Action Draws 5th metacarpal anteriorly and rotates it, bringing little finger (5th digit) into opposition with thumb Innervation Deep branch of ulnar nerve (C8 and T1) (C8, T1)
Opponens Digiti Minimi
Origin
Oblique head: bases of 2nd and 3rd metacarpals, capitate, and adjacent carpals; Transverse head: anterior surface of body of 3rd metacarpal
Insertion
Medial side of base of proximal phalanx of thumb
Action
Draws 1st metacarpal laterally to oppose thumb toward center of palm and rotates it medially
Innervation
Deep branch of ulnar nerve (C8 and T1) (C8, T1)
Adductor Pollicis
Origin
1 - 3: Palmar surfaces of 2nd, 4th and 5th metacarpals (unipennate muscles)
Insertion
1 - 3: Extensor expansions of digits and bases of proximal phalanges of digits 2, 4 and 5
Action
1 - 3: Adduct digits toward axial line and assist lumbricals in flexing metacarpophalangeal joints and extending interphalangeal joints
Innervation
Deep branch of ulnar nerve (C8 and T1) (C8, T1)
Interosseous Mucles, Palmar
O:Tendons of FDP I: Tendons of Extensor digitorum N: median and ulnar A: Finger flexion(metacarpophalangeal) A: Finger ext: Interphalangeal
Lumbricales
Origin
1 - 4: Adjacent sides of two metacarpals (bipennate muscles)
Insertion
1 - 4: Extensor expansions and bases of proximal phalanges of digits 2 - 4
Action
1 - 4: Abduct digits from axial line and act with lumbricals to flex metacarpophalangeal joints and extend interphalangeal joints
Innervation
Deep branch of ulnar nerve (C8 and T1) (C8, T1)
Interosseous Muscles, Dorsal
Origin:
Manubrium sternal and medial portion of the clavicle
Insertion:
Mastoid process of the temporal bone, superior nuchal line
Nerve
Motor: accessory nerve
sensory: cervical plexus
Actions
Acting alone, tilts head to its own side and rotates it so the face is turned towards the opposite side.
Acting together, flexes the neck, raises the sternum and assists in forced inspiration.
Sternocleidomastoid
Origin: Cervical vertebrae (CII-CVII) Insertion: First and second ribs Nerve: Cervical nerves (C3-C6) Actions: Elevation of the ribs when contracts
Scalene Muscles
Proximal Attachment apex coracoid process (short head) supraglenoid turbercle (long head) Distal Attachment radial tuberosity (biceps tendon deep fascia of anterior forearm (aponeurosis) Innervation Musculocutaneous (C5, C6, C7)- Lateral cord Action powerful supinator of forearm powerful flexor of elbow joint weak flexor of shoulder joint
Biceps Brachii
Proximal Attachment tip of coracoid process Distal Attachment Middle third of medial surface of humerus Innervation Musculocutaneous (C5, C6, C7) Action Flexes arm Adducts arm Stabilizes glenohumeral joint
Coracobrachialis
O: Distal half of humerus
I: Coronoid process of ulna
Brachialis
Proximal Attachment
infraglenoid tubercle of scapula (long head)
posterior surface of humeral shaft-below radial groove (medial head)
posterior surface of humerus-above radial groove (lateral head)
Distal Attachment
olecranon process of ulna via common tendon
Innervation
Radial Nerve (C6, C7, C8)
Action
Chief extensor of forearm
Triceps Brachii
Proximal Attachment Lateral epicondyle of humerus Distal Attachment Lateral surface of olecranon Superior part of posterior surface of ulna Innervation Radial Nerve (C7, C8, T1) Action Assists triceps in extending forearm Stabilizes elbow joint
Anconeus
