Upper Extremity Flashcards
Pectoralis Major (clavicular fibers) ORIGIN
Anterior surface of sternal 1/2 of clavicle
Pectoralis Major (clavicular fibers) INSERTION
Crest of greater tubercle of humerus
Pectoralis Major (clavicular fibers) ACTION
Shoulder flexion, MR and horizontal adduction
Origin fixed: humeral adduction and MR
Insertion fixed: assists in elevation of thorax in forced inspiration
Pectoralis Major (clavicular fibers) NERVE
Lateral pectoral n. (C5,6,7)
Pectoralis Major (sternal fibers) ORIGIN
Anterior surface of sternum, cartilages of ribs 1-7, and aponeurosis of external obliques
Pectoralis Major (sternal fibers) INSERTION
Crest of greater tubercle of humerus
Pectoralis Major (sternal fibers) ACTION
Depress shoulder
Oblique adduction of humerus toward opposite iliac crest
Origin fixed: humeral adduction and MR
Insertion fixed: assists in elevation of thorax in forced inspiration
Pectoralis Major (sternal fibers) NERVE
Lateral and Medial Pectoral n. (C6,7,8,T1)
Pectoralis Minor ORIGIN
Superior margins, outer surfaces of 3rd, 4th, and 5th ribs near the cartilages; and from fascia over corresponding intercostals muscles
Pectoralis Minor INSERTION
Medial border, superior surface of coracoid process of scapula
Pectoralis Minor ACTION
Downward rotation and medial rotation of scapula
Prevents upward rotation of scapula
Origin fixed:
Tilts scapula anteriorly
Insertion fixed:
Assist in forced inspiration
Pectoralis Minor NERVE
Medial Pectoral n. (C6,7,8,T1)
Subclavious ORIGIN
1st rib and cartilage
Subclavious INSERTION
Undersurface of the clavicle
Subclavious ACTION
Draws the clavicle down and stabilizes joint
Subclavious NERVE
Subclavian n. (C5,C6)
Latissimus Dorsi ORIGIN
Spinous processes of last 6 thoracic vertebra
Last 3 or 4 ribs
Through the thoracolumbar fascia from the lumbar and sacral vertebrae
Posterior 1/3 of external lip of iliac crest
Slip from the inferior angle of the scapula
Latissimus Dorsi INSERTION
Intertubercular groove of humerus
Latissimus Dorsi ACTION
Origin fixed: Shoulder MR, add, and extension Depresses shoulder girdle Assists in trunk lateral flexion
Insertion fixed:
Assists in anterior and lateral pelvic tilts
Assists in lumbar hyperextension
Latissimus Dorsi NERVE
Thoracodorsal n. (C6,7,8)
Teres Major ORIGIN
Dorsal surface of inferior angle and
lower third of lateral border of scapula
Teres Major INSERTION
Crest of lesser tubercle of humerus
Teres Major ACTION
Shoulder MR, add, ext
Scapular internal rotation
Teres Major NERVE
Lower Subscapular n. (C5,6,7)
Serratus Anterior ORIGIN
Outer surface and superior borders of upper 8 or 9 ribs
Serratus Anterior INSERTION
Costal surface of medial border of scapula
Serratus Anterior ACTION
Origin fixed:
Abduction, posterior tilt, external rotation, and upward rotation of scapula.
Holds medial border of scapula against thorax.
Lower fibers may depress the
scapula and upper fibers may
elevate.
Serratus Anterior NERVE
Long Thoracic n. (C5,6,7,8)
Supraspinatus ORIGIN
Medial 2/3 of supraspinous fossa of scapula
Supraspinatus INSERTION
Superior facet of greater tubercule of humerus, and shoulder joint capsule
Supraspinatus ACTION
Abduct shoulder
Stabilizes head of humerus in glenoid cavity during movements
May assist with shoulder LR from neutral to full LR
Supraspinatus NERVE
Suprascapular n. (C4,5,6)
Infraspinatus ORIGIN
Medial 2/3 of infraspinous fossa of scapula
Infraspinatus INSERTION
Middle facet of greater tubercle of humerus, shoulder joint capusle
Infraspinatus ACTION
LR shoulder
Stabilizes head of humerus in glenoid cavity during movements
Scapular internal rotation
Infraspinatus NERVE
Suprascapular n. (C4,5,6)
Subscapularis ORIGIN
Subscapular fossa of scapula
Subscapularis INSERTION
Lesser tubercle of humerus and shoulder joint capsule
Subscapularis ACTION
MR shoulder
Stabilizes head of humerus in glenoid cavity during movements.
Prevents humeral anterior glide.
Subscapularis NERVE
Upper and Lower Subscapular n. (C5,6,7)
Deltoid ORIGIN
ANTERIOR:
Anterior border, superior surface of acromion, and lateral 1/3 of clavicle
MIDDLE
Lateral margin and superior surface of acromion
POSTERIOR
Inferior lip of posterior border of spine of scapula
Deltoid INSERTION
Deltoid tuberosity
Deltoid ACTION
ABD shoulder
Anterior:
Shoulder flexion and MR
Middle:
shoulder abduction; scapular downward rotation
Posterior:
Shoulder extension and LR
Scapular internal rotation
Deltoid NERVE
Axillary n. (C5,6)
Upper Trapezius ORIGIN
External occipital protuberance, medial 1/3 of superior nuchal line, ligamentum nuchae, and spinous process of C7 vertebra
Upper Trapezius INSERTION
Lateral 1/3 of clavicle and acromion process of scapula
Upper Trapezius ACTION
Origin fixed:
Stabilization of scapula
Insertion fixed and acting unilaterally:
Extend, laterally flex, and rotate head and cervical vertebrae so face turns to opposite side
Acting bilaterally: Extends neck Elevation of scapula Elevation and adduction of the scapula and clavicle Accessory muscle to respiration
Upper Trapezius NERVE
Spinal Accessory n. (CN XI)
Anterior Primary rami (C2,3,4)
Middle Trapezius ORIGIN
Spinous process of T1-5
Middle Trapezius INSERTION
Medial margin of acromion process and superior lip of spine of scapula
Middle Trapezius ACTION
Adduction (with stabilization by upper and lower fibers), ER, and upward rotation of scapula.
Stabilizes scapula during upward rotation
Middle Trapezius NERVE
Spinal Accessory n. (CN XI)
Anterior primary rami (C2,3,4)
Lower Trapezius ORIGIN
Spinous process of T6-12
Lower Trapezius INSERTION
Tubercle of at apex of spine of scapula
Lower Trapezius ACTION
Depression, ER, and upward rotation of the scapula.
Best upward rotator of scapula in early range of arm elevation
Lower Trapezius NERVE
Spinal Accessory n. (CN XI)
Anterior primary rami (C2,3,4)
Levator scapulae ORIGIN
Transverse process of cervical vertebrae 1-4
Levator scapulae INSERTION
Medial border of scapula between superior angle and root of spine
Levator scapulae ACTION
Origin fixed:
Elevation and downward rotation of the scapula
Insertion fixed and acting unilaterally:
Laterally flexes and rotates cervical vertebrae to SAME side
Acting bilaterally:
Assist in cervical extension
Levator scapulae NERVE
Dorsal Scapular n. (C4,5,)
Cervical Spinal n. (C3,4)
Rhomboideus Major ORIGIN
Spinous processes of T2-T5
Rhomboideus Major INSERTION
By fibrous attachment to medial border of scapula between spine and inferior angle
Rhomboideus Major ACTION
Adduction, elevation, downward rotation and ER of the scapula
(Stiffness helps prevent scapular internal rotation)
Rhomboideus Major NERVE
Dorsal Scapular n. (C4,5)
Rhomboideus Minor ORIGIN
Ligamentum nuchae, spinous processes of C7-T1 vertebrae
Rhomboideus Minor INSERTION
Medial border at root of spine of scapula
Rhomboideus Minor ACTION
Adduction, elevation, ER and downward rotation of scapula
Rhomboideus Minor NERVE
Dorsal Scapular n. (C4,5)
Teres Minor ORIGIN
Upper 2/3 and dorsal surface of lateral border of scapula
Teres Minor INSERTION
Lowest facet of greater tubercle of humerus, and shoulder joint capsule
Teres Minor ACTION
LR shoulder
Scapular IR
Stabilizes head of humerus in glenoid cavity during movements
Teres Minor NERVE
Axillary n. (C5,6)
Pronator teres ORIGIN
Humeral head:
Immediately above medial epicondyle of humerus, common flexor tendon, and deep antebrachial fascia
Ulnar head:
Medial side of coronoid process of ulna
Pronator teres INSERTION
Middle of lateral surface of radius
Pronator teres ACTION
Pronate forearm
Assists in elbow flexion
Pronator teres NERVE
Median n. (C6,7)
Flexor carpi radialis ORIGIN
Common flexor tendon from medial epicondyle of humerous, an deep antebrachial fascia
Flexor carpi radialis INSERTION
Base of 2nd metacarpal and slip to base of 3rd metacarpal bone
Flexor carpi radialis ACTION
ABD and flexion of wrist
Assists in forearm pronation and elbow flex
Flexor carpi radialis NERVE
Median n. (C6,7,8)
Palmaris longus ORIGIN
Common flexor tendon from medial epicondyle of humerous, deep antebrachial fascia
Palmaris longus INSERTION
Flexor retinaculum, and palmar aponeurosis
Palmaris longus ACTION
Tenses palmar fascia
Flexion of wrist
Assists in elbow flexion
Palmaris longus NERVE
Median n. (C6,7,8, T1)
Flexor digitorum superficialis ORIGIN
Humeral head:
Common flexor tendon from medial epicondyle of humerus, ulnar collateral ligament of elbow joint, and deep antebrachial fascia
Ulnar head:
Medial side of coroniod process
Radial head:
Oblique line of radius
Flexor digitorum superficialis INSERTION
By 4 tendons into sides of middle phalanges of 2-5th digits
Flexor digitorum superficialis ACTION
Flexion of PIP of digits 2-5
Assists in MCP joint flexion and wrist flexion
Flexor digitorum superficialis NERVE
Median n. (C7,8,T1)
Flexor digitorum profundus ORIGIN
Anterior and medial surface of proximal ¾ of ulna, interosseus membrane, and deep antebrachial fascia
Flexor digitorum profundus INSERTION
By 4 tendons into palmar surface of bases of distal phalanges of digits 2-5
Flexor digitorum profundus ACTION
Flexion of DIP joint of digits 2-5
Assists in PIP, MCP and wrist flexion
Flexor digitorum profundus NERVE
Lateral - Anterior interosseus n. (C7,8, T1)
Medial - Ulnar n. (C7,8, T1)
Flexor pollicis longus ORIGIN
Anterior surface of body of radius below tuberosity, interosseus membrane, medial border or coronoid process or ulna, and/or medial epicondyle of humerus
Flexor pollicis longus INSERTION
Base of distal phalanx of thumb, palmar surface
Flexor pollicis longus ACTION
Thumb IP flexion
Assists in MCP and CMC flexion and wrist flexion
Flexor pollicis longus NERVE
Anterior interosseus n. (C6,7,8,T1)
Flexor pollicis brevis ORIGIN
Superficial head:
Flexor retinaculum and Trapezium bone
Deep head:
Trapezoid and Capitate bones
Flexor pollicis brevis INSERTION
Base of proximal phalanx of thumb, radial side, and extensor expansion
Flexor pollicis brevis ACTION
Flexion of MCP & CMC joints of thumb
Thumb opposition
May extend IP joint
Flexor pollicis brevis NERVE
Superficial head:
Median n. (C6,7,8,T1),
Deep head:
Ulnar n. (C8,T1)
Pronator quadratus ORIGIN
Anteromedial surface of distal ¼ of ulna
Pronator quadratus INSERTION
Anterolateral surface of distal ¼ of radius
Pronator quadratus ACTION
Pronate forearm
Pronator quadratus NERVE
Anterior interosseus n. (C7,8,T1)
Abductor pollicis brevis ORIGIN
Flexor retinaculum, tubercle of scaphoid and trapezium
Abductor pollicis brevis INSERTION
Lateral aspect of base of proximal phalanx of thumb and extensor expansion
Abductor pollicis brevis ACTION
Palmar abduction of CMC and MCP of thumb
Extend thumb IP joint
Assists in opposition, flexion and MR of CMC joint
Abductor pollicis brevis NERVE
Median n. (C6,7,8,T1)
Opponens pollicis ORIGIN
Flexor retinaculum
Tubercle of trapezium bone
Opponens pollicis INSERTION
Entire length of first metacarpal bone, radial side
Opponens pollicis ACTION
Opposes thumb CMC
Opponens pollicis NERVE
Median (C6,7,8,T1)
Lumbricals (UE) ORIGIN
1 and 2nd:
Radial surface of flexor profundus tendons of index and middle fingers, respectively
3rd:
Adjacent sides of flexor profundus tendons of middle and ring fingers
4th:
Adjacent sides of flexor profundus tendons of ring and little fingers”
Lumbricals (UE) INSERTION
Into the radial border of the extensor expansion on the dorsum of the respective digits
Lumbricals (UE) ACTION
Extends IP joint and simultaneously flex MCP joints of 2-5th digits
Extend IP joints with MCP extended
Lumbricals (UE) NERVE
1st and 2nd: Median (C6,7,8,T1)
3rd and 4th: Ulnar C7,8,T1)
Flexor carpi ulnaris ORIGIN
Humeral head:
Common flexor tendon from medial epicondyle of humerus
Ulnar head:
Medial margin of olecranon via aponeorosis
Proximal 2/3 of posterior border of ulna
Deep antebrachial fascia
Flexor carpi ulnaris INSERTION
Pisiform bone and by ligaments to hamate and 5th metacarpal bones
Flexor carpi ulnaris ACTION
Flexion and ulnar deviation of wrist
Assists in elbow flexion
Flexor carpi ulnaris NERVE
Ulnar n. (C6,7,8,T1)
Abductor digiti minimi ORIGIN
Tendon of flexor carpi ulnaris and PISIFORM bone
Abductor digiti minimi INSERTION
By 2 slips, one into base of proximal phalanx of little finger, ulnar side, 2nd into the ulnar border of the extensor expansion
Abductor digiti minimi ACTION
Abduct small finger MP joint
Assists in opposition and flexion of CMC of 5th digit
Assists in extension of IP joint
Abductor digiti minimi NERVE
Ulnar n. (C7,8,T1)
Flexor digiti minimi ORIGIN
Hook of hamate, and flexor retinaculum
Flexor digiti minimi INSERTION
Base of proximal phalanx of 5th digit, ulnar side
Flexor digiti minimi ACTION
Flexion of MCP joint of little finger
Assists in opposition
Flexor digiti minimi NERVE
Ulnar n. (C7,8,T1)
Opponens digiti minimi ORIGIN
Hook of hamate
Flexor retinaculum
Opponens digiti minimi INSERTION
Entire length of 5th metacarpal, ulnar side
Opponens digiti minimi ACTION
Opposes 5th CMC joint
Opponens digiti minimi NERVE
Ulnar n. (C7,8,T1)
Interossei (UE) ORIGIN
DORSAL:
1st Lateral head:
Proximal ½ of ulnar border of 1st metacarpal bone
1st Medial head:
Radial border of 2nd metacapal bone
2-4th:
Adjacent sides of metacarpal bones in each interspace
PALMAR:
1st: Length of 2nd metacarpal bone, ulnar side
2nd: Length of 4th metacarpal bone, radial side
3rd: Length of 5th metacarpal bone, radial side
Interossei (UE) INSERTION
Into extensor expansion and to base of proximal phalanx as follows: 1st: Radial side of 2nd digit, chiefly to base of proximal phalanx 2nd: Radial side of 3rd digit 3rd: Ulnar side of 3rd digit into extensor expansion 4th: Ulnar side of 4th digit
Chiefly into the extensor expansion of the respective digit, with possible attachment to the base of proximal phalanx as follows:
1-Ulnar side of 2nd digit
2-Radial side of 4th digit
3-Radial side of 5th digit
Interossei (UE) ACTION
DORSAL:
ABD of digits 2-4 from axial line through third digit
Assists in MCP flexion and extension of IP joint of digits 2-4
1st dorsal interossei assists with thumb ADD
PALMAR:
ADD of digits 2,4, and 5
Assists in MCP flexion and extension of IP of digits 2,4, and 5
Interossei (UE) NERVE
Ulnar n. (C8,T1)
Adductor Pollicis ORIGIN
Oblique fibers:
Capitate bone, bases of 2nd and 3rd metacarpals
Transverse fibers:
Palmar surface of 3rd metacarpal
Adductor Pollicis INSERTION
Oblique head:
Into extensor expansion
Transverse head:
Into ulnar side of base of proximal phalanx of thumb
Adductor Pollicis ACTION
ADD of CMC
Assists in flexion of MCP joint of thumb
Assists thumb opposition and extension of IP joint
Adductor Pollicis NERVE
Ulnar n. (C8,T1)
Triceps Brachii ORIGIN
Long head:
Infraglenoid tubercle of scapula
Lateral head:
Lateral and posterior surface of proximal ½ of body of humerus, lateral intermuscular septum
Medial head:
Distal 2/3 of medial and posterior surface of humerus below the radial groove, and from medial intermuscular septum
Triceps Brachii INSERTION
Posterior surface of olecranon process of ulna and antebrachial fascia
Triceps Brachii ACTION
Extend elbow
Long head:
Assists in ADD and extension of shoulder
Triceps Brachii NERVE
Radial n. (C6,7,8,T1)
Anconeus ORIGIN
Lateral epicondyle of humerus, posterior surface
Anconeus INSERTION
Lateral side of olecranon process, upper ¼ of posterior surface of body of ulna
Anconeus ACTION
Extend elbow, stabilize ulna during pronation & supination
Anconeus NERVE
Radial n. (C7,8)
Brachioradialis ORIGIN
Proximal 2/3 of lateral supracondylar ridge of humerus, lateral intermuscular septum
Brachioradialis INSERTION
Lateral side of base of styloid process of radius
Brachioradialis ACTION
Elbow flexion
Assists in pronation & supination of forearm
Brachioradialis NERVE
Radial n. (C5,6)
Extensor carpi radialis longus ORIGIN
Distal 1/3 of lateral supracondylar ridge of humerus and lateral intermuscular septum
Extensor carpi radialis longus INSERTION
Dorsal surface of base of 2nd metacarpal bone, radial side
Extensor carpi radialis longus ACTION
Extends and radially deviates wrist
Assists in elbow flexion
Extensor carpi radialis longus NERVE
Radial n. (C5,6,7,8)
Extensor carpi radialis brevis ORIGIN
Common extensor tendon from lateral epicondyle of humerus, radial collateral ligament of elbow joint, and deep antebrachial fascia
Extensor carpi radialis brevis INSERTION
Dorsal surface of base of 3rd metacarpal bone
Extensor carpi radialis brevis ACTION
Extends wrist
Assist in wrist radial deviation
Extensor carpi radialis brevis NERVE
Radial - posterior interosseus n. (C6,7,8)
Extensor digitorum ORIGIN
Common extensor tendon from lateral epicondyle of humerus, and deep antebrachial fascia
Extensor digitorum INSERTION
By 4 tendons to extensor expansion on the dorsum of digits 2-5, attaching to the sagittal bands and then dividing over the proximal phalanx into a medial and two lateral bands.
MEDIAL BAND:
Into the base of the middle phalanx (central slip)
LATERAL BANDS:
Reunite over the middle phalanx and insert into the base of the distal phalanx (terminal tendon)
Extensor digitorum ACTION
Extend MCP joint and in conjunction with lumbricals and interossei,
Extend IP joints of digits 2-5
Assist in abducting digits 2,4 and 5
Extend and radial deviate wrist
Extensor digitorum NERVE
Radial - posterior interosseus n. (C6,7,8)
Extensor digiti minimi ORIGIN
Common extensor tendon from lateral epicondyle of humerus & deep antebrachial fascia
Extensor digiti minimi INSERTION
Into extensor expansion of little finger with extensor
digitorum tendon
Extensor digiti minimi ACTION
Extend MCP joint
Extend IP joints of little finger in conjunction with lumbricals and interossei
Assist in ABD of 5th digit
Extensor digiti minimi NERVE
Radial - posterior interosseus n. (C6,7,8)
Extensor carpi ulnaris ORIGIN
Common extensor tendon from lateral epicondyle of humerus by aponeurosis from posterior border of ulna & deep antebrachial fascia
Extensor carpi ulnaris INSERTION
Base of 5th metacarpal bone, ulnar side
Extensor carpi ulnaris ACTION
Extend and ulnarly deviate wrist
Extensor carpi ulnaris NERVE
Radial - posterior interosseus n. (C6,7,8)
Extensor indicis ORIGIN
Posterior surface of body of ulna distal to origin of extensor pollicis longus & interosseus membrane
Extensor indicis INSERTION
Into extensor expansion of index finger with extensor digitorum longus tendon
Extensor indicis ACTION
Extend MCP joint
Extend IP joint of index finger in conjunction with lumbricals and interossei
Assist in adduction of index
Extensor indicis NERVE
Radial n. (C6,7,8)
Abductor pollicis longus ORIGIN
Posterior surface of body of ulna distal to origin of supinator, interosseus membrane, and posterior surface of middle 1/3 of body of radius
Abductor pollicis longus INSERTION
Base of 1st metacarpal bone, radial side
Abductor pollicis longus ACTION
Extend CMC joint of thumb with slight abduction
Wrist radial deviation
Assists wrist flexion
Abductor pollicis longus NERVE
Radial n. (C6,7,8)
Extensor pollicis longus ORIGIN
middle 1/3 of posterior surface of ulna distal to origin of APL & interosseus membrane
Extensor pollicis longus INSERTION
Base of distal phalanx of thumb, dorsal surface
Extensor pollicis longus ACTION
Extend IP joint of thumb
Assists thumb MCP and CMC extension
Assists in radial deviation and extension of wrist
Extensor pollicis longus NERVE
Radial n. (C6,7,8)
Extensor pollicis brevis ORIGIN
Posterior surface of body of radius distal to origin of APL and interosseus membrane
Extensor pollicis brevis INSERTION
Base of proximal phalanx of thumb, dorsal surface
Extensor pollicis brevis ACTION
Extend thumb MCP joint
Extend and abduct CMC joint
Assists in wrist radial deviation
Extensor pollicis brevis NERVE
Radial n. (C6,7,8)
Supinator ORIGIN
Lateral epicondyle of humerus, radial collateral ligament of elbow joint, annular ligament of radius, and supinator crest of ulna
Supinator INSERTION
Lateral surface of upper 1/3 of body of radius covering part of anterior and post surface
Supinator ACTION
Supinate forearm
Supinator NERVE
Radial - posterior interosseus n. (C5,6,7)
Coracobrachialis ORIGIN
Apex of coracoid process of scapular
Coracobrachialis INSERTION
Medial surface of middle of shaft of humerus, opposite deltoid tuberosity
Coracobrachialis ACTION
Flexion and adduction of shoulder
Coracobrachialis NERVE
Musculocutaneous (C6,7)
Biceps Brachii ORIGIN
“Short head
Apex of coracoid process of scapula
Long head
Supraglenoid tubercle of scapula”
Biceps Brachii INSERTION
Radial tuberosity, aponeurosis
of biceps brachii
Biceps Brachii ACTION
Long head:
Evidence is unclear regarding role of LHBT at the shoulder.
May passively restrict humeral anterior and superior translation.
Origin fixed: Elbow flexion moving forearm toward humerus, forearm supination
Insertion fixed: Elbow flexion moving humerus toward forearm
May contribute to scapular anterior tilt
Shoulder flexion
Biceps Brachii NERVE
Musculocutaneous (C5,6)
Brachialis ORIGIN
Distal ½ of anterior surface of humerus, medial and lateral intermuscular septa
Brachialis INSERTION
Tuberosity and coronoid process of ulna
Brachialis ACTION
Elbow flexion
Brachialis NERVE
Musculocutaneous (C5,6)
