Upper limb attachments Flashcards
Pectoralis major
Proximal=medial third of clavicle (clavicular head), anterior surface of sternum (sternocostal head), costal cartilages 1-7, sternal end of 6th rib and aponeurosis of external oblique (abdominal part)
Distal=lateral lip of intertubercular sulcus
Pectoralis minor
Proximal=ribs 3-5 (anterior surface and superior rib border)
Distal=coracoid process of scapula
Trapezius
Proximal=ligamentum nuchae, external occipital protuberance, the thoracic spine (spinous processes of vertebra C7-T12), superior nuchal line
Distal=acromion, posterior border of lateral third of clavicle, crest of the scapular spine
Serratus anterior
Origin=lateral surface of ribs 1-8
Insertion=costal surface of medial border to scapula
Latissimus dorsi
Proximal=spinous processes of T6-T12, spinous processes of lumbar vertebrae (L1-L5) via thoracolumbar fascia, iliac crest, lower 3-4 ribs
Distal=floor of intertubercular sulcus
Deltoid
Proximal=anterior border of lateral third of clavicle, acromion and crest of the spine of the scapula
Distal=deltoid tuberosity of the humerus
Teres major
Proximal=posterior surface of inferior angle of scapula
Distal=medial lip of intertubercular sulcus
Supraspinatus
Proximal=supraspinous fossa
Distal=greater tubercle (most superior facet)
Infraspinatus
Proximal=infraspinous fossa
Distal=greater tubercle (middle facet)
Teres minor
Proximal=posterior surface of scapula immediately adjacent to lateral border of scapula
Distal=greater tubercle (inferior facet)
Subscapularis
Proximal=medial 2/3rds of subscapular fossa
Distal=lesser tubercle
Coracobrachialis
Proximal=coracoid process
Distal=midshaft of humerus on medial side (linear roughening)
Biceps brachii
Short proximal=coracoid process
Long proximal=supraglenoid tubercle
Distal=radial tuberosity and bicipital aponeurosiis
Brachialis
Proximal=anterior humeral shaft and intermuscular septae adjacent
Distal=ulnar tuberosity
Triceps
Long proximal=infraglenoid tubercle
- Long medial and long lateral=posterior humeral shaft
- Distal=triceps tendon attaches to olecranon
Pronator teres
Proximal=coronoid process (ulnar head), medial epicondyle and supra-epicondylar ridge adjacent (humeral head)
Distal=lateral surface of radial midshaft
Flexor carpi ulnaris
Proximal humeral head=medial epicondyle
Proximal ulnar head=olecranon and posterior ulnar border
Distal=pisiform bone, and then via pisohamate and pisometacarpal ligaments into the hamate and base of metacarpal V
Flexor carpi radialis
Proximal=medial epicondyle
Distal=metacarpals 2 and 3 (base)
Palmaris longus
Proximal=medial epicondyle
Distal=palmar aponeurosis of hand
Flexor digitorium superficialis
Proximal=oblique line of radius (radial head), medial epicondyle and adjacent margin of coronoid process (humero-ulnar head)
Distal=middle phalanx (4 tendons)
Flexor digitorium profundus
Proximal=ulna (anterior and medial surfaces) and interosseous membrane (anterior medial half)
Distal=palmar surface of distal phalanges (4 tendons)
Flexor pollicus longus
Proximal=anterior surface of radius and interosseous membrane (radial half)
Distal=base of distal phalanx of thumb (palmar surface)
Pronator quadratus
Proximal=linear ridge on distal anterior surface of ulna
Distal-distal anterior surface of radius
Supinator
Proximal=lateral epicondyle of humerus, radial collateral and anular ligaments (superficial part) and supinator crest of ulna (deep part)
Distal=lateral radius superior to anterior oblique line
Brachioradialis
Proximal=lateral supraepicondylar ridge and intermuscular septum adjacent
Distal=lateral surface of distal radius
Extensor carpi radialis longus
Proximal=lateral supraepicondylar ridge (distal part) and intermuscular septum adjacent
Distal=dorsal surface of base of second metacarpal
Extensor carpi radialis brevis
Proximal=lateral epicondyle and intermuscular septum adjacent
Distal=dorsal surface of base of second and third metacarpals
Extensor carpi ulnaris
Proximal=laterla epicondyle and posterior border of ulna
Distal=tubercle on base of medial side of fifth metacarpal
Extensor digitorium
Proximal=lateral epicondyle and intermuscular septum and adjacent and deep fascia
Distal=insert via extensor hoods into dorsal aspect of base of middle and distal phalanges of 4 fingers (not thumb=4 tendons)
Extensor digiti minimi
Proximal=lateral epicondyle and intermuscular septum adjacent together with extensor digitorum
Distal=extensor hood of little finger
Adductor pollicis
Proximal= third metacarpal (transverse head), capitate and bases of second and third metacarpals (oblique head)
Distal=base of proximal phalanx and medial side of extensor hood of thumb
Palmaris brevis
Proximal=palmar aponeurosis and flexor retinaculum
Distal=dermis of skin on medial margin of hand
Palmar interossei
Proximal= adjacent sides of metacarpals
Distal=extensor hoods of thumb, index, ring and little fingers and proximal phalanx of thumb
Dorsal interossei
Proximal=adjacent sides of two metacarpals
Distal=sides of extensor hoods and base of proximal phalanges of index, middle and ring fingers
Lumbricals
Proximal=flexor digitorium profundus tendons
Distal=lateral side of extensor hoods of 4 fingers (not thumb)
Opponens pollicis
THENAR COMPARTMENT
Proximal=tubercle of trapezium and flexor retinaculum
Distal=lateral margin and adjacent palmar surface of first metacarpal
Abductor pollicis brevis
THENAR COMPARTMENT
Proximal=tubercles of scaphoid and trapezium and flexor retinaculum adjacent
Distal=proximal phalanx and outside of extensor hood of thumb
Flexor pollicis brevis
THENAR COMPARTMENT
Proximal=tubercle of trapezium and flexor retinaculum
Distal=proximal phalanx of thumb
Opponens digiti minimi
HYPOTHENAR COMPARTMENT
Proximal=hook of hamate and flexor retinaculum
Distal=medial aspect of 5th metacarpal
Flexor digiti minimi brevis
HYPOTHENAR COMPARTMENT
Proximal=hook of hamate and flexor retinaculum
Distal=proximal phalanx of little finger
Abductor digiti minimi
HYPOTHENAR COMPARTMENT
Proximal=pisiform, pisohamate ligament, flexor carpi ulnaris tendon
Distal=proximal phalanx of little finger
Abductor pollicis longus
Proximal=posterior surface of ulna and radius and intervening interosseous membrane
Distal=lateral side of base of first metacarpal
Extensor pollicis brevis
Proximal=posterior surface of radius and interosseous membrane adjacent
Distal=dorsal surface of base of proximal phalanx of thumb
Extensor pollicis longus
Proximal=posterior surface of ulna and interosseous membrane adjacent
Distal=dorsal surface of base of distal phalanx of thumb
Extensor indicis
Proximal=posterior surface of ulna and interosseous membrane adjacent
Distal=extensor hood of index finger