upper limbs and muscles Flashcards
classification of joint movement
immovable
semi-movable
fully-movable
immovale: synarthroses (joints of the skull & pelvic joints)
semi-moveabl: amphiarthrosis (intervertebral joints and pubic symphysis)
fully-moveable: diaorthosis (elbows, hips, knees)
classification of joint structure
fibrous: immovable no joint space, structures of the skull
cartilaginous: band of thick cartlidge
synovial: synovial fluid
degrees of freedom
3 translational DoFs
foward/ back.
up down (sup/inf)
left/right (med/lat).
3 rotational DoFs
sagittal axis
frontal axis
transverse axis
sternoclavicular joint
synovial saddle
DoF:2
limits superior and lateral displacement of clavicle
acromioclavicular joint
synovial plane
restriction to overhead arm movements
scapulothoracic joint
allow for smooth movement
allows arm to abduct beyond the 120 degrees allowed by the genohumeral joint alone.
protraction/ retraction (ab&ad)
superior and inferior (up and down)
elevation and depression
serratus anterior:
origin: external surfaces of the lateral ribs 1-8
insertion: anterior surfaces of the medial border of the scapula
action: protract sthe scapula and holds it against the thoracic wall; rotates the scapula in an upward direction
innervation: long thoracic nerve
pec major
Origin - Clavicular Head: Anterior surface of the
medial half of the clavicle
Sternocostal head: anterior surface of the sternum,
superior six costal cartlidges , aponeurosis of the
external oblique muscle.
Insertion - Lateral lip of the intertubercular groove
of the humerus .
Actions - Adducts and medially rotates the
humerus; draws the scapula anteriorly and
inferiorly. Acting alone the clavicular head flexes
the humerus, and the sternocostal head will
extend the humerus from a flexed position
Innervation – Lateral and Medical Pectoral Nerves.
Clavicular head (C5, C6), Sternocostal head ( C7,
C8, & T1).
Origin – Ant. Surface of ribs 3,4 & 5
Insertion – Coracoid Process of the Scapula
Action – Anchors, depresses and protracts the
scapula
Innervation – Medial Pectoral n. (C8, T1
middle fibers of the trapezius
Origin: Spinous processes of the first-
fifth thoracic vertebrae.
* Insertion: Medial margin of the
acromion and superior lip of the spine
of the scapula.
* Action: Retracts the scapula
* Innervation: Spinal Accessory
Nerves (CN XI)
rhomboids
Origin: Spinous processes of the thoracic
vertebrae 2-5 (Major). Ligamenteum
Nuchae, spinous process of the 7th
cervical and 1st thoracic vertebrae (Minor)
* Insertion: By fibrous attachment to the
medial border of the scapula between the
spine and inferior angle (Major). Medial
border of the scapula, at the root of the
spine of the scapula. (Minor)
* Action: Adducts and elevates the
scapula, downwardly rotates the scapula
* Innervation: Dorsal Scapular nerve (C4,
C5)
what muscles elevate the scapula
rhomboids
trapezius
levator scapula
upper fibers of the trapezius
Origin: External occipital
protuberance, medial 1/3 of the
superior nuchal line, ligamentum
nuchae and spinous process of the 7th
cervical vertebrae.
* Insertion: Lateral 1/3 of the of the
clavicle and acromion process of the
scapula.
* Action: Elevates the scapula
* Innervation: Spinal Accessory
Nerves (CN XI)
Origin:
– Transverse processes of the first 4
cervical vertebrae.
* Insertion:
– Medial border of the scapula,
between the superior angle and the
root of the spine.
* Action:
– Elevates scapula and assists with
downward rotation of the scapula.
– Can also assist with lateral flexion of
the c-spine (unilaterally) or extension
of the c-spine (bilaterally), if the
scapula is stabilized by other
muscles.
* Innervation:
– Cervical 3 & 4, and Dorsal Scapular
nerve (C4, C5)
rhomboids
Origin (Major):
– Spinous processes of the thoracic
vertebrae 2-5.
* Insertion (Major):
– By fibrous attachment to the medial
border of the scapula between the spine
and inferior angle.
* Origin (Minor):
– Ligamenteum Nuchae, spinous process
of the 7th cervical and 1st thoracic
vertebrae
* Insertion (Minor):
– Medial border of the scapula, at the root
of the spine of the scapula.
* Action:
– Adducts and elevates scapula.
– Downward rotation of the scapula
* Innervation:
dorsal scapula nerve
lower fibers of the trapezius
Origin: Spinous processes of the 6th-12th
thoracic vertebrae.
* Insertion: Tubercle at the apex of the
spine of the scapula.
Action: Depresses the scapula and
retracts scapula
* Innervation: Spinal Accessory
Nerves (CN XI)
subclavius
Origin – Junction of 1st rib and its costal
cartlidge
Insertion – Inferior surface of the middle third
of the clavicle
Action – Anchors and depresses the scapula
Innervation – Nerve to subclavius (C5, C6)
shoulder pain
supraspinatus
instability- overuse- rotator cuff tendinopathy
swelling decreased subacromial space- impingement
what casues paralysis of serratus anterior
long thoracic nerve
-innervates teh serratus antierior
-damaged by traction on neck or shoulder or by blunt trauma
nerve entrapment
suprascapula nerve entrapement
-nerve passes through suprascapular notch and supplies the supraspinatus and infraspinatus mucles
-most commonly caused by extremes of scapular motion associated with throwing
glenohumeral joint
greatest ROM of all the joints in the body
deltoid
Origin: Anterior border and
upper surface of the lateral
1/3 of the clavicle, acromion
and the spine of the scapula
* Insertion: Deltoid
tuberosity of the humerus.
* Action: Abduction, Flexion
and Extension of the
shoulder.
* Innervation: Axillary Nerve
(C5, C6).
coracobrachialis
Origin: Tip of the
coracoid process of the
scapula
Insertion: middle 1/3
of the medial surface of
the humerus.
Innervation:
Musculocutaneous
Nerve (C5, C6, C7).
Action: Flexes and
adducts the shoulder
joint.
lattismius dorsi
Origin: Spinous processes of
inferior 6 thoracic vertebrae,
throaco-lumbar fascia, iliac crest,
and inferior 3-4 ribs.
Insertion: Floor of the
intertubercular groove.
Action: Extends, adducts and
medially rotates humerus; raises
body toward arms during
climbing.
Assists in tilting pelvis anteriorly
and laterally, acting bilaterally,
assists in hyperextending the
spine depending on the
orientation of the pelvis.
Innervation: Thoracodorsal
teres major
Origin: Posterior aspect of the
inferior angle of the scapula
* Insertion: Medial lip of the
bicipital grove
* Action: adduction at the
shoulder joint, medial rotation
of the shoulder joint. Extend
the shoulder from a flexed
position.
* Innervation: Lower
subscapular nerve (C5, C6).
internal vs external rotators
internal rotators are able to produce more force becuase of the cross-sectional area of the internal rotators
biceps brachii
Origin: Supraglenoid Tubercle of
the Scapula.
* (SH) - Tip of the Coracoid Process
* Insertion: Radial Tuberosity and
fascia of the forearm via the
bicipital aponeurosis.
* Action: Supinates forearm and
flexes the elbow. Short head resists
dislocation of the shoulder
* Innervation: Musculocutaneous
Nerve. (C5, C6, C7).
Origin: Distal ½ of the anterior surface
of the humerus.
Insertion: Coronoid process and
tuberosity of the ulna.
* Action: Flexes the elbow in all positions.
Innervation: Musculocutaneous Nerve
(C5, C6, C7). Small branch from Radial
Nerve (C5,
brachioradialis
Origin: Proximal 2/3 of lateral
supracondylar ridge of humerus
* Insertion: Lateral surface of distal end of
radius
* Action: Flexes elbow joint, especially in
semi-pronated position.
* Innervation: Radial nerve (C5, C6 and C7)
Origin: Long Head – infraglenoid
tubercle of the scapula.
* Lateral Head – Posterior surface of
the humerus, superior to the radial
grove.
* Medial Head – Posterior surface of
the humerus, inferior to the radial
groove.
* Insertion: Proximal end of the
olecranon of the ulna and fascia of
the forearm.
* Action: Primary extensor of the
elbow joint. Long head resists
dislocation of the shoulder,
especially during adduction.
Innervation: radial nerve (C6, C7,
C8)
Origin: Lateral epicondyle of the humerus.
* Insertion: Lateral surface of the olecranon and
superior part of the posterior surface of the
ulna.
* Action: Assists triceps in extending the elbow,
stabilizes the elbow joint, may abduct the ulna
during pronation.
* Innervation: radial nerve (C7, C8, T1)
supinator
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 (C7,
C8).
pronator quadratus
Origin: Distal ¼ of anterior surface of
the ulna
* Insertion: Distal 1/4 of anterior
surface of radius
* Action: Pronates forearm; deep fibers
bind radius and ulna together
* Innervation: Anterior interosseous
nerve from median nerve (C8 and T1)
pronator teres
Origin: Humeral head: Medial
Epicondyle of the humerus.
* Ulnar Head: Coronoid process of the
ulna.
* Insertion: Middle convexity of the
lateral surface of the radius
* Action: Pronates the Forearm and
Flexes the Elbow
* Innervation: Median Nerve (C6 & C7)
flexor carpi radialis
Origin: Medial Epicondyle of the
humerus.
* Insertion: Base of the 2nd
Metacarpal
* Action: Flexes & radially deviates
Wrist Joint
* Innervation: Median Nerve (C6 &
C7)
flexor carpi ulnairs
Origin: Humeral Head- Medial
Epicondyle of the humerus.
* Ulnar Head – Olecranon and posterior
border of the Ulna.
* Insertion: Pisiform, hook of the hamate
and 5th metacarpal bone
* Action: Flexes & ulnarlly deviates Wrist
Joint
* Innervation: Ulnar Nerve (C7 & C8)
extensor carpi radialis longus
Origin: Lateral supracondylar ridge of humerus
* Insertion: Base of 2nd metacarpal
* Action: Extend and radially deviates the wrist
joint
* Innervation: Radial nerve (C6 and C7)
extensor carpi radialis brevis
Origin: Lateral epicondyle of
humerus
* Insertion: Base of 3rd
metacarpal
* Action: Extend and radially
deviates the wrist joint
* Innervation: Deep branch of
radial nerve (C7, C8)
extensor carpi ulnaris
Origin: Lateral epicondyle of
humerus and posterior border of
ulna
* Insertion: Base of 5th
metacarpal
* Action: Extends and ulnarlly
hand at wrist joint
* Innervation: Deep branch of
radial nerve (C7, C8)
extensor digitorum
Origin: Lateral epicondyle of humerus
Insertion: Extensor expansions of medial
four digits
Innervation: Deep Branch of the Radial
Nerve (C7, C8).
Action: Extends medial four digits at
metacarpophalangeal joints; Extends
hand at wrist joint
extensor digiti mini
Origin: Lateral epicondyle of
humerus
Insertion: Extensor expansion of
5th digit
Innervation: Deep Branch of the
Radial Nerve (C7, C8).
Action: Extends 5th digit at
metacarpophalangeal and
interphalangeal joints
flexor digitorum superficialis
Origin: Humeroulnar Head- Medial
Epicondyle of the humerus, ulnar
collateral ligament, and coronoid
process of the ulna;
Radial head –superior half of the
anterior border of the radius.
Insertion: Shafts of the middle
phalanges of digits 2-5.
Innervation: Median Nerve (C7 & C8,
T1)
Action: Flexes middle phalanges a the
PIP joints. With stronger contractions it
can also flex MCP joints, and the wrist
joint.
flexor difitorum profundus
Origin: proximal 3/4 of medial and
anterior surfaces of ulna and
interosseous membrane
Insertion: Base of the distal phalanx
of digits 2- 5
Innervation: Medial part: ulnar nerve
(C8 and T1); Lateral part: anterior
interosseous branch of median nerve (C8
and T1) (C8, T1)
Action: Flexes distal phalanges at distal
interphalangeal joints of medial four
digits; assists with flexion of the wrist
extensor indicis
Origin: Posterior surface of ulna and
interosseous membrane
Insertion: Extensor expansion of 2nd digit
Innervation: Posterior interosseous nerve
(C7 and C8), the continuation of the deep
branch of the radial nerve (C7, C8)
Action: Extends 2nd digit and helps to
extend hand at the wrist joint
flexor pollicis longus
Origin: Anterior surface of radius and
adjacent interosseous membrane.
Insertion: Base of distal phalanx of
thumb
Innervation: Anterior interosseous nerve
from median nerve (C8 and T1) (C8, T1)
Action: Flexes phalanges of 1st digit
(thumb)
adductor pollicis longus
Origin: Posterior surfaces of ulna, radius and
interosseous membrane
Insertion: Base of 1st metacarpal
Innervation: Posterior interosseous nerve (C7
and C8), the continuation of the deep branch
of the radial nerve
Action: Abducts thumb and extends it at
carpometacarpal joint
extensor pollicis longus
Origin: Posterior surface of middle
1/3 of ulna and interosseous
membrane
Insertion: Base of distal phalanx of
thumb
Innervation: Posterior interosseous
nerve (C7 and C8), the continuation
of the deep branch of the radial
nerve.
Action: Extends distal phalanx of
thumb at carpometacarpal and
interphalangeal joints
extensor pollicis brevis
Origin: Posterior surfaces of radius and
interosseous membrane
Insertion: Base of proximal
phalanx of thumb
Innervation: Posterior interosseous
nerve (C7 and C8), the continuation of
the deep branch of the radial nerve
Action: Extends proximal phalanx of
thumb at carpometacarpal joint
7 interossi
-3 palmar (adduct)
-4 dorsal (abduct)
Origin: shafts of the metacarpals
Insertion: Bone & extensor expansion of
the proximal phalanges of 2-5.
Innervation: Deep branch of the ulnar
nerve (C8, T1)
Action: adduct & abduct
carpal tunnel syndrome
loss of entrophy due to lack of use of the thenar muscles from impingement of the transverse carpal ligament median nerve
