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E R

6
– UP P
ER E
PT T H
HA F
C S IM O B
LE L
SC
U
M
Skeletal muscle:


What is origin?

Insertion?

Muscle belly ? and

Tendon?
TERMS USED FOR DESCRIBING MUSCLES:

 ORIGIN - The end of a muscle which is relatively fixed


during it’s contraction.
 INSERTION - The end of a muscle which moves during
it’s contraction.
 BELLY - The fleshy contractile part of a muscle.
 TENDON - The fibrous non-contractile and cord-like part
of a muscle (Fig. 6).
Fig.6
Origin, belly, tendon &
insertion of a muscle.

(Name of the muscle


here is Gastrocnemius)
APPENDICULAR MUSCLES
Move upper and lower limbs and stabilize
pectoral and pelvic girdles
Organized into groups based on their location
(compartment) in the body and the part of the
skeleton they move
Refer to Figure 10.14
MUSCLES THAT MOVE THE PECTORAL
GIRDLE AND UPPER LIMB
Organized into specific groups:
1. Muscles that move the pectoral girdle
2. Muscles that move the glenohumeral
(shoulder) joint/arm
3. Muscles of the arm and forearm that move
the elbow joint/forearm
4. Muscles of the forearm that move the wrist
joint, hand and fingers
5. Intrinsic muscles of the hand
MUSCLES THAT MOVE THE PECTORAL
GIRDLE
These muscles function to stabilize the scapula during
vigorous activities of the upper limb. They
include:
1. Pectoralis minor
2. Serratus anterior
3. Subclavius
4. Levator scapulae
5. Rhomboid major
6. Rhomboid minor
7. Trapezius
PECTORALIS MINOR
Origin
3-5 ribs
Insertion
Coracoid process of
scapula
Nerve supply
Medial pectoral nerve
Action
Pulls shoulder down and
forward (protraction)
SERRATUS ANTERIOR
Origin
1-8 ribs
Insertion
Medial border and inferior
angle of scapula
Nerve supply
Long thoracic N of Bell (C5, 6,
7) (from roots) slips from ribs
1 and 2: C5; 3 and 4: C6; 5-8:
C7)
Action
Draws scapula forward and
rotates scapula
SUBCLAVIUS
Origin
1st costal cartilage
Insertion
 Subclavian groove on
inferior surface of middle
third of clavicle
Nerve supply
Nerve to subclavius
Action
Depresses and steadies
the clavicle
LEVATOR SCAPULAE
Origin
transverse processes of C1-C3
or C4
Insertion
superior angle of scapula
toward the scapular spine
Nerve Supply
nerves off cervical plexus, C3,4
dorsal scapular nerve, C5
Action:
elevates the scapula
extends and/or laterally flexes
the head
RHOMBOID MAJOR
Origin
spinous processes of T2-
T5
Insertion
medial scapula from the
scapular spine to the
inferior angle
Nerve Supply
dorsal scapular nerve, C5
Action:
retract scapula
RHOMBOID MINOR
Origin
spinous process of C7 & T1
ligamentum nuchae
Insertion
medial margin of the
scapula at the medial angle
Nerve Supply
dorsal scapular nerve, C5,
[C4]
Action:
retract scapula
TRAPEZIUS
Origin
Med third sup nuchal line, lig nuchae, spinous
processes and supraspinous ligs to T12
Insertion
Upper fibres to lat third of post border of
clavicle; lower to med acromion and superior
lip of spine of scapula to deltoid tubercle
Nerve Supply
Spinal accessory N (lat roots, C1-5)(spinal
nerves C3 and C4 for proprioception)
Action
Upper fibers : Elevation and upward rotation
of scapula
Middle fibers : Retract Scapula
Lower fibers : Depress scapula
ANTERIOR MUSCLES OF THE PECTORAL
GIRDLE
POSTERIOR MUSCLES OF THE
PECTORAL GIRDLE
MUSCLES THAT MOVE THE
GLENOHUMERAL JOINT/ARM
All of these muscles insert on the humerus and
cause movement of the arm.
Two have their origins on the axial skeleton:
1. Pectoralis major
2. Latissimus dorsi
PECTORALIS MAJOR
Origin
Clavicle,sternum,1-6 costal
cartilages
Insertion
Intertubercular groove of
humerus
Nerve supply
Medial and lateral pectoral
nerve
Action
Adducts and medically
rotates arm
LATISSIMUS DORSI
Origin
 Spine T7, spinous processes and
supraspinous ligs of all lower thoracic,
lumbar and sacral vertebrae, lumbar
fascia, post third iliac crest, last four ribs
(interdigitating with ext oblique
abdominis ) and inf angle of scapula
Insertion
 Floor of bicipital groove of humerus
after spiraling around teres major
Nerve supply
 Thoracodorsal N (C6, 7, 8) (from post
cord)
Action
 Extends, adducts and med rotates arm.
Costal attachment helps with deep
inspiration and forced expiration
MUSCLES THAT MOVE THE
GLENOHUMERAL JOINT/ARM
Nine have their origins on the scapula:
1. Deltoid
2. Coracobrachialis
3. Teres major
4. Triceps brachii
5. Biceps brachii
6. Rotator cuff muscles (4)
 Subscapularis
 Supraspinatus
 Infraspinatus
 Teres minor
MUSCLES THAT MOVE THE
GLENOHUMERAL JOINT/ARM
MUSCLES THAT MOVE THE
GLENOHUMERAL JOINT/ARM
DELTOID
Origin
Anterior fiber - anterior 1/3 of distal
clavicle
Lateral fiber - lateral boarder of the
acromion
Posterior fiber - scapular spine
Insertion
deltoid tuberosity of humerus
Nerve Supply
axillary nerve, C5,6
Action
 abducts arm (lateral fiber)
flexion and medial rotation (anterior
fiber)
extension and lateral rotation
(posterior
CORACOBRACHIALIS
Origin
Coracoid process of
scapula
Insertion
Medial shaft of humerus
Nerve supply
Musculocutaneous Nerve
Action
Flexion , Adduction of
Arm
TERES MAJOR
Origin
 Oval area (lower third) of lat
side of inf angle of scapula
below teres minor
Insertion
Medial lip of bicipital groove
of humerus
Nerve supply
 Lower subscapular N (C5, 6)
(from post cord)
Action
 Med rotates and adducts arm.
Stabilises shoulder jnt
TRICEPS BRACHII
Origin
 Long head
 infragleniod tubercle
 Lateral Head
 upper 1/2 posterior humerus
 Medial Head
 lower 1/2 posterior humerus
Insertion
 Olecranon process of Ulna
Nerve supply
 Radial Nerve
Action
 Extends forearm at elbow
BICEPS BRACHII
Origin
◦ Long head
 supraglenoid tubercle
◦ short head
 corocoid process
Insertion
◦ Radial tuberosity of Radius
Nerve supply
◦ Musculocutaneous Nerve
Action
◦ Flexes arm at elbow and
supinates forearm
SUBSCAPULARIS
Origin
Subscapularis Fossa
Insertion
Humerus (Proximal
Anterior)
Lesser Tubercle
Nerve supply
Suprascapular Nerve
Action
Medial Rotation of
shoulder
INFRASPINATUS
Origin
Infraspinous fossa
Insertion
Humerus
Greater Tubercle
(Posterior)
Nerve supply
Suprascapular Nerve
Action
•Lateral rotation of shoulder
TERES MINOR
Origin
Scapula – Lateral border
Insertion
Humerus
Greater Tubercle (Posterior)
Nerve supply
Axillary N (C5, 6) (from post
cord)
Action
•Lat rotates arm and stabilises
shoulder jnt
SUPRASPINATUS
Origin
medial 2/3 of supraspinatus
fossa above spine of scapula
Insertion
greater tuberosity of
humerus
Nerve supply
Suprascapular Nerve
Action
•Initial Abduction of shoulder
joint
MUSCLES THAT MOVE THE
GLENOHUMERAL JOINT/ARM
MUSCLES THAT MOVE THE ELBOW
JOINT/FOREARM
Flexors of the forearm are as follows:
1. Biceps brachii
2. Brachialis
3. Brachioradialis
Extensors of the forearm are as follows:
4. Triceps brachii
5. Anconeus
FLEXOR MUSCLES OF THE ELBOW
JOINT/FOREARM
EXTENSOR MUSCLES OF THE ELBOW
JOINT/FOREARM
PRONATOR AND SUPINATOR MUSCLES
OF THE FOREARM
The two muscles located on the anterior
forearm that pronate the forearm are:
1. Pronator quadratus
2. Pronator teres
The one muscle located on the posterior
forearm that supinates the forearm is:
3. Supinator
PRONATOR AND SUPINATOR MUSCLES
OF THE FOREARM
FOREARM MUSCLES THAT MOVE THE
WRIST JOINT, HAND AND FINGERS
Most muscles that move the wrist joint, hand and
fingers originate on the forearm and are called
extrinsic muscles
In general, the muscles of anterior forearm originate
on the medial epicondyle of the humerus and produce
flexion of the wrist, hand and fingers
In general, the muscles of the posterior forearm
originate on the lateral epicondyle of the humerus and
produce extension of the wrist, hand and fingers
MUSCLES OF THE ANTERIOR FOREARM
Except for the pronator muscles, muscles in the
anterior compartment produce flexion
As the tendon of these muscle cross over the
anterior surface of the carpal bones, they are
held in place by the flexor retinaculum
The space between the carpal bones and the
flexor retinaculum is the carpal tunnel
CARPAL TUNNEL
MUSCLES OF THE ANTERIOR FOREARM
These muscles are as follows:
1. Pronator teres
2. Flexor carpi radialis
3. Palmaris longus
4. Flexor carpi ulnaris
5. Flexor digitorum superficialis
6. Flexor pollicis longus
7. Flexor digitorum profundus
8. Pronator quadratus
MUSCLES OF THE ANTERIOR FOREARM
MUSCLES OF THE POSTERIOR FOREARM
These muscles are as follows:
1. Extensor carpi radialis longus
2. Extensor carpi radialis brevis
3. Extensor digitorum
4. Extensor minimi
5. Extensor carpi ulnaris
6. Abductor pollicis longus
7. Extensor pollicis brevis
8. Extensor pollicis longus
9. Extensor indicis
10. Supinator
MUSCLES OF THE POSTERIOR
FOREARM
INTRINSIC MUSCLES OF THE HAND
Small muscles that both originate and insert on
the hand
Divided into three groups:
1. Thenar group
2. Hypothenar group
3. Midpalmer group
THENAR GROUP
These muscles affect the motion of the thumb
and are as follows:
1. Flexor pollicis brevis
2. Abductor pollicis brevis
3. Opponens pollicis
INTRINSIC MUSCLES OF THE HAND
HYPOTHENAR GROUP
These muscles affect the motion of finger 5 and
are as follows:
1. Flexor digiti minimi brevis
2. Abductor digiti minimi
3. Opponens digiti minimi
MIDPALMAR GROUP
These muscles affect the motion of all fingers
and thumb. They are as follows:
1. Lumbricals
2. Dorsal interossei
3. Palmer interossei
4. Adductor pollicis
INTRINSIC MUSCLES OF THE HAND
REVIEW OF NAMING
What do the following names TELL you about the muscle?

Naming
 Flexor carpi ulnaris
 Flexor digitorum superficialis
 Flexor pollicis longus
 Pronator quadratus
 Extensor carpi radialis brevis
If ORIGIN on scapula = Move Arm
MUSCLES  Subscapularis
Rotator
OF  Supraspinatus
 Infraspinatus Cuff

SCAPULA  Teres Minor


 Teres Major
 Latissimus Dorsi (partial O on scap)
 Coracobrachialis
If INSERTION on scapula = Move
scapula
 Rhomboids
 Trapezius
 Pectoralis Minor
 Serratus Ventralis
 Levator Scapulae

pg 283
Use location of Insertion to determine movement!!
INNERVATION OF SCAPULA
MUSCLES
Origin on Scapula:
 Latissimus dorsi = Thoracodorsal nerve
 Subscapularis, Teres Major = Subscapular nerves
 Supraspinatus, Infraspinatus = Suprascapular nerves
 Teres Minor = Axillary nerve

Insertion on Scapula
 Levator Scapular, Rhomboids = Dorsal Scapular nerve
 Pectoralis Minor = Pectoral n.
 Serratus Ventralis = Long Thoracic n.
 Trapezius = Accessory n.
MUSCLES OF ARM: CROSS ELBOW, MOVE FOREARM
2 Compartments
 Anterior: Flexors of forearm
 Posterior: Extensors of forearm
Anterior Compartment
 Biceps brachii = MC nerve
 Brachialis = MC nerve
 Brachioradialis = Radial nerve
Coracobrachialis = MC nerve
 O = coracoid process of scapula
 I = medial side humeral shaft
 A = flex, adduct arm
Posterior Compartment
 Triceps brachii = Radial nerve
 Anconeus = Radial nerve

MC = musculocutaneous nerve
MUSCLES OF FOREARM: CROSS WRIST + FINGER
JOINTS, MOVES HAND

Cross Wrist = flex, extend, abduct, adduct hand


Cross Fingers = flex, extend fingers
Most muscles fleshy proximally, long tendons distally
Flexor + Extensor Retinacula
 wristbands keep tendons from bowing
 thick, deep fascia
Anterior Flexor Compartment (Superficial + Deep layers)
 Most flexors have common tendon on medial epicondyle
 Contains 2 pronators
 Innervated by *Median, Ulna nerves
Posterior Extensor Compartment (Superficial + Deep layers)
 Innervated by Radial nerve (or branches of)
INNERVATION OF ANTERIOR
COMPARTMENT-FOREARM
Muscle
MUSCLES Nerve

Superficial Muscles
 Flexor digitorum superficialis Median
 Flexor carpi radialis Median
 Pronator teres Median
 Palmaris longus Median
 Flexor carpi ulnaris Ulnar
Deep Muscles
 Pronator quadratus Median
 Flexor pollicis longus Median
 Flexor digitorum profundus Ulnar (med 1/2)
Median (lat 1/2)
ANTERIOR COMPARTMENT
FOREARM pg 302
Medial Epicondyle

Brachioradialis
Pronator Teres

Flexor Carpi Radialis

Flexor Carpi Ulnaris


Flexor Retinaculum

Flexor Digitorum Superficialis


Anterior View is deep to other flexors
INNERVATION OF POSTERIOR
COMPARTMENT-FOREARM
Muscle
MUSCLES
Nerve
Superficial
 Extensor carpi radialis longus Radial
 Extensor digitorum Radial
 Extensor carpi ulnaris Radial
Deep
 Supinator Radial
 Abductor pollicis longus Radial
 Extensor pollicis longus + brevis Radial
 Extensor indicus Radial
POSTERIOR COMPARTMENT OF
FOREARM

Lateral Epicondyle

Brachioradialis
Extensor digitorum
Ext Carpi Radialis Longus
Extensor carpi ulnaris

Posterior View
INTRINSIC MUSCLES OF
HAND
Muscle Nerve

Pinky (little finger)


 All digiti minimi Ulnar (Flexor, Abductor, Opponens)
Thumb
 Abductor pollicis brevis Median
 Flexor pollicis brevis Median
 Opponens pollicis Median
 Adductor pollicis Ulnar
Other Intrinsic Muscles
 Palmar + Dorsal Interossei Ulnar
 Lumbricals Median, Ulnar
INTRINSIC MUSCLES OF HAND

Palmar Dorsal Lumbricals


Interossei Interossei
3rd
ADDuction ABduction
2nd

4th 1st

Interossei help the lumbricals to extend IP joints and


flex MC-P joints

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