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Upper Limb (MOORE)
Upper Limb (MOORE), insertion, action, innervation
Name | PA | DA | Innervation | Main Action |
---|---|---|---|---|
Serrates anterior | External surfaces of lateral parts of 1st-8 ribs | Anterior surface of medial border of scapula | Long thoracic nerve C6 C7 | Protracts scapula and holds it against thoracic wall; rotates scapula |
Trapezius | Medial third of superior nuchal line; external occipital protuberance; nuchal ligament; spinous processes of C7-T12 vertebrae | Lateral third of clavicle; acromion and spine of scapula | Spinal accessory nerve CNXI motor fibres, C3 C4 Spinal nerves pain an proprioceptive | Descending part elevates; ascending part depresses; middle part retracts scapula; descending and ascending act together to rotate glenoid cavity superiorly |
Latissimus dorsi | Spinous processes of inferior 6 thoracic vertebrae, thoracolumbar fascia, iliac crest and inferior 3 or 4 ribs | Floor of bicipital groove | Thoracodorsal Nerve C6 C7 | Extends, adducts and medially rotates humerus, |
Levator Scapulae | Posterior tubercles of transverse processes of C1-C4 vertebrae | Medial border o scapula superior to root of scapular spine | Dorsal scapular C4 C5 and cervical C3 C4 nerves | Elevates scapula and rotates its glenoid cavity inferiorly by rotating scapula |
Rhomboid Minor | Nuchal ligament, spinous processes of C7 and T1 | Smooth triangular area at medial end of scapular spine | Dorsal scapular nerve C5 | Retract scapula and rotate its glenoid cavity inferiorly, fix scapula to thoracic wall |
Rhomboid Major | Spinous processes of T2-T5 | Medial border of scapula from level of spine to inferior angle | Dorsal scapular nerve C5 | Retract scapula and rotate its glenoid cavity inferiorly, fix scapula to thoracic wall |
Deltoid | Lateral third of clavicle, acromion and spine of scapula | Deltoid tuberosity | Axillary Nerve C5 | Clavicular - flexes medially rotates Acromial - Abducts arm Spinal - Extends and laterally rotates arm |
Supraspinatus | Supraspinous fossa of scapula | Superior facet of greater tubercle of humerus | Suprascapular nerve C5 | Initiates and assists deltoid in abduction of arm and acts with rotator cuff muscles |
infraspinatus | Infraspinous fossa of scapula | Middle facet of great tubercle of humerus | Suprascapular nerve C5 | Laterally rotes arm and acts rotator cuff |
Teres minor | Middle part of lateral border of scapula | inferior races of greater tubercle of humerus | axially nerve C5 | Laterally rotates arm, rotator cuff |
Teres major | Posterior surface of inferior angle of scapula | Medial lip of bicipital groove of humerus | Lower subscapualar nerve C6 | Adducts and medially rotates arm |
Subscapularis | Sub scapular fossa | Lesser tubercle | Upper and lower sub scapular nerves C6 | Medially rotates arm, as part of rotator cuff helps hold head of humerus in glenoid cavity |
Biceps brachii | Short head - tip of coccoid press of scapula Long head - supraglenoid tubercle of scapula | Tuberosity of radius and fascia of forearm via bicipital aponeurosis | Musculocutaneous C6 | Supinates forearm and when it is supine flexes forearm, short head resists dislocation of shoulder |
Coracobrachialis | tip of coccoid press of scapula | middle third of medial surface of humerus | Musculocutaneous C6 | Helps flex and adduct arm, resists dislocation of shoulder |
Brachialis | Distal half of anterior surface of humerus | Coronoid process and tuberosity of ulna | Musculocutaneous nerve C5 C6 and Radial nerve C5, C7 | Flexes forearm in all positions. |
Triceps brachii | Long head - infraglenoid tubercle of scapula Lateral head - posterior surface of humerus superior to radial groove Medial head posterior surface of humerus inferior to radial groove | Proximal end of olecranon of ulna and fascia of forearm | Radial nerve C7 C8 | Chief extensor of forearm, long head resists dislocation especially important during adduction |
Anconeus | Lateral epicondyle of humerus | Lateral surface of olecranon and superior part of posterior surface of ulna | Radial Nerve C7 C8 T1 | Assists triceps in extending forearm stabilises elbow joint, may abduct ulna during pronation |
Pronator teres | Ulnar Head - Cornoid process Humeral Head - Medial epicondyle of humerus | Middle of convexity of lateral surface of radius | Median nerve C7 | Pronates and flexes forearm |
Flexor carpi radialis | Medial epicondyle of humerus | Base of 2nd metacarpal | Median nerve C7 | Flexes and abducts hand |
Palmaris Longus | Medial epicondyle of humerus | Distal half of flexor retinaculum and apex of palmar aponeurosis | Median nerve C7, C8 | Flexes hand and tenses palmar aponeurosis |
Flexor carpi ulnaris | Humeral Head:Medial epicondyle of humerus Ulnar Head - Olecranon and posterior border of ulna | Pisiform, hook of hamate and 5th metacarpal | Ulnar Nerve C8 | Flexes and adducts hand |
Flexor digitorum superficialis | Humeroulnar head - medial epicondyle (common flexor origin and coronoid process) Radial head Superior half of anterior border | Shafts of middle phalanges of medial four digits | Median nerve C7, C8 T1 | Flexes middle phalanges at proximal interphalaneal joints of middle four digits, acting more strongly it also flexes proximal phalanges at metacarpohalangeal joints |
Flexor digitorum profundus | Proximal three quarters of medial and anterior surfaces of ulna an dinterosseious membrane | bases of distal phalanges of 2nd-5th metatarsals | Medial 2 digits - Ulnar Nerve T1 2nd and 3rd digits - Anterior interosseous nerve from median nerve C8 | Flexes distal phalanges of 2-5 digits at distal interphalangeal joints |
Flexor pollicis Longus | Anterior surface of radius and adjacent interosseous membrane | Base of distal phalanx of thumb | Anterior interosseous nerve from median nerve C8 | Flexes phalanges of first digit |
Pronator quadratus | Distal quarter of anterior surface of ulna | Distal quarter of anterior surface of radius | Anterior interosseous nerve from median nerve C8 | Pronates forearm, deep fibres bind radius and ulna together |
Brachioradioalis | Proximal two thirds of supra-epicondylar ridge of humerus | Lateral surface of distal end of radius proximal to styloid process | Radial Nerve C6 | Relatively weak flexion of forearm, maximal when forearm is in mid pronated position |
Extensor carpi radialis longus | Lateral supra-epicondylar ridge of humerus | Dorsal Aspect of base of 2nd metacarpal | Radial Nerve C6 C7 | Extend and abduct hand at the wrist joint, |
Extensor carpi radialis brevis | Lateral epicondyle of humerus (common extensor origin) | Dorsal aspect of base of 3rd Metacarpal | Deep branch of radial nerve C7 | Extend and abduct hand at the wrist joint, |
Extensor Digitorum | Lateral epicondyle of humerus (common extensor origin) | Extensor expansions of medial four digits | Deep branch of radial nerve C7 | Extends medial four digits primarily at metacarpophalangeal joints secondarily at interphalangeal joints |
Extensor digitorym minimi | Lateral epicondyle of humerus (common extensor origin) | Extensor expansion of 5th Digit | Deep branch of radial nerve C7 | Extends 5th digit primarily at metacarpophalangeal joint and secondary interphalangeal joint |
Extensor carpi ulnaris | Lateral epicondyle of humerus, posterior border of ulna via a shared aponeurosis | Dorsal aspect of base of 5th metacarpal | Deep branch of radial nerve C7 | Extends and adducts hand at wirst |
Supinator | Lateral epicondyle of humerus, radial collateral and angular ligaments, supinator fossa, crest of ulna | lateral, posterior, anterior surfaces of proximal third of radius | Deep branch of radial nerve C8 | Supinates forearm, rotates radius to turn palm anteriorly or superiorly ( if elbow is flexed) |
Extensor indicis | Posterior surface of distal third of ulna and interosseous membrane | Extensor expansion 2nd digit | Posterior interosseous nerve C7 , continuation of deep branch of radial nerve | Extends 2nd digit ( enable independent extension, helps wrist extend hand |
Abductor pollicis longus | Posterior surface of proximal halves of ulna, radius and interosseous membrane | Base of 1st metacarpal | Posterior interosseious nerve C8 continuation of deep branch of radial nerve | Abducts thumb and extends it at carpometacarpal joint |
Extensor pollicis longus | Posterior surface of middle third of ulna and interosseous membrane | dorsal aspect of base of distal phalanx of thumb | Posterior interosseious nerve C8 continuation of deep branch of radial nerve | Extends distal phalanx of thumb at interphalangeal joint, extends metacarpophalangeal joint, extends carpometacarpal joint |
Extensor pollicis brevis | Posterior surface of distal third of radius and interosseous membrane | Dorsal aspect of base of proximal phalanx of thumb | Posterior interosseious nerve C8 continuation of deep branch of radial nerve | Extends proximal phalanx of thumb at metacarpophalangeal joint extends carpometacarpal joint |
Opponens Pollicis | Flexor retinaculum and tubercles of scaphoid and tapezium | Lateral side of 1st metacarpal | Recurrent branch of median nerve C8 | To oppose thumb, it draws 1st metacarpal medially to centre of palm and rotates it medially |
Abductor pollicis brevis | Flexor retinaculum and tubercles of scaphoid and trapezium | Lateral side of base of proximal phalanx of thumb | Recurrent branch of median nerve C8 | Abducts thumb, helps oppose it |
Flexor pollicis brevis | Flexor retinaculum and tubercles of scaphoid and tapezium | Lateral side of base of proximal phalanx of thumb | Superficial head -Recurrent branch of median nerve C8 Deep Head - Deep branch of ulnar nerve T1 | Flexes Thumb |
Adductor Pollicis | Oblique head - bases of 2nd and 3rd metacarpals, capitate, adjacent carpals Transverse head - anterior surface of shaft of 3rd metacarpal | medial side of base of proximal phalanx of thumb | Deep branch of ulnar nerve T1 | adducts thumb toward lateral border of palm |
abductor digiti minimi | Pisiform | Medial side of base of proximal phalanx of 5th digit | Deep branch of ulnar nerve T1 | Abducts 5th digit, assists in flexion of its proximal phalanx |
Flexor digiti minimi brevis | Hook of hamate and flexor retinaculum | Medial side of base of proximal phalanx of 5th digit | Deep branch of ulnar nerve T1 | Flexes proximal phalanx of 5th digit |
Opponens digiti | Hook of hamate and flexor retinaculum | Medial border of 5th metacarpal | Deep branch of ulnar nerve T1 | Draws 5th metacarpal anterior and rotes it, bringing 5th digit into opposition with thumb |
Lumbricals 1st-4th | 1st - 2nd -Lateral two tendons of flexor digitorum profundus (as unipennate muscles) 3rd-4th - medial three tendons of flexor digitorum profundus (as bipinnate muscles) | Lateral sides of extensor expansions of 2nd - 5th digits | 1st and 2nd - Median nerve T1 3rd and 4th - Deep branch of ulnar nerve T1 | Flex metacarpophlangeal joints, extend interphalangeal joints 2nd-5th digits |
Dorsal interossei 1st-4th | Adjacent sides of two metacarpals (as bipinnate muscles) | Bases of proximal phalanges, extensor expansions of 2nd-4th digits | Deep branch of ulnar nerve T1 | Abduct 2nd-4th digits from axial line, act with lumbricals in flexing metacarpophalangeal joints and extending interphalangeal joints |
Palmar Interossei 1st-3rd | Palmar surfaces of 2nd, 4th and 5th metacarpals(as unipennate muscles) | Bases of proximal phalanges, extensor expansions of 2nd, 4th and 5th digits | Deep branch of ulnar nerve T1 | Adduct 2nd, 4th and 5th digits toward axial line, assist lumbricals in flexing metacarpophalangeal joints and extending interphalangeal joints, extensor expansions of 2nd-4th digits |
Pectoralis Major | Clavicular head: anterior surface of medial half of clavicle Sternocostal head: anterior surface of sternum superior six postal cartilages, aponeurosis of external oblique muscle | lateral lip of bicipital groove of humerus | Lateral and medial pectoral nerves clavicular head C6 Sternocostal head C7 C8 | Adducts and medially rotates humerus, draws scapula anteriorly and inferiorly, acting alone clavicular head flexes humerus and sternocostal head extends it from the flexed position |
Pectoralis minor | 3rd-5th ribs near their costal cartilages | medial border and superior surface of coracoid process of scapula | medial pectoral nerve C8 T1 | stabilises scapula by drawing it inferiorly and anteriorly agains thoracic wall |
Subclavius | Junction of 1st rib and its costal cartialge | inferior surface of middle third clavicle | Nerve to subclavius C5 C6 | Anchors and presses clavicle |