Muscle Guide (OIAN) PDF

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Summary

Muscle origins, insertions, actions and nerve innervations...

Description

Upper Extremity Peripheral Nerve

Cutaneous Sensory Region

Muscle

Origin

Insertion

Action

Med ½ sup nuchal line, ext occipital protuberance, nuchal lig, SP C7T12 Sternal head: manubrium Clavicular head: sup surface med 1/3 clavicle

Lat 1/3 clavicle, acromion, spine of scapula

Lat. surface mastoid process, lat. half of sup nuchal line

Tilts head to same side; rotates head to opposite direction; simultaneously flex neck

Supraspinatus

Supraspinous fossa

Infraspinatus

Infraspinous fossa

Long Thoracic

Serratus Anterior

Ribs 1-8 (lateral portion)

Greater tuberosity Conjoin tendon Greater tuberosity Conjoin tendon Anterior surface of medial border of scapula

Dorsal Scapular

Levator Scapulae

TP of C1-C4

Shoulder Abduction Compress GH joint Shoulder ER Humeral depression (inf glide) Scapular Protraction; holds scapular against thoracic wall (prevents winging), Scapular upward & scapular external rotation Scapular Elevation/ Downward Rotation

Trapezius

Accessory (CN XI)

SCM

Suprascapular

No cutaneous *Supplies deep sensation to AC & GH joints

Rhomboids (Major/Minor) Thoracodorsal

Latissimus Dorsi

Upper Subscapular

Subscapularis

Elevates, retracts and upwardly rotates scapula Lower: prevents anterior tilting

Superior part of medial border of scapula Medial border of Major: SP of T2-5 Minor: nuchal lig; scapula (from spine SP of C7-T1 to inf angle) SP T7-12; last 3-4 rib; Floor of Thoracolumbar intertubercular aponeurosis/iliac crest groove of humerus Subscapular fossa Lesser tubercle of humerus

Scapular Retraction/ Downward Rotation Shoulder Adduction/ Extension/IR Shoulder IR Humeral depression (inf glide)

1 Morey J. Kolber, PT, PhD, OCS, Cert MDT, CSCS*D rev 4/20/16

Peripheral Nerve

Cutaneous Sensory Region

Muscle

Origin

Insertion

Action

Lower Subscapular (C5,6)

(Subscapularis)

S/A

S/A

S/A

Teres Major

Pectoralis Major

Medial lip of intertubercular groove of humerus Lateral lip of intertubercular groove of humerus

Shoulder Adduction & IR Possibly extension

Lateral Pectoral

Dorsal surface of inferior angle of scapula Clavicular head: med ½ of clavicle

(Pectoralis Major) Pectoralis Minor

Medial Pectoral

Axillary

Lat & ant & post shoulder (prox region of arm) “Epaulette patch”

Teres Minor Deltoid (ant/lat/post) Long head triceps

Musculocutaneous

Lateral Forearm

Coracobrachialis Biceps

Brachialis

Sternal head: Anterior sternum; costal cartilage 1-6; aponeurosis of external obliques S/A Ribs 3-5 near costal cartilage

Post/ lateral border of scapula Lateral 1/3 of clavicle; acromion; spine of scapula Infraglenoid tubercle of scapula Coracoid process Short head: coracoid process Long head: supraglenoid tub. Distal half of anterior humerus

S/A Coracoid process of scapula

Greater tuberosity Deltoid tuberosity of humerus Olecranon process of ulna Medial surface of humerus Radial tuberosity & bicipital aponeurosis Coronoid process & tuberosity of ulna

Shoulder Horizontal Adduction/ IR

S/A Stabilizes scapula against thorax Anterior tilting of scapula Scapular internal rotation & downward rotation Shoulder ER Humeral depression (inf glide) Shoulder flexion(A) Extension & GH compression (P) Abduction(L) Elbow extension & possibly arm extension Shoulder Flex/ Adduction Elbow Flexion/Sup Also: Shoulder flexion/abd (long head) when in external rotation Elbow Flexion

2 Morey J. Kolber, PT, PhD, OCS, Cert MDT, CSCS*D rev 4/20/16

Peripheral Nerve Medial Brachial Cutaneous (C8-T1)

Cutaneous Sensory Muscle Region Medial Arm Sensory only

Medial Antebrachial Cutaneous (C8-T1)

Medial Forearm

Sensory only

Radial

Lat thumb Dorsal aspect of hand (digits 1,2,3,1/2 of 4; except for regions distal to the DIP joints)

Triceps

Median

Long head: infraglenoid *Long head tubercle of scapula receives innervation Lateral head: supfrom axillary nerve post surface of in most (not all) humerus cases Medial head: infpost surface of humerus Anconeous

Ulnar

Radial

Brachioradialis

Extensor Carpi Radialis Longus

Median Ulnar

Origin

Lateral epicondyle of humerus Prox 2/3 lateral supracondylar ridge of humerus Lateral supracondylar ridge of humerus

Insertion

Olecranon process of ulna

Action

Elbow Extension Long head crosses GH thus may extend shoulder albeit not a major extensor)

Elbow extension Lateral surface of distal end of radius

Elbow flexion

Base of 2nd MC

Wrist extension/ Radial deviation

Extensor Carpi Radialis Brevis

Lateral epicondyle of humerus

Base of 3rd MC

Supinator

Lateral epicondyle of humerus; radial collateral & annular lig; supinator fossa; crest of ulna

Lat, post and ant Supination surfaces of proximal 1/3 of radius

3 Morey J. Kolber, PT, PhD, OCS, Cert MDT, CSCS*D rev 4/20/16

Peripheral Nerve

Cutaneous Sensory Region

Radial (continued)

Muscle

Extensor Digitorum Lateral epicondyle and Digiti Minimi of humerus

Extensor Indicis Extensor Carpi Ulnaris Abductor Pollicis Longus#

Extensor Pollicis Brevis# Extensor Pollicis Longus#

#

Origin

Insertion

Extensor expansion of digits 2-5; extensor expansion of digit 5 Post surface of ulna Extensor expansion & interosseous mem of digit 2 Base of 5th MC Lateral epicondyle of humerus & post border of ulna Post surface of ulna, Base of 1st MC radius & interosseous membrane Post surface of Base of proximal radius; interosseous phalanx of thumb membrane Post surface of Base of distal middle 1/3 ulna; phalanx of thumb interosseous memo

Action Extension of digits 2-5 at MCP joints (& wrist extension); Extension of digit 5 at MCP & IP joint Extends 2nd digit Extension / ulnar deviation of wrist Abduction 1st digit (thumb)

Extends prox phalanx of thumb at CMC joint Extends distal phalanx of thumb at MCP & IP joints

Anatomical Snuff Box

4 Morey J. Kolber, PT, PhD, OCS, Cert MDT, CSCS*D rev 4/20/16

Peripheral Nerve Median

Carpal tunnel syndrome

Cutaneous Sensory Muscle Region Palmar aspect of Pronator Teres hand (digits 1,2,3, ½ of 4) Dorsal – tip of thumb and digits Pronator Quadratus 2,3, ½ of 4)

Origin Medial epicondyle of humerus; coronoid process of ulna Distal anterior ulna

Flexor Carpi Radialis Palmaris Longus

Medial epicondyle of humerus

Flex Digitorum Superficialis

Medial epicondyle of humerus; ulnar collateral lig; coronoid process of ulna; sup ½ ant surface of radius Prox ¾ medial and anterior surface of ulna & interosseous membrane Anterior surface of radius and interosseous mem Flexor retinaculum; tubercles of scaphoid & trapezium

S:Digits3½ no palm M: LOAF (*) Flex Dig Profundus (2&3)

Flex Pollicis Longus *Flexor Pollicis Brevis *Abductor Pollicis Brevis *Opponens Pollicis *Lumbricals I & II

Lateral 2 tendons of FDP

Insertion

Action

Middle of lateral surface of radius

Pronation and flexion of forearm

Distal anterior radius Base of 2nd MC

Pronation Wrist Flexion/ Radial Dev

Distal ½ flexor retinaculum and palmar aponeurosis Middle phalanges of digits 2-5

Wrist Flexion; tightens palmar aponeurosis

Base of distal phalanges of digits 2-3

Flexion of digits 2 & 3 of distal IP joints

Base of distal phalanx of thumb

Thumb Flexion

Lateral side of base of proximal phalanx of thumb

Thumb Flexion

Lateral side 1st MC

Thumb Opposition

Lateral side of extensor expansions of digits 2&3

IP Extension/ MCP Flexion of digits 2&3

Wrist Flexion/ Flexion digits 2-5

Thumb Abduction

5 Morey J. Kolber, PT, PhD, OCS, Cert MDT, CSCS*D rev 4/20/16

Peripheral Nerve

Ulnar

Cutaneous Sensory Region Palmar and dorsal medial aspect of hand (digits 5 and ½ of 4)

Muscle

Flexor Carpi Ulnaris

Flex Digitorum Profundus (4&5)

Abductor Digiti Minimi Opponens Digiti Minimi Flexor Digiti Minimi Brevis Palmar Interossei

Origin

Medial epicondyle of humerus; olecranon and post border of ulna Prox ¾ medial and anterior surface of ulna and interosseous membrane Pisiform Hook of hamate & flexor retinaculum

Palmar surface of 2nd, 4th and 5th MC

Dorsal Interossei

Adjacent sides of 2 metacarpals

Lumbricals III & IV

Medial 3 tendons of FDP

Adductor Pollicis

Oblique head: base of 2nd & 3rd MC, capitate Transverse head: 3rd MC

Insertion

Action

Pisiform bone, hook of hamate & 5th MC bone

Wrist Flexion/ Ulnar Deviation

Base of distal phalanges of digits 4-5

Flexion of digits 4 & 5

Medial side of base of prox phalanx of 5th digit

Abduction of digit 5

Medial border 5th MC Base of prox phalanges of digits 2,4,5 Base of prox phalanges of digits 2-4 Lateral side of extensor expansion of digits 4&5 Medial side of base of prox phalanx of thumb

Flexion of digit 5

Opposition of digit 5

Adduction of digits 2,4,5 (to midline) Abduction of digits 2,3,4 (away) IP Extension/MCP Flexion Thumb Adduction

6 Morey J. Kolber, PT, PhD, OCS, Cert MDT, CSCS*D rev 4/20/16

Lower Extremity Peripheral Nerve Lateral Femoral Cutaneous (L2-3) Anterior Femoral Cutaneous (L2-4) Ventral Rami L1 ,2 Femoral (L2-4)

Superior Gluteal

Cutaneous Sensory Region Lateral thigh

Muscle Sensory only

Anterior thigh

Sensory only

N/A For MS consider cutaneous nerves of thigh

Psoas major Iliacus

Origin

Insertion

Action

Nerve responsible for “Meralgia paresthetica”

Pectineus

Lumbar T.P. Iliac crest, iliac fossa, ala of sacrum, ant S-I ligaments Sup ramus of pubis

Sartorius

ASIS

Quadriceps

RF: AIIS and ilium sup to acetabulum VL: Greater trochanter and linea aspera VM: Intertrochanteric line and linea aspera VI: Ant and lat surface of femur Gluteal surface of ilium b/w ant and post gluteal lines Gluteal surface of ilium b/w ant and inf gluteal lines

Gluteus Medius Has ant & post fibers Gluteus Minimus

Tensor Fasciae Latae

ASIS, ant iliac crest

Lesser Trochanter Hip Flexion Tendon of psoas Hip Flexion/ER major, lesser trochanter Pectineal line of Hip ADD femur Pes anserinus: Hip Flexion/ ER/ superior part of ABD/ Knee Flexion medial surface of tibia Base of patella and Hip Flexion(RF) / tibial tuberosity via Knee Ext (ALL) patellar ligament

Greater trochanter

Greater trochanter

Iliotibial tract(band) attaching to lateral condyle of tibia

Hip ABD/IR; keeps pelvis level when opposite leg is raised *Post fibers of medius will ER hip. AKA “Hip Rotator Cuff” Hip Flexion/ ABD/ IR

7 Morey J. Kolber, PT, PhD, OCS, Cert MDT, CSCS*D rev 4/20/16

Peripheral Nerve

Cutaneous Sensory Region

Muscle

Inferior Gluteal

Gluteus Maximus

N. to Piriformis

Piriformis

N. to Quadratus Femoris

Quadratus Femoris

Sciatic: Tibial and Common Peroneal Divisions (L4-S3)

Use dermatomes

Biceps Femoris LH: Tib N. SH: Comm Per. N. Semitendinosus Tib N.

*Adductor magnus also receives innervation from obturator nerve Obturator

Medial thigh

Semimembranosus Tib N. (Adductor Magnus) Adductor Brevis Adductor Longus Gracilis

Obturator Externus

Origin

Insertion

Ilium post to posterior gluteal line, dorsal surface sacrum & coccyx, sacrotuberous ligament Ant surface of sacrum and sacrotuberous ligament Ischial tuberosity

Gluteal tuberosity and iliotibial tract

Hip Extension/ ER

Greater trochanter

Hip ER

Quadrate tubercle on intertrochanteric crest of femur Head of fibula

Hip ER

Long head: Ischial tuberosity Short head: linea aspera and lateral supracondylar line Ischial tuberosity

Pes anserine- superior part of medial surface of tibia Post part of medial condyle of tibia

Action

Hip Extension/ Knee Flexion (can extend trunk when thigh and leg are flexed) Knee Flexion

Knee Flexion

Body and inferior ramus of pubis Body of pubis Body and inferior ramus of pubis

Pectineal line and Hip ADD/Flexion linea aspera Linea aspera of femur Hip ADD/Flexion Hip ADD/ IR Pes anserinus: superior part of medial surface of tibia

Obturator foramen

Trochanteric fossa of femur

Hip ER

8 Morey J. Kolber, PT, PhD, OCS, Cert MDT, CSCS*D rev 4/20/16

Peripheral Nerve

Cutaneous Sensory Region

Muscle Adductor Magnus *Obturator and sciatic

Obturator (continued)

Origin Adductor: inf ramus of pubis, ramus of ischium

Posterior: midline of thigh from prox to dist and post aspect of knee Plantar surface of foot and heel (excluding very small areas which may receive sensory from sural and saphenous)

Hip Adduction

Lateral head: lateral condyle of femur Medial head: popliteal surface of femur, sup to medial condyle Head of fibula and medial border of tibia Inferior end of lateral supracondylar line and popliteal lig Lateral condyle of femur & lat meniscus Inf 2/3 post fibula and interosseous membrane

Posterior surface of calcaneus via Achilles tendon

Ankle PF when knee is extended, raises heel during walking, flexes knee

Flexor Digitorum Longus

Post surface of tibia

Tibialis Posterior

Interosseous membrane, post surface of tibia and fibula

Bases of distal phalanges of digits 25 Navicular tuberosity, cuneiform & cuboid; bases of MT 2-4

Hip Extension

Sensory only

Gastrocnemius

Soleus Plantaris

Medial* Plantar Lateral** Plantar

Action

Adductor: gluteal tuberosity, linea aspera, med supracondylar line Hamstring: adductor tubercle of femur

Hamstring: Ischial tuberosity Posterior Femoral Cutaneous (S1-3) Tibial (L5-S2)

Insertion

*mid/forefoot 3 ½ **mid/forefoot ½ 4 & 5

Popliteus Flexor Hallucis Longus

Post surface of tibia Base of distal phalanx of great toe

Ankle PF independent of knee position Assists gastroc in ankle PF and knee flexion Flexes knee and unlocks it Flexion of great toe; also weak ankle PF; supports med longitudinal arches Flexes digits 2-5 and ankle PF; supports longitudinal arches PF and Inversion

Plantar Muscles* &**

9 Morey J. Kolber, PT, PhD, OCS, Cert MDT, CSCS*D rev 4/20/16

Peripheral Nerve Common Peroneal

Superficial Peroneal

Deep Peroneal

Cutaneous Sensory Region Ant, post, lat portion of prox ½ of leg (around fibular head) Anterior distal ½ of lateral leg and dorsum of foot (minus web space b/w digits 1-2) Web space b/w digits 1-2

Muscle

Origin

Action

Sensory only

Peroneus Longus

Peroneus Brevis Tibialis Anterior

Peroneus Tertius

Extensor Hallucis Longus Extensor Digitorum Longus

Saphenous (terminal end of femoral nerve) Infrapatellar branch of the saphenous Sural (arises from both tibial and common peroneal nerves)

Insertion

Medial side of leg and foot

Sensory only

Inferomedial to patella or inferolateral to patella

Sensory only

Distal posterior and lateral leg; lateral foot

Sensory only

Head and superior 2/3 lateral surface of fibula Inferior 2/3 lateral surface of fibula Lateral condyle, lateral tibia, interosseous membrane Ant surface of fibula, interosseous membrane Ant surface of fibula , interosseous membrane Lateral condyle of tibia, medial surface of fibula, interosseous membrane

Base of 1st MT and medial cuneiform

Eversion/PF

Tuberosity on lateral side of base of 5th MT Med and inf surface of medial cuneiform and base of 1st MT

Eversion/PF

Base of 5th MT

Eversion/DF

Base of great toe

Great toe extension and ankle DF

Middle and distal phalanges of digits 25

Extension of MTPs 25 and ankle DF

DF/Inversion

Hypoesthesia common after knee surgery

10 Morey J. Kolber, PT, PhD, OCS, Cert MDT, CSCS*D rev 4/20/16...