Upper Extremity Muscle Cheat Sheet PDF

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Summary

Shoulder/Neck/ BackPA DA Movement Innervation Special FeaturesMuscle Fiber Dir. Trapezius Superior: nuchal line, occipital protuberance, C1-C spinous processes Transverse: T1-T spinous processes Inferior: T7-T spinous processesSuperior: lateral 1/ clavicle posterior border Transverse: superior lip o...

Description

Shoulder/Neck/Bac k Trapezius

Latissimus Dorsi

Rhomboid Major

PA

DA

Superior: nuchal line, occipital protuberance, C1-C7 spinous processes Transverse: T1-T6 spinous processes Inferior: T7-T12 spinous processes

Superior: lateral 1/3 clavicle posterior border Transverse: superior lip of spine of scapula Inferior: Base of spine scapula

T7-T12 spinous processes, thoracolumbar fascia, posterior iliac crest, Ribs 9-12 T2-T5 spinous processes

Rhomboid Minor

C7-T1 spinous processes

Levator Scapulae

C1-C4 transverse processes

Pectoralis Major

Medial ½ clavicle anteriorly, anterior sternum, Ribs 1-7 costal cartilage, EAO aponeurosis

Movement

Innervation

Superior: scap elevation, upward rotation Transverse: scapular retraction Inferior: scapular depression, upward rotation

Spinal accessory nerve (C3,4)

Bicipital groove on humerus

GH extension, adduction, internal rotation

Thoracodorsal (C6,7,8)

Medial border of scapula from base of spine Corocoid process of scapula

Scapular retraction, downward rotation

Medial border of scapula between superior angle and base of spine Lateral lip on bicipital groove on humerus

Scapular elevation, downward rotation

Dorsal Scapular (c4,5) Dorsal scapular (c4,5) Dorsal scapular (C4,5)

Scapular retraction, downward rotation

GH adduction and internal rotation;

Medial and Lateral Pectoral (C5,6) (C7,8, T1)

Special Features Upper: affected by clavicle fracture

Muscle Fiber Dir. Upper: inferior to lateral Middle: lateral Lower: superior and lateral Superior and lateral

Inferior and lateral Inferior and lateral Inferior and lateral

Clavicular fibers flex an extended shoulder; sternal fibers

Sternal: head Superior and lateral Clavicular head: inferior and lateral

extend a flexed shoulder Pectoralis Minor

Ribs 3-5 costal cartilage

Corocoid process of scapula

Subclavius

Rib 1 costal cartilage

Serratus Anterior

Ribs 1-8 lateral aspect

Deltoid

Anterior: lateral 1/3 clavicle anterior aspect Middle: acromion process of scapula Posterior: Spine of scapula

Inferior middle 1/3 of clavicle Medial border of scapula along costal surface Deltoid tuberosity on midshaft of humerus

Scapular protraction, depression, downward rotation, internal rotation, anterior tilt Depressions clavicle, stabilizes SC joint Scapular protraction, upward rotation, prevents winging Anterior: flex and IR of GH

Superior and lateral

Medial and Lateral Pectoral (C5,6) (C7,8,T1) Nerve to Subclavius Long Thoracic (C5,6,7) Suprascapular (C5,6)

Middle: abduction of GH

Superior and lateral Anterior to posterior Anterior: affected by clavicular fracture

Posterior: extensions and ER of GH

Anterior: inferior and lateral Middle: inferior Posterior: lateral and inferior Lateral

Supraspinatus**

Supraspinous fossa

Superior/anterior facet on greater tubercle of humerus

Abduction of GH

Suprascapular (C5,6)

Infraspinatus**

Infraspinous fossa

ER of GH

Teres minor**

Lateral border of scapular superior aspect Subscapular fossa

Middle facet on greater humerus Posterior/inferior facet on greater tubercle of humerus Lesser tubercle of

ER of GH

Suprascapular (C5,6) Axillary (C5,6)

Superior and lateral Superior and lateral

IR of GH

Upper and

lateral

Subscapularis**

Most torn Rotator cuff tendon

humerus

Teres Major

Brachium Muscles Anterior

Lateral border of scapula

PA

Bicipital groove

DA

Extension, adduction, and IR of GH

Action

lower subscapular nerve (C5,6) Lower subscapular nerve (C5,6,7)

Innervation

Coracobrachialis

Coracoid process of scapula

Midshaft of humerus medially

GH flexion

Musculocutaneou s (C5,6,7)

Biceps Brachii

Long head: supraglenoid tubercle of scapula Short head: coracoid process of scapula

Radial tuberosity, bicipital aponeurosis

GH and elbow flexion, supination of forearm

Musculocutaneou s (C5,6,7)

Brachialis

Distal ½ anterior surface of humerus

Ulnar tuberosity, cornoid process of ulna

Elbow flexion

Musculocutaneou s (C5,6,7) and Radial (C7) on lateral portion

Long head: infraglenoid tubercle of scapula

Olecranon process of ulna

Elbow extension, long head adductions GH

Radial (C6,7,8)

Posterior Triceps Brachii

Special Features Pierced by musculocutaneous nerve Long head travels through bicipital groove when transverse humeral ligament holds it down; bicipital tendonitis related to its inflammation Musculocutaneou s nerve is superficial to this muscle and deep to biceps brachii

Superior and lateral

Muscle Fiber Direction

Lateral head: superior to spiral line of humerus Medial head: inferior to spiral line of humerus

Anterior anti-brachium (forearm flexors) Superficial PA Pronator teres Humeral: proximal to medial epicondyle of humerus Ulnar: cornoid process of Ulna Medially Flexor Carpi Radialis-FCR Palmaris Longus-PL

Flexor Carpi Ulnaris -FCU

Medial epicondyle of humerus Medial epicondyle of humerus Humeral: medial epicondyle Ulnar: medial olecranon and posterior border of ulna

DA Midshaft of lateral radius

Action Pronates forearm, secondary elbow flexion

Innervation Median (C6,7)

Special Features Median nerve goes through two heads into cubital fossa

Base of 2nd and 3rd Wrist flexion, metacarpals radial deviation

Median (C6,7)

Radian artery just lateral

Flexor retinaculum and palmar aponeurosis Hook of hamate, pisiform, and base of 5th metacarpal

Wrist flexion, tenses palmar aponeurosis

Median (C7,8)

Wrist flexion, ulnar deviation

Ulnar (C7,8, T1)

Tendon used to repair UCL Ulnar nerve goes between two heads and enters volar forearm

Muscle Fiber Dir.

Intermediate Flexor Digitorum Superficialis-FDS

Deep Flexor Digitorum Profundus -FDP

Flexor Pollicis Longus-FPL

Pronator Quadratus

Posterior Antibrachium (forearm extensors) Superficial Brachioradialis

Humeroulunar: medial epicondyle, medial aspect of coronoid process of ulna Radial: oblique line

Middle phalanges of digits 2-5 along sides of shaft

Wrist flexion, MCP and PIP flexion digits 2-5

Median (C8, T1)

4 tendons go through carpal tunnel of wrist

Proximal ¾ shaft of ulna and coronoid process of ulna Radial shaft below oblique line

Distal phalanges of digits 2-5

Median (digits 23) Ulnar (digits 4 and 5) (C8,T1)

4 tendons go through carpal tunnel of wrist

Distal phalanx of 1st digit

DIP flexion, Secondary PIP, MCP and wrist flexion Flexes IP of 1st digit

4 tendons go through carpal tunnel of wrist

Distal ¼ anterior shaft of radius

Pronation of forearm

Anterior interosseous branch of Median (C7,8) Anterior interosseous branch of Median (C7,8)

Innervation Radial (C5,6)

Special Features Forms lateral border of cubital fossa; Only muscle in posterior compartment

Anterior surface of distal ulna (oblique ridge)

PA Lateral supracondylar ridge of humerus

DA Lateral distal shaft of radius just proximal to styloid process

Action Elbow flexion

Muscle Fiber Dir.

that flexes Lateral supracondylar ridge and lateral epicondyle of humerus Lateral epicondyle of humerus, radial collateral ligament

Base of 2nd metacarpal

Wrist extension and radial deviation

Radial (C6,7)

Base of 3rd metacarpal

Radial (C7,8)

Extensor DigitorumED

Lateral epicondyle of humerus

Dorsal digital expansions of digits 2-5

Extensor Digiti Minimi-EDM

Lateral epicondyle of humerus

Dorsal digital expansion of digit 5

Extensor Carpi Ulnaris

Lateral epicondyle of humerus, posterior border of ulna

Base of 5th metacarpal

Wrist extension and radial deviation PIP and DIP extension of digits 25, wrist extension PIP and DIP extension of digit 5, wrist extension Wrist extension, biiation

Lateral epicondyle of the humerus, posterior aspect

Lateral olecranon and proximal posterior shaft of ulna Proximal posterior, lateral, and anterior radial shaft

Aids in elbow extension

Radial (C6,7,8)

Supination of forearm

Posterior interosseous branch of radial (C6,7)

Extensor Capri Radialis Longus -ECRL

Extensor Carpi Radialis Brevis -ECRB

Deep Anconeus

Supinator

Lateral epicondyle of humerus, supinator of crest of ulna

Radial (C7,8)

Radial (C7,8)

Radial (C7,8)

Deep branch of radial nerve goes through fibers = place for entrapment

Abductor Pollicis Longus-APL

Posterior mid-shaft of ulna, posterior mid-shaft radius

Base of 1st MC and trapezium

Abduction of 1st digit/thum b at CMC

Posterior interosseous branch of radial (C7,8)

Extensor Pollicis Longus-EPL

Posterior shaft of ulna (below APL)

Distal phalanx of 1st digit

Posterior interosseous branch of radial (C7,8)

Extensor Pollicis Brevis-EPB

Posterior shaft of radius (below APL)

Proximal phalnx of 1st digit

Extension of IP, MCP, and CMC of 1st digit/thum b Extension of MCP and CMC of 1st digit

Extensor indicis

Posterior Shaft of Ulna

Extensor digitorum Extension of 2nd digit tendon to index finger along medial side

Intrinsic Hand Muscles Thenar Abductor Pollicis Brevis Flexor Pollicis Brevis

PA Trapezium and scaphoid carpals Superficial head: trapezium Deep head: trapezoid and

DA Lateral base of proximal phalnx of 1st digit Base of proximal phalynx of 1st digit

Posterior interosseous branch of radial (C7,8)

Out cropper muscle forming anterior border of anatomical snuffbox with EPB; most anterior/lateral Out cropper muscle forming posterior border of snuffbox

Out cropper muscle forming anterior border of anatomical snuffbox with APL

Posterior interosseous branch of radial (C7,8)

Action Abduction of 1st digit

Innervation Median (C8,t1)

Flexion of 1st digit at MCM and CMC

Superficial: Median/Deep ulnar (C8,T1)

Special Features Abduction in sagittal plane; most superficial Flexion in frontal plane

Muscle Fiber Dir.

Opponens Pollicis Hypothenar Abductor Digiti Minimi

capitate Trapezium

Pisiform

Flexor Digiti Minimi

Hook of hamate

Opponens Digiti Minimi Intermediate Adductor Pollicis

Hook of hamate

Lumbricals

Deep Palmar interossei

Dorsal interossei

Transverse: shaft of 3rd MCC Oblique: capitate and bases of 2nd and 3rd MC Respective FDP tendons to digits 2-5

2nd finger: medial shaft of MC 4th finger: lateral shaft of MC 5th finger: lateral shaft of MC 2nd: adjacent sides

Lateral shaft of 1st MC

Opposition of thumb

Median (C8,T1)

Base of proximal phalnyx of 5th digit Base of proximal phalynx of 5th digit, dorsal digital Medial shaft of 5th MC

Abduction of 5th digit at MCP

Ulnar (C8,T1)

Flexion of 5th digit at MCP

Ulnar (c8,T1)

Opposition of pinky

Ulnar (C8,T1)

Thumb at base of proximal phalnx

Adduction of thumb at CMC

Both heads: Ulnar (C8,T1)

Lateral aspect of dorsal digital expansion of digits 2-5 between MC shafts

Flexion of MCPs, extensions of IPs digits 2-5 (1st lumbrical acts on digit 2, 2nd on digit 3, etc.)

1 and 2: median 3 and 4: ulnar (C8,t1)

Arise from tendons of FDP (lateral/radial part of the tendon)

2nd: medial base of proximal phalynx 4: lateral base of proximal phalynx 5th: lateral base of proximal phalnx 2nd finger: medial

ADDuct fingers 2,4,5 towards 3rd finger

Ulnar (C8,T1)

Note: not on middle (3) digit bc it doesn’t adduct

Abducts fingers

Ulnar (C8,T1)

No “true”

Most lateral

of 1st and 2nd MC shafts 3rd: adjacent

base of proximal phalnx 3rd: lateral and medial bases of proximal phalnx 4th: lateral base of proximal phalnx

2,3,4

Muscles with multiple heads Three heads: 

Deltoid, trapezius, triceps brachii, palmar interossi, dorsal interossi

Two heads: 

Biceps brachii, pronator teres, flexor pollicis brevis, adductor pollicis, flexor capri ulnaris

Dual Innervation:      

Pectoralis Major/Minor o Medial and lateral pectoral nerve Subscapularis o Upper and low subscapular nerve Brachialis o Musculocutaneous and radial Flexor digitorum profundus o Median and ulnar Flexor pollicis brevis o Median and ulnar Lumbricals o Median and ulnar

Arteries:

muscles on dorsal of the hand

  

Subclavian becomes the axillary when it passes the lateral border of the first rib Axillary becomes the brachial artery after it passes the inferior border of the teres major Brachial artery splits into two at the cubital fossa -> ulnar and radial artery o Ulnar artery feeds into superficial palmar arch o Radial artery feeds into deep palmar arch o Both form digital arteries that run down the medial and lateral sides of the digits

Spaces of the UE 1. SCAPULAR FORAMEN 



Borders o

Superior: superior transverse scapular ligament

o

Inferior: floor of scapular notch

Contents: o

Suprascapular nerve (suprascapular artery runs over the ligament)

2. QUADRANGULAR SPACE 

Borders o

Superior: teres minor

o

Inferior: teres major

o

Medial: long head of triceps

o

Lateral: humerus



Contents o

Axillary nerve

o

Posterior circumflex humeral artery

3. TRIANGULAR SPACE 



Borders o

Superior: teres minor

o

Inferior: teres major

o

Lateral: long head of triceps

Contents o

Circumflex scapular artery

4. TRICEPS HIATUS 



Borders o

Superior: teres major

o

Medial: long head of triceps

o

Lateral: lateral head of triceps

Contents o

Radial nerve

o

Deep brachial artery

5. AXILLA 



Borders o

Roof/apex: cervicoaxillary canal

o

Floor: axillary skin and fascia

o

Anterior: pectoralis major, pectoralis minor

o

Posterior: latissimus dorsi, teres major, subscapularis

o

Medial: serratus anterior, ribs, intercostal mm

o

Lateral: bicipital groove of humerus

Contents o

Brachial plexus (cords, terminal branches)

o

Axillary artery and branches

o

Axillary vein and tributaries

o

Lymphatic vessels/nodes

6. CUBITAL FOSSA 

Borders: o

Superior: imaginary line connecting medial and lateral epicondyles

o

Medial: pronator teres

o 

Lateral: brachioradialis

Contents o

Tendon of biceps brachii (Bicipital aponeurosis)

o

BrachiaFl artery and vein

o

Proximal part of radial and ulnar arteries and veins

o

Radial nerve

o

Median nerve

o

Cutaneous branch of musculocutaneous nerve (lateral cutaneous nerve of forearm)

7. CUBITAL TUNNEL 



Borders: o

Medial epicondyle

o

Tendinous arch joining humeral and ulnar heads of flexor carpi ulnaris

Contents o

Ulnar nerve

o

Posterior ulnar recurrent artery

8. ULNAR TUNNEL (GUYON’S CANAL) 

Borders o

Floor: Flexor retinaculum



o

Roof: Palmar carpal ligament

o

Medial: Pisiform

o

Lateral: Hamate

Contents o

Ulnar nerve

o

Ulnar artery

9. CARPAL TUNNEL 



Borders o

Floor: Carpal bones

o

Roof: Flexor retinaculum (transverse carpal ligament)

Contents o

4 tendons of flexor digitorum superficialis

o

4 tendons of flexor digitorum profundus

o

Tendon of flexor pollicis longus

o

median nerve runs most anteriorly/superficially through tunnel

10. ANATOMICAL SNUFFBOX 

Borders

o Extensor pollicis longus tendon, extensor pollicis brevis/abductor pollicis longus tenson o Floor: scaphoid and trapezium 

Contents

o Radial artery o (Cephalic vein and superifical branch of radial nerve cross superficially)

11. OTHER: 

Arcade of Struthers: passageway for ulnar nerve in brachium as it passes from anterior compartment through the intermuscular septa into posterior compartment; ulnar nerve then travels under the medial head of the triceps



Arcade of Frohse: most superior part of supinator muscle; fibrous arch over posterior interosseous nerve (deep branch of radial nerve)...