Upper Extremity Flashcards by Nathalia Sanchez

Levator Scapulae

Action: elevates scapula, downward rotation of scapula

Sup/prox: Posterior tubercle of transverse processes, CV1-CV4

Inf/dist: superior aspect of medial border of scapula

Innervations: Dorsal scapular n. C5; C3-C4 ventral rami(sensory)

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Upper Trapezius

Action: upwardly rotate with lower trapezius (inferior angle lateral) elevate and retract scapula

Sup/prox: Medial 1/3 superior nuchal line (on back of head); occipital protuberance to CV7, (ligamentum nuchlae- large median ligament composed of tendons and fascia located between posterior muscle of the neck (C1-C6)

Inf/dist: Lateral 1/3 clavicle

Innervation: CN XI (motor); ventral rami C3-C4 (sensory)

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Middle Trapezius

Action: retract scapula

Sup/prox: CV7 to TV4 spinous process

Inf/dist: acromion and crest of spine of scapula

Innervation: CN XI (motor); ventral rami C3-C4 (sensory)

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Lower Trapezius

Action: upwardly rotate scapula with upper trap, depress, retract scapula

Sup/prox: TV4-TV12 spinous process

Inf/dist: spine of scapula

Innervation: CN XI (motor), C3, C4 ventral rami (sensory)

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Serratus Anterior

Action: protract scapula and holds it against thoracic wall; upward rotation of scapula

Sup/prox: exterior lateral surface of ribs 1-8

-digitations on anterior side, lateral to ribs, inferior to scapula laterally

Inf/dist: anterior surface of medial border of scapula

Innervation: Long thoracic N. C5, *C6*, C7

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Pectoralis Major

Action: adduction and internal rotation of humerus

-clavicular head alone: flexes humerus

-SC (sternocostal) head alone: extends humerus from overhead position

-horizontal adduction at g/h joint

Sup/prox: clavicular head-anterior surface of medial 1/2 of clavicle

-sternocostal heads-anterior surface of sternum, upper 6 costal cartilages, and aponeurosis (sheet of peraly white fibrous tissue that takes place of tendon ins heetlike muscles having wide area of attachment)

Inf/dist: lateral lip of intertubercular groove of humerus

Innervation: Lateral and medial pectoral n., Clavicular C5-C6, SC C7, C8, T1

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Pectoralis Minor

Action: stabilizes scapula by drawing it inferiorly and anteriorly against the thoracic wall

Sup/prox: 3rd to 5th ribs near costal cartilages

Inf/dist: medial border and superior surface of coracoid process of scapula

Innervation: Medial and lateral pectoral n. C6, C7, C8

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Anterior Deltoid

Action: abduction, flexion, internal rotation of humerus

Sup/prox: Lateral 1/3 of the clavicle, anterior surface

Inf/dist: deltoid tuberosity of the humerus (posterior)

Innervation: axillary n. C5, C6

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Middle Deltoid

Action: abduct the humerus

Sup/prox: lateral aspect of the acromion

Inf/dist: deltoid tuberosity (post)

Innervation: axillary N. C5, C6

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Posterior Deltoid

Action: extend, externally rotate, abduct humerus

Sup/prox: inferior lip of crest of spine of scapula

Inf/dist: deltoid tuberosity

Innervation: axillary n. C5, C6

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Supraspinatus

Action: Initiates and assists deltoid in abduction of humerus

-holds head in glenoid cavity (rotator cuff)

sup/prox: supraspinous fossa (medial 2/3) of scapula

inf/dist: superior facet on greater tubercle

Innervation: suprascapular n. C4, C5, C6

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Infraspinatus

Action: external rotation of humerus

-holds humeral head in glenoid (rotator cuff)

Sup/prox: infraspinous fossa of scapula

inf/dist:middle facet of greater tubercle of humerus

Innervation: suprascapular n. C5, C6

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Teres Minor

Action: external rotation of humerus

-holds humeral head in glenoid (rotator cuff)

Sup/prox: middle part of lateral border of scapula

inf/dist:inferior facet on greater tubercle of humerus

Innervation: axillary n. C5, C6

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Subscapularis

Action: internal rotation and adduction of humerus

-holds head of humerus in glenoid (rotator cuff)

Sup/prox: subscapular fossa

inf/dist: lesser tubercle of humerus

Innervation: upper and lower subscapular n. C5, C6, C7

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Teres Major

Action: extension, adduction, internal rotation of humerus

Sup/prox: dorsal surface of inferior angle of scapula

inf/dist: medial lip of intertubercular groove (anterior aka bicipital groove)

Innervation: lower subscapular n. C5, C6

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Rhomboids Major

Action: retract scapula, downward rotation of scapula, fix scapula against thoracic wall

Sup/prox: spinous process TV2-TV5

inf/dist: medial border of scapula from spine to inferior angle

Innervation: dorsal scapular N. C4-C5

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Rhomboids Minor

Action: retract scapula, elevate scapula, downward rotation scapula, fix scapula against thoracic wall

Sup/prox: nuchal ligament and spinous process CV7 +TV1

Inf/dist: medial border of scapula at level of spine

Innervation: Dorsal scapular n. C4-C5

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Latissmus Dorsi

Action: extension, adduction, internal rotation of humerus

sup/prox: thoracolumbar fascia (aponeurosis), spinous process TV6-TV12, inferior 3 or 4 ribs, iliac crest

Inf/Dist: floor of intertubercular (bicipital) groove of humerus (posterior)

Innervation: Thoracodorsal N. C6, C7, C8

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Coracobrachialis

Action: flexion with adduction of humerus

sup/prox: tip or apex of coracoid process of scapula (anterior)

inf/dist: middle 1/3, medial humerus

Innervation: musculocutaneous n. C5, C6, C7

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Biceps Brachii

Action: Long- weak shoulder flexion

-weak abduction of humerus externally rotates

*both heads- elbow flexion with forearm supination

sup/prox:

short head-coracoid process of scapula

long head- supraglenoid tubercle of scapula

Inf/dist: Radial tuberosity and fascia of forearm via bicipital aponeurosis

Innervation: musculocutaneous n. C5, C6

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Brachialis

Action: elbow flexion regardless of position

sup/prox: distal half humerus, anterior surface (from elbow)

inf/dist: ulnar tuberosity and anterior aspect of coronoid process of ulna

Innervation: musculocutaneous n. C5, C6

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Brachioradialis

Action: elbow flexion (midpronation most effective)

sup/prox: proximal 2/3 of lateral supracondylar ridge of humerus

Inf/dist: lateral surface of distal end of radius

Innervation: radial n. C5, C6, C7

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Triceps

Action: (all heads) elbow extension

-(long head) steadies head of abducted humerus

sup/prox: (long head) infraglenoid tubercle of scapula

(lateral head) posterior surface of humerus, superior to radial groove

(medial head) posterior surface humerus, inferior to radial groove

inf/dist: proximal end of olecranon process of the ulna and fascia of forearm

Innervation: Radial n. C6, C7, C8

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Aconeus

Action: assists in elbow extension

sup/prox: lateral epicondyle of humerus (posterior surface)

inf/dist: olecranon process of ulna (lateral surface)

Innervation: radial n. C7, C8, T1

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Pronator Teres

_Action_: pronates forearm, flexes elbow _Sup/prox:_ (humeral head) medial epicondyle of humerus (ulnar head) coranoid process of the ulna _Inf/dist:_ middle of lateral surface of radius _Innervation_: median n. C6, **C7**

Pronator Quadratus

_Action:_ pronates forearm _sup/prox:_ distal 1/4 of anterior surface of the ulna _inf/dist_: distal 1/4 of anterior surface of radius _Innervation_: anterior interosseus n. (from median n.) **C8**-T1

Supinator

_Action_: supinates forearm _Sup/prox_: lateral epicondyle of humerus, radial collateral and annular ligaments, supinator fossa and crest of ulna _inf/dist_: proximal radius, anterior, lateral, posterior surfaces _innervation:_ deep branch radial n. C7,**C8**

Triangular Space

**Circumflex scapular artery** Borders: _Inferior:_ superior border of the teres major (inf. margin) _Lateral:_ the long head of the triceps _Superior:_ Teres minor of subscapularis

Quadrangular Space

**Axillary nerve and posterior circumflex humeral artery** Borders: _Above/superior:_ the teres minor (inf. margin) _Below/inferior:_ the teres major (sup. margin) _Medially:_ the long head of the triceps brachii (lat. margin) _Laterally:_ the surgical neck of the humerus _Anteriorly:_ the subscapularis

Rotator Cuff (SITS)

Hold head of humerus in the glenoid cavity - Supraspinatus - Infraspinatus - Teres minor - Subscapularis

Upward rotation of scapula

- upper and lower traps working together - serratus anterior

Downward rotators of scapula

- rhomboid major - rhomboid minor - levator scapulae

Retractors of Scapula

- Rhomboid major - Rhomboid minor - Upper, middle, lower trapezius

Protractors of Scapula

-Serratus Anterior

Internal Rotation of Humerus

- Pectoralis major - Anterior deltoid - Subscapularis - Teres major - Latissmus Dorsi

External Rotation

- posterior deltoid - infraspinatus - teres minor

Adduction of humerus

-Pectoralis major (entire) \*SC head of pec major-horizontal add @ g/h joint - subscapularis - teres major - latissmus dorsi

Abduction of humerus

- anterior,middle, posterior deltoid - supraspinatus (assists deltoids) - long head of triceps (steadies humerus)

Extension of humerus

- sternocostal head of pec major (from overhead position) - posterior deltoid - teres major - latissmus dorsi

Flexion of humerus

- clavicular head of pec major - anterior deltoid - coracobrachialis (with adduction)

Muscles that fix scapula against thoracic wall

- rhomboid major - rhombod minor - serratus anterior - pectoralis minor

Elevation of scapula

- Rhomboid major - Rhomboid minor - Levator scapulae - upper trapezius

Depress Scapula

lower trapezius

Elbow flexion

- brachialis - brachioradialis (most effective in midpronation) - pronator teres - biceps brachii (both heads)

Forearm pronators

- pronator teres - pronator quadratus

Flexor carpi radialis

_Action_: Flexion and abduction of hand at the wrist \*SUPERFICIAL\* _Sup/prox_: medial epicondyle of the humerus _Inf/dist_: base of 2nd metacarpal _Innervation_: Median n. C6-**C7**

Flexor carpi ulnaris

_Action_: flexes and adducts hand at the wrist \*SUPERFICIAL\* _sup/prox:_ - humeral head: medial epicondyle of humerus - ulnar head: olecranon and posterior border of ulna _Inf/dist_: pisiform, hook of hamate and base of 5th metacarpal _Innervation_: Ulnar n. C7-**C8**

Palmaris Longus

_Action_: assist wrist flexion; tense palmar aponeurosis \*SUPERFICIAL\* _Sup/prox_: medical epicondyle from the common flexor origin _Inf/dist_: distal 1/2 of the flexor retinaculum and palmar aponeurosis _Innervation_: Median N. (C7, C8)

Flexor Digitorum Superficialis

_Action_: flexes PIP joints of medial four digits: also flexes MCP joints; assist wrist flexion \*SUPERFICIAL\* _Sup/prox:_ Humeroulnar head: medial epicondyle of humerus, ulnar collateral ligament, coronoid process of ulna; Radial head: sup 1/2 of ant border of radius _Inf/dist:_ Bodies of middle of phalanges of medial 4 digits _Innervation_: Median N. C7-T1

Flexor digitorum profundus

_Action_: DIP flexion of medial four digits; also flexes PIP and MCP; assist wrist flexion \*DEEP\* _sup/prox_: proximal 3/4 of medial and anterior surface of ulna and interosseous membrane _inf/dist_: bases of distal phalanges of medial 4 digits _Innervation_: Anterior interosseous n. (from median n.) **C8**-T1 to lateral 2 FDP -ulnar n. C8-**T1** to medial 2 FDP

Flexor Pollicis Longus

_Action_: flexes IP, MCP, CMC of thumb \*DEEP\* _Sup/prox_: anterior surface of radius adj interosseous membrane _Inf/dist_: base of distal phalanx of thumb _Innervation_: Ant. interosseous n. (from median n. **C8**-T1)

Extensor Carpi Radiais Longus

_Action_: extension and abduction of hand at wrist joint _Sup/prox:_ lateral supracondylar ridge of humerus _Inf/dist:_ base of 2nd metacarpal bone _Innervation_: Radial n. C6, C7

Extensor carpi radial brevis

_Action_: extension and abduction of hand at wrist joint _Sup/prox_: lateral epicondyle of humerus _Inf/dist_: Base of 3rd metacarpal _Innervation_: Deep branch of radial n. **C7**-C8

Extensor Digitorum

_Action_: Extend medial 4 digits at MCP, PIP, DIP, CMC joints _Sup/prox_:lateral epicondyle of humerus _Inf/dist_: Base of middle phalanges of fingers of medial 4 digits via **extensor expansion (hood mechanism)** _Innervation_:Post interosseous n. **C7**-C8 (continuation of deep branch of radial n.)

Extensor Digiti Minimi

_Action_: Extension of 5th digit at CMC, MCP and IP (PIP,DIP) joints _Sup/prox_: lateral epicondyle of humerus _Inf/dist_: extensor expansion of 5th digit _Innervation_: PIN **C7**-C8

Extensor Carpi Ulnaris

_Action_: extension and adduction of hand at wrist _Sup/prox_: lateral epicondyle of humerus and posterior border of ulna _Inf/dist_: Base of 5th metacarpal _Innervation:_ PIN **C7**-C8

Abductor Pollicis Longus

_Action_: abduction of thumb and extends it at CMC joint _Sup/prox:_ posterior surface of proximal halves of ulna, radius, and interosseous membrane _Inf/dist_: Base of 1st metacarpal _Innervation_: PIN C7-**C8**

Extensor Pollicis Brevis

_Action_: extends proximal phalanx of thumb at MCP; extension at CMC _Sup/prox_: posterior surface of radius and interosseous membrane _Inf/dist:_ dorsal aspect base of proximal phalanx of thumb _Innervation_: PIN

Extensor pollicis longus

_action:_ extension of distal phalanx of thumb at IP; extension of MCP and CMC joints _sup/prox_: posterior surface of middle 1/3 of ulna and interosseous membrane _Inf/dist:_ base of distal phalanx of thumb _Innervation_: PIN C7-**C8**

Extensor Indicis

_Action_: extension of 2nd digit; assists with wrist extension _Sup/prox_: posterior surface of distal 1/3 of ulna and interosseous membrane _Inf/dist_: extensor expansion of 2nd digit _Innervation_: PIN C7-**C8**

Abductor Pollicis Brevis

_Action:_ abduction of thumb; assist thumb opposition _Sup/prox_: Flexor retinaculum and tubercles of scaphoid and trapezium _Inf/dist:_ lateral side of base of proximal phalanx of thumb and extensor expansion _Innervation_: Recurrent branch Median N. (**C8**,T1)

Flexor Pollicis Brevis

Action: (2 heads), flexion of thumb Sup/prox: flexor retinaculum and tubercles of scaphoid and trapezium Inf/dist: lateral side of base of proximal phalanx of thumb Innervation: - Superficial head: Recurrent branch of median n. (**C8**,T1) - Deep head: Deep branch of ulnar n. (C8, **T1)**

Opponens Pollicis

_Action_: oppose thumb _Sup/prox_: flexor retinaculum and tubercles of scaphoid and trapezium _Inf/dist_: lateral aspect of 1st MC _Innervation_: Recurrent branch of median n. (**C8,** T1)

Adductor Pollicis

_Action_: (2 heads), adducts thumb _Sup/prox:_ - oblique: base of 2nd and 3rd MC, capitate and adj carpals - transverse: anterior surface of shaft of 3rd MC _Inf/dist:_ medial side of base of proximal phalanx of thumb _Innervation_: Deep branch ulnar n. (C8, **T1**)

Abductor Digiti Minimi

_Action_: abduct 5th digit; assist MCP flexion of 5th proximal phalanx _Sup/prox_: pisiform _Inf/dist_: medial side of base of proximal phalanx of 5th digit _Innervation_: Deep branch of ulnar n. (C8, **T1**)

Flexor digiti minimi brevis

_Action_: flexes proximal phalanx (MCP) of 5th digit _Sup/prox:_ hook of the hamate and flexor retinaculum _Inf/dist_: medial side base of proximal phalanx of 5th digit _Innervation_: Deep branch of ulnar n. (C8, **T1**)

Opponens Digiti Minimi

_Action_: draws 5th MC anteriorly to oppose the thumb _Sup/prox:_ hook of the hamate and flexor retinaculum _Inf/dist_: medial border of 5th MC _Innervation:_ Deep branch of ulnar n. (C8, **T1**)

Lumbricals 1 and 2

_Action_: flex MC joints and extend IP joints _Sup/prox:_ lateral tendons of FDP _Inf/dist_: lateral sides of extensor expansion of digits 2-5 _Innervation_: Median nerve (C8, **T1**)

Lumbricals 3 and 4

_Action_: flex MC joints and extend IP joints _Sup/prox_: bipennate from medial 3 tendons of FDP _Inf/dist:_ lateral sides of extensor expansion of digits 2-5 _Innervation_: Deep branch of ulnar n. (C8, **T1**)

Palmar Interossei

_Action_: adduct 2nd, 4th, and 5th digit toward midline: assist with MCP flexion, IP extension _Sup/prox_: palmar surfaces of 2nd, 4th, and 5th MC _Inf/dist_: base of proximal phalanges and extension expansion of 2nd, 4th, and 5th digits _Innervation:_ Deep branch of ulnar n. (C8, **T1**)

Dorsal Interossei

_Action_: abduct digits 2-4 away from midline; assist with MCP flexion; IP extension _Sup/prox_: bipennate adjacent sides of metacarpals _Inf/dist:_ base of proximal phalanges and extension expansions of 2nd, 3rd (bilaterally), and 4th digits _Innervation:_ Deep branch of ulnar n. (C8, **T1**)

Thenar Muscles

opponens pollicis flexor pollicis brevis abductor pollicis brevis \*flex and abd brevis both originate at flexor retinaculum and insert at lateral base of proximal phalanx \*opponens pollicis is deep to abd poll brevis

Hypothenar muscles

abductor digiti minimi, opponens digiti minimi, flexor digiti minimi brevis \*flexor digiti minimi and opponens digiti minimi both originate at hook of hamate and flexor retinaculum \*opponens digiti minimi is deep to flexor digiti minimi \*all insert onto proximal phalanxe of 5th digit

Elbow Flexors

Biceps Brachii Brachialis Brachioradialis (midpronation) Pronator Teres

Elbow Extensors

Tricpes Anconeus

Abductors of Wrist

Extensor Carpi radialis longus Extensor Carpi Radialis Brevis Flexor carpi radialis

Adductors of Wrist

Flexor Carpi Ulnaris Extensor Carpi Ulnaris

Abductors (hand)

abductor pollicis brevis abductor pollicis longus abductor digiti minimi dorsal interossei

Adductors (hand)

Palmar Interossei adductor pollicis

Opposers

opponens pollicis abductor pollicis brevis opponens digiti minimi

Upper Extremity Flashcards

(80 cards)