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Shoulder Girdle

and
Upper Limb
Muscles
Upper Limb Skeleton

● Scapula
● Humerus
● Radius, ulna
● Carpals--proximal,
distal
● Digits
● Metacarpals
● Phalanges
The muscles of back
Superficial group
● Trapezius
● Latissimus dorsi
● Levator scapulae
● Rhomboideus

Deep group
● Erector spinae
● Splenius
● Thoracolumbar
The muscles of thorax
Extrinsic muscles
● Pectoralis major
● Pectoralis minor
● Serratus anterior

Intrinsic muscles
● Intercostales externi
● Intercostales interni
● Intercostales intimi
Major muscles of the trunk
Trapezius
● Origin: superior nuchal line, external
occipital protuberance, ligamentum
nuchae and spinous processes of
seventh cervical and all thoracic
vertebrae
● Insertion: lateral third of clavicle,
acromion, and spine of scapula

● Action:
● upper fibers elevate scapula, lower
fibers depress scapula;
● if scapula is fixed, one side acting along,
draws head toward the same side, and
turn face to opposite side; both sides
together, draw head directly backward
● Nerve: n accesory, cervical plexus
Latissimus dorsi

● Origin: spinous processes of


lower six thoracic and all
lumbar vertebrae, median
sacral crest, and posterior
part of iliac crest.

● Insertion: floor of
intertubercular groove of
humerus.

● Action: trunk fixed, extends,


adducts and medially rotates
arm ; arm fixed, elevates
trunk.
● Nerve: toracodorsal
Pectoralis major

● Origin: medial half of


clavicle,sternum,1th-6th costal
cartilages.

● Insertion: crest of greater


tubercle of humerus.

● Action: flexes, adducts and


rotates arm medially; arm fixed,
elevates trunk; elevates ribs 1-
6,aidding in forced inspiration.

● Nerve: lateral and medial


pectoralis n.
Pectoralis Minor
O: 3rd to 5th ribs near their
costal cartilages
I: Medial border and
superior surface of
coracoid process of
scapula
A: Stabilizes scapula by
drawing it inferiorly and
anteriorly against thoracic
wall
N: Medial Pectoral Nerves
The Muscles of Upper Limb

Muscles of shoulder
● Deltoid
● Supraspinatus
● Infraspinatus
● Teres minor
● Teres major
● Subscapularis
Deltoid
● Origin: lateral third of
clavicle, acromion, and
spine of scapula
● Insertion: deltoid tuberosity
of humerus
● Action: abducts,flexes and
medically rotates, extends,
and laterally rotates arm
● Nerve: axilary n.
• If INSERTION on scapula =
Muscles of
Move scapula
– Rhomboids
Scapula – Trapezius
– Pectoralis Minor
– Serratus Anterior
– Levator Scapulae
• If ORIGIN on scapula = Move
Arm
– Subscapularis
– Supraspinatus
– Infraspinatus Rotator
– Teres Minor Cuff
– Teres Major
– Latissimus Dorsi (partial O on scap)
– Coracobrachialis
Supraspinatus

O: Supraspinous fossa
I: Superior facet on
greater tubercle of
humerus
A: Initiates and assists
Deltoid in abduction;
acts with rotator cuff
muscles
N: Suprascapular Nerve
Infraspinatus

O: Infraspinous fossa
I: Middle facet on
greater tubercle of
humerus
A: Laterally rotates the
arm
N: Suprascapular Nerve
Teres minor

O: Superior part of the


lateral border of the
scapula
I: Inferior facet on
greater tubercle of
humerus
A: Laterally rotates the
arm
N: Axillary Nerve
Subscapularis

O: Subscapular fossa
I: Lesser tubercle of
humerus
A: Medial rotation of
arm and adduction
N: Upper and Lower
Subscapular
Teres major
O: Dorsal surface of
inferior angle of scapula
I: Medial lip of
intertubercular groove
of humerus
A: Adducts and
medially rotates arm
N: Lower subscapular
nerve
Rhomboid major and minor
O: Minor - Nuchal ligament and
spinous processes C7 - T1
Major - Spinous processes T2 -
T5
I: Medial border of scapula from
level of the spine to inferior
angle
A: Retracts and rotates scapula
to depress it to glenoid cavity
N: Dorsal Scapular Nerve
Levator scapulae
O: Posterior tubercles
of transverse processes
of C1 - C4 vertebrae
I: Superior part of
medial border of
scapula
A: Elevates scapula
and tilts its glenoid
cavity inferiorly by
rotating scapula
N: Dorsal Scapular
Upper Arm & Shoulder Muscles
deltoid

brachialis

triceps brachii

teres major teres minor


supraspinatus

infraspinatus teres minor subscapularis

Rotator Cuff Muscles


Muscles of arm
● Anterior group
● Biceps brachii
● Coracobrachialis
● Brachialis

● Posterior group –
triceps brachii
Biceps brachii
O: Short head: tip of
coracoid process of
scapula
Long head: supraglenoid
tubercle of scapula
I: Tuberosity of radius and
fascia of forearm via
bicipital aponeurosis
A: Supinates forearm and,
when it is supine, flexes
forearm
N: Musculocutaneous nerve
Coracobrachialis
O: Tip of coracoid
process of scapula
I: Middle third of medial
surface of humerus
A: Helps to flex and
adduct arm
N: Musculocutaneous
nerve
Brachialis
● O: from the lower half of the front
of the humerus, commencing
above at the insertion of the
Deltoideus and from the
intermuscular septum;
● I: into the tuberosity of the ulna
and the rough depression on the
anterior surface of the coronoid
process.
● N: Musculocutaneous nerve
● A: flexor of the forearm, and
forms an important defence to the
elbow-joint. When the forearm is
fixed, the Biceps brachii and
Brachialis flex the arm upon the
forearm, as in efforts of climbing.
Triceps brachii
O: 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
I: Proximal end of olecranon
process of ulna and fascia of
forearm
A: Chief extensor of forearm; long
head steadies head of
abducted humerus
N: Radial Nerve
L brachioradialis M
a e
t Pronator d
e teres i
r biceps a
a brachii l
l

brachialis triceps
brachii

Upper
Arm
Muscles
Muscles of forearm

● Anterior Compartment Forearm


● Posterior Compartment of Forearm
Anterior Compartment Forearm
Medial Epicondyle

Brachioradialis
Pronator Teres

Flexor Carpi Radialis

Flexor Carpi Ulnaris

Flexor Retinaculum

Flexor Digitorum Superficialis is


Frolich, Human Anatomy,UpprLimb
Anterior View deep to other flexors
Posterior Compartment of Forearm

Lateral Epicondyle

Brachioradialis
Extensor digitorum
Ext Carpi Radialis Longus
Extensor carpi ulnaris

Frolich, Human Anatomy,UpprLimb


Posterior View
● Superficial layer
● Pronator teres
● Flexor carpi radialis
● Palmaris longus
● Flexor carpi ulnaris
● Second layer
● flexor digitorum superficials
● Third layer
● Flexor digitorum profundus
● Flexor pollicis longus
● Fourth layer
● pronator quadratus
Muscles of forearm: Anterior Compartment

● Superficial layer
● Pronator teres
● Flexor carpi radialis
● Palmaris longus
● Flexor carpi ulnaris
The Pronator teres
● O: has two heads of origin—humeral
and ulnar.
● humeral head - the medial epicondyle,
and from the tendon common to the
origin of the other muscles;
● ulnar head: the medial side of the
coronoid process of the ulna;
● median nerve enters the forearm
between the two heads of the muscle,
and is separated from the ulnar artery by
the ulnar head.
● i: rough impression at the middle of the
lateral surface of the body of the radius.
● N: median nerve
● A: rotates the radius upon the ulna,
rendering the hand prone; when the
radius is fixed, it assists in flexing the
forearm.
Flexor carpi radialis
● o: the medial epicondyle by the common
tendon;
● i: the base of the second metacarpal bone,
and sends a slip to the base of the third
metacarpal bone.
● N: median nerve;
● A: is a flexor and abductor of the wrist; it
also assists in pronating the hand, and in
bending the elbow.
Palmaris longus
● O: medial epicondyle of the humerus by
the common tendon;
● i: the central part of the transverse carpal
ligament and lower part of the palmar
aponeurosis;
● N: median nerve;
● A: is a flexor of the wrist-joint; it also
assists in flexing the elbow
Flexor carpi ulnaris
● O: two heads, humeral and ulnar, connected by a
tendinous arch, beneath which the ulnar nerve and
posterior ulnar recurrent artery pass.
● humeral head - the medial epicondyle of the humerus by the
common tendon;
● ulnar head - the medial margin of the olecranon and from the
upper two-thirds of the dorsal border of the ulna by an
aponeurosis, common to it and the Extensor carpi ulnaris and
Flexor digitorum profundus;
● i: the pisiform bone, and is prolonged from this to the
hamate and fifth metacarpal bones by the pisohamate
and pisometacarpal ligaments; it is also attached by a
few fibers to the transverse carpal ligament.
● N: ulnar nerve;
● A: is a flexor and adductor of the wrist; it also assists in
bending the elbow;
● Second layer-
flexor digitorum
superficials
Flexor digitorum superficialis
● O: 3 heads:
● humeral head - the medial epicondyle of
the humerus
● ulnar head - the medial side of the
coronoid process
● radial head the oblique line of the radius
● i: the sides of the second phalanx
about its middle.
● N: median nerve;
● A: flexes first the middle and then the
proximal phalanges; it also assists in
flexing the wrist and elbow.
● Third layer
● Flexor digitorum
profundus
● Flexor pollicis longus
● Fourth layer- pronator
quadratus
Flexor pollicis longus
● O:
● volar surface of the body of the radius,
● adjacent part of the interosseous
membrane,
● a fleshy slip from the medial border of
the coronoid process;
● i: the base of the distal phalanx of
the thumb.
● N: median nerve;
● A: is a flexor of the phalanges of
the thumb; when the thumb is fixed,
it assists in flexing the wrist.
Flexor digitorum profundus

● O: from the upper three-fourths of the


volar and medial surfaces of the body
of the ulna and from the ulnar half of
the interosseous membrane.
● i: into the bases of the last phalanges
(toes II – V)
● N: median nerve and ulnar nerve;
● A: is the flexors of the phalanges.
Pronator quadratus
● O:
● the pronator ridge on the lower part of
the volar surface of the body of the
ulna;
● from the medial part of the volar surface
of the lower fourth of the ulna;
● i: the lower fourth of the lateral
border and the volar surface of the
body of the radius.
● N: median nerve;
● A: rotates the radius upon the ulna,
rendering the hand prone.
Posterior group (12)
● Superficial layer (7)
● Brachioradialis
● Extensor carpi radialis
longus
● Extensor carpi radialis
brevis
● Extensor digitorum
● Extensor digiti minimi
● Extensor carpi ulnaris
● Anconæus
Brachioradialis (Supinator longus)
● O: the upper two-thirds of the lateral
supracondylar ridge of the humerus,
and from the lateral intermuscular
septum;
● i: the lateral side of the base of the
styloid process of the radius.
● on its ulnar side is the radial artery.
● N: radial nerve;
● A: is a flexor of the elbow-joint, but
only acts as such when the
movement of flexion has been
initiated by the Biceps brachii and
Brachialis.
Extensor carpi radialis longus
● O: the lower third of the lateral
supracondylar ridge of the
humerus, from the lateral
intermuscular septum;
● i: the dorsal surface of the
base of the second metacarpal
bone, on its radial side.
● N: radial;
● A:
● extends the wrist and abducts the
hand.
● It may also assist in bending the
elbow-joint; at all events it serves
to fix or steady this articulation.
Extensor carpi radialis brevis
● O: the lateral epicondyle of
the humerus, by a tendon
common to it and the three
following muscles;
● i: the dorsal surface of the
base of the third metacarpal
bone on its radial side.
● N: radial
● A: extends the wrist, and may
also act slightly as an
abductor of the hand.
Extensor digitorum communis
● O: the lateral epicondyle of
the humerus, by the common
tendon;
● i: into the second and third
phalanges of the fingers;
● N: radial;
● A: extends the phalanges,
then the wrist, and finally the
elbow; it acts principally on
the proximal phalanges;
Extensor digiti quinti proprius
(Extensor minimi digiti)
● O: the common Extensor tendon by a thin
tendinous slip, from the intermuscular septa
between it and the adjacent muscles.
● i: joins with the expansion of the Extensor
digitorum communis tendon on the dorsum of
the first phalanx of the little finger.
● N: radial
● A: extends the little finger, and by its continued
action assists in extending the wrist; the little
finger can be extended or pointed while the
others are flexed.
Extensor carpi ulnaris
● O: the lateral epicondyle of the humerus, by the
common tendon;
● i: into the prominent tubercle on the ulnar side of
the base of the fifth metacarpal bone.
● N: radial
● A: extends the wrist, but when acting alone
inclines the hand toward the ulnar side; by its
continued action it extends the elbow-joint.
Anconæus
● O: the back part of the
lateral epicondyle of the
humerus;
● i: medial side of the
olecranon, and upper
fourth of the dorsal
surface of the body of the
ulna.
● N: radial;
● A: assists the Triceps in
extending the forearm.
Deep layer (5)
● Supinator
● Abductor pollicis longus
● Extensor pollicis brevis
● Extensor pollicis longus
● Extensor
Supinator (Supinator brevis)
● O:
● the lateral epicondyle of the
humerus;
● from the ridge on the ulna, which
runs obliquely downward from the
dorsal end of the radial notch;
● i: the dorsal and lateral surfaces
of the body of the radius,
midway between the oblique line
and the head of the bone.
● N: radial;
● A: is suggested by its name; it
assists the Biceps in bringing
the hand into the supine
position.
Abductor pollicis longus
● O:
● the lateral part of the dorsal
surface of the body of the ulna
below the insertion of the
Anconæus,
● the interosseous membrane,
● the middle third of the dorsal
surface of the body of the radius.
● i: the radial side of the base of
the first metacarpal bone.
● N: radial;
● A: the chief action is to carry
the thumb laterally from the
palm of the hand; it helps to
extend and abduct the wrist.
Extensor pollicis brevis
● O: the dorsal surface of
the body of the radius
and from the
interosseous membrane.
● i: the base of the first
phalanx of the thumb.
● N: radial;
● A: extends the proximal
phalanx; help to extend
and abduct the wrist.
Extensor pollicis longus
● O: the lateral part of the middle third of the
dorsal surface of the body of the ulna;
● i: into the base of the last phalanx of the
thumb.
● N: radial;
● A: extends the terminal phalanx of the
thumb; help to extend and abduct the
wrist.
Extensor indicis proprius
● O: the dorsal surface of the
body of the ulna;
● i: joins the ulnar side of the
tendon of the Extensor
digitorum communis which
belongs to the index finger.
● N: radial;
● A: extends the index finger,
and by its continued action
assists in extending the wrist.
flexor digitorum
(under palmaris &
flexor carpi radialis)
retinaculum

palmaris longus extensor


flexor carpi digitorum
radialis
brachioradialis

Forearm pronator teres


Muscles

Anterior Posterior
The Muscles of the Hand

● The muscles of the hand are subdivided into


three groups:
● (1) those of the thumb, which occupy the radial side
and produce the thenar eminence;
● (2) those of the little finger, which occupy the ulnar
side and give rise to the hypothenar eminence;
● (3) those in the middle of the palm and between the
metacarpal bones.
● Volar Carpal Ligament (ligamentum carpi volare)
● is the thickened band of antibrachial fascia which
extends from the radius to the ulna over the Flexor
tendons as they enter the wrist.
● Transverse Carpal Ligament (ligamentum carpi
transversum; anterior annular ligament)
● is a strong, fibrous band, which arches over the carpus,
converting the deep groove on the front of the carpal
bones into a tunnel, through which the Flexor tendons of
the digits and the median nerve pass.
● is attached:
● medially, to the pisiform and the hamulus of the hamate bone;
● laterally, to the tuberosity of the navicular, and to the medial part
of the volar surface and the ridge of the greater multangular.
● is continuous, above, with the volar carpal ligament; and
below, with the palmar aponeurosis.
● is crossed by the ulnar vessels and nerve, and the
cutaneous branches of the median and ulnar nerves.
● On its volar surface the tendons of the Palmaris longus;
● Dorsal Carpal Ligament
(ligamentum carpi dorsale;
posterior annular ligament)
● is a strong, fibrous band,
extending obliquely
downward and medialward
across the back of the wrist,
and consisting of part of the
deep fascia of the back of the
forearm;
● is attached:
● medially, to the styloid process
of the ulna and to the triangular
and pisiform bones;
● laterally, to the lateral margin of
the radius;
● Palmar Aponeurosis
(aponeurosis
palmaris; palmar
fascia)
● invests the muscles of
the palm, and
consists of central,
lateral, and medial
portions.
Muscles of hand
● Lateral group-thenar (4)
● Abductor pollicis brevis
● Flexor pollicis brevis
● Opponens pollicis
● Adductor pollicis
● Action: flex, abduct, adduct
and oppose thumb
● Medial group-hypothenar
(3)
● Abductor digiti minimi
● Flexor digiti minimi brevis
● Opponens digiti minimi
● Action: flex, abduct , and
oppose little finger
Intermedial group
● Lumbricales (4)-flex
fingers at MP joints;
extend fingers at IP joints
● Palmar interossei (3)-
adduct fingers towards
middle finger at MP joints
● Dorsal interossei (3)-
abduct fingers away from
middle finger at MP joints