Muscles and bones of the upper limb Musculoskeletal Block Anatomy Practical team - Med 439 1 the information in this file is based on the things that was given during practical sessions along with doctors’ notes To ensure your grade on each question : 1-Make sure your SPELLING is correct 2-Make sure you write the FULL name or location of the object precisely 2 Pectoral region Origin clavicular head: medial ½ of the front of clavicle. Sternocostal head: lateral border of sternum, upper 6 costal cartilages & aponeurosis of the external oblique muscle Insertion Lateral lip of bicipital groove of humerus Nerve supply Lateral & Medial pectoral nerves Action - Adduction + medial rotation of arm. - Clavicular head helps in flexion of arm (shoulder) Pectoralis Major Origin Ribs 3, 4, 5 close to their costal cartilages Insertion Coracoid process of the scapula Nerve supply Medial pectoral nerve Action - Depression of the shoulder - Drawing the ribs upwards & outwards during deep inspiration. Pectoralis Minor Broken clavicles and torn subclavius muscle Subclavius Serratus Anterior Origin Junction of 1st rib with its Origin Upper eight ribs costal cartilage Insertion Anterior aspect of the medial border Insertion Subclavian groove at middle ⅓ and inferior angle of scapula of inferior surface of clavicle Nerve supply Long thoracic nerve Nerve supply Nerve to subclavius Action - Draws the scapula forward Action Fixes the clavicle during - Rotates scapula outward in movement of shoulder joint raising the arm above 90 degrees Shoulder region Teres minor below the infraspinatus + the long head of triceps is between teres minor and major Deltoid Teres minor Teres major Origin Lateral 1/3 of clavicle , acromion & spine of The lateral (Axillary) border of scapula scapula Origin Insertion Deltoid tuberosity of the humerus Insertion Greater tubercle of the Medial lip of bicipital humerus groove of humerus Nerve supply Axillary nerve Nerve supply Axillary nerve Lower supscalper nerve Anterior fibers: medial rotation & flexion Action Middle fibers: Abduction (15-90) Posterior fibers: lateral rotation,extension Action Lateral rotation of humerus medial rotation ,extension, All these actions of humerus adduction of humerus ﻛﻠﮭم ﻻﺻﻘﯾن ﻋﻠﻰ اﻟﻌظم ﻧﻔﺳﮫ Subscapularis Supraspinatus infraspinatus Origin Subscapular fossa of the scapula Origin Supraspinous fossa of the Infraspinous fossa of the scapula scapula Insertion Lesser tubercle of the humors Insertion Greater tubercle of the humors Lower and upper subscapular nerve Nerve supply Nerve supply Suprascapular nerve Action Medial rotation Action Abduction (0-15) of humerus Lateral rotation of humerus Identify this part of bone, and what is the muscle attached to? Muscles of the arm Anterior of Arm Short head Long head In the same origin with short Biceps Brachii head of Brachialis Coracobrachialis Biceps 2 heads: Origin - long head → supraglenoid tubercle of scapula - short head → coracoid process of scapula Origin Tip of coracoid Origin Front of the lower half of process of scapula humerus Posterior part of the radial tuberosity + into the Insertion deep fascia, medial of forearm through bicipital Insertion Middle of the medial Insertion Anterior surface of aponeurosis side of humerus shaft coronoid process of ulna Nerve Musculocutaneous nerve Nerve supply musculocutaneous supply nerve Nerve supply Musculocutaneous & Radial nerves - Strong supinator of forearm Action - Flexor of shoulder Action - Powerful flexor of elbow - Weak adductor of Action Strong flexor of the - Weak flexor of shoulder arm forearm Posterior of Arm supraglenoid= long head of biceps Triceps Brachii Infraglenoid= long head of triceps 3 heads: Long head → infraglenoid tubercle of scapula Origin Lateral head → posterior upper half of humerus shaft (above spiral groove) Medial head → posterior lower half of humerus shaft (below spiral groove) Insertion upper surface of the olecranon process of ulna Nerve supply Radial nerve Action Strong extensor of the elbow joint The spiral groove separates the humerus to two halves: above “Lateral head”, Below “Medial head” 12 Muscles of the forearm Notes to memorize the insertion of the muscles Digitorum Pollicis Digiti minimi Carpi Insert in phalanges Insert in the base of Insert in the Insert in metacarpal of medial 4 fingers phalanx of thumb little finger bones Superficialis Profundus Longus Ulnaris Radialis Insert in fifth Insert in second or Specifically in Specifically in Specifically in the metacarpal third metacarpal middle distal phalanges base of distal bone “Ulnaris= bone “Radius= phalanges of of medial 4 phalanx of thumb medial 4 fingers fingers medial” lateral” Muscles of the Forearm (flexors) Flexor carpi Flexor carpi Pronator Teres Palmaris longus radialis ulnaris Common flexor origin Origin (front of medial epicondyle) Important Base of 2nd Flexor retinaculum Pisiform, hook of Middle of lateral Insertion metacarpal and palmar hamate & base of surface of radius bone aponeurosis 5th metacarpal Nerve Median nerve Ulnar nerve supply Flexion & Flexes hand (wrist) & Flexion and Pronation & Action abduction of tightens the palmar adduction of the flexion of forearm wrist aponeurosis hand (wrist) Flexor carpi ulnaris has* ﻣﺎ راح ﺗوﺻل ﻟﻠﮭﺎﻧد ﻋﺷﺎن ﺗﻘدر ﺗﺳوي two heads one is at اﻟـ pronation common flexor origin, the second is at the olecranon process Muscles of the Forearm (flexors) راح ﺗﻛون ﺗﺣت اﻷرﺑﻌﺔ ﻋﺿﻼت اﻟﻠﻲ اﻧذﻛرت ﻓﻲ اﻟﺳﻼﯾد اﻟﻠﻲ ﻓﺎت Flexor digitorum superficialis Flexor digitorum profundus (deep) Multiple heads originating from common flexor Origin In Front of ulna Origin origin, coronoid process of ulna and anterior surface of radius Insertion Bases of distal phalanges of medial four digits Insertion Base of middle phalanges of the medial 4 fingers Anterior interosseous Nerve (branch of the Nerve supply Median nerve Nerve supply median nerve), medial half is supplied by the ulnar nerve Action - Flexes middle & proximal phalanges of medial 4 fingers. Action Flexes distal phalanges of medial four digits - Flexion of hand (wrist) Muscles of the Forearm (flexors) Deep Flexor pollicis longus Pronator quadratus Origin In Front of radius Origin In Front of lower ¼ of ulna Insertion Base of distal phalanx of thumb Insertion Distal ¼ of anterior surface of radius Nerve supply Nerve supply anterior interosseous nerve ( branch of anterior interosseous nerve ( branch the median nerve ) of the median nerve ) Action - Pronator of forearm (primover) Action Flexes all joints of thumb - Holds the 2 bones together Laterally to Radial nerve Muscles of the Forearm (Extensors) Brachioradialis Origin Lateral supracondylar ridge of humors Insertion base of styloid process of radius Nerve supply radial nerve Action flexion of forearm and midpron position Extensor curbi radialis longus Origin Lateral supracondylar ridge of humors Insertion base 2 metacarpal Nerve supply radial nerve Action Extends and abducts hand at wrist joint Muscles of the Forearm All arises from the common extensor origin (front of lateral (Extensors) epicondyle of the humerus) Below ECRL Extensor carpi radialis brevis: Insertion : Base of 3rd base of metacarpal bone Extensor digitorum Insertion : extensor expansion of the medial 4 fingers Extensor carpi ulnaris Insertion : base of 5th metacarpal bone Extensor digiti minimi Insertion : extensor expansion of the little finger All innervated by deep branch of radial nerve (Posterior interosseous) Don’t stop until you are proud. Team Members: Team Leaders: - Duaa Alhumoudi - Mishal Althunayan - Renad Alhomaidi - Mona Alomiriny - Omar alhalabi - Bassam Alasmari - Rania Almutiri - Khalid Alosaimii - Taif Almotiri - Hadi Alhemsi - Nourah Alklaib - Nasser Alohali - Arwa Alqahtani - Norah Alasheikh - Sara Alharbi - Najd Alzahrani 21.