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Slides for anatomy review of upper
extremities
Prepared by Deepak ghimire
Mham cm- 2012
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Muscles Connecting the Upper Limb to
the Thoracic Wall
ANTERIOR GROUP
Pectoralis major= medial & lateral pectoral nerve both
Pectoralis minor= medial pectoral nerve, @ minor has less nerve supply ie only medial pectoral N.
Subclavius- Nerve to subclavis
Serratus anterior- long thoracic nerve
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Pectoralis major
O=Clavicle, sternum, and upper 6 costal cartilages
I = Lateral lip ofbicipital grooveof humerus
N= Medial and lateral pectoral nerves from brachial plexus C 5,6, 7, 8; T1
Action =Adducts arm and rotates it medially;
clavicular fibers also flex arm
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Pectoralis minor
O= 3rd ,4th ,5th ribs
I =Coracoid process of scapula
N =Medial pectoral nerve from brachial plexusC 6, 7, 8
Action
Depresses point of shoulder;
if the scapula is fixed, it elevates the ribs of origin
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Subclavius O = 1st costal cartilage
I = Clavicle
N = Nerve to subclavius from uppertrunk of brachial plexus C5, 6
Action
Depresses the clavicle
steadies clavicle during
movements of the shouldergirdle
Serratus anterior O = Upper 8 ribs
I = Medial border and inferior angleof scapula
N = Long thoracic nerve C5, 6, 7
Action
Draws the scapula forward aroundthe thoracic wall;
rotates scapula
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Lateral rotators of the arm
Deltoid-posterior fibers (axillary nerve)
Infra-spinatus muscle (suprascapular
nerve)
Teres minor ( axillary nerve)
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Medial pectoral nerve
pectoralis major + lateral pectoral N.
Pectoralis minor ;less= only medial pectoral N.
Lower Subscapular nerve
teres minor ; minor= only lower Subscapular N.
Subscapularis + upper subscapularis N.
axillary nerve
Teres major & deltoid
Dorsal scapular nerve
Levetor scapulae
Rhomboid major & minor
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1) Trapezius - accessary nerve
2) Latissimus dorsi lower
thoracodorsal nerve, climbing muscle,
lati-wide, widest and strongest muscle of
the back !v
3) Levator scapule-superior side
4) Rhombodus major & minor-medial
side
Muscles Connecting the Upper Limbto the Vertebral Column
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Muscles Connecting the Upper Limb to the
Vertebral Column
Trapezius
Origin ( midline of back upto T12) Occipital bone, ligamentum nuchae, spine of 7th
cervical vertebra, spines of all thoracic vertebrae
Insertion Upper fibers =lateral third of clavicle;
middle and lower fibers = acromion and spine ofscapula
Nerve = Spinal part of accessory nerve (motor)
= and C3 and 4 (sensory)
Action :
Upper fibers > elevate the scapula;
middle fibers > pull scapula medially;
lower fibers > pull medial border of
scapula downward
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Latissimus dorsi
Origin
Iliac crest, lumbar fascia,spines of lower 6 thoracicvertebrae, lower 3 0r 4 ribs,and inferior angle of scapula
Insertion
Floor of bicipital groove ofhumerus
NerveThoracodorsal nerveC6, 7, 8,
ActionExtends, adducts, andmedially rotates the arm
@ ex a m
L t l
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Levator scapulae
Origin
Transverse processes of first 4cervical vertebrae
C1 - c 4
Insertion Medial border of scapula
Nerve C3,c4 & c 5(dorsal scapular
nerve)
Action Raises medial border of
scapula
Rh b id j d i
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Rhomboid major and minor
Rhomboid major and rhomboid minor Origin of Rhomboid minor
Ligamentum nuchae and spines of c7 & T1
Origin of rhomboid major T2- T5 spines
Insertion of both Medial border of scapula
Nerve to both : Dorsal scapular nerveC4, 5
Action of both Raises medial border of scapula upward and
medially
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Triangle of auscultation
It has the following boundaries:
Above/superior
Trapezius
Below/inferior Latissimus dorsi
Lateral
by the medial margin of the scapula
The floo r
partly formed by the
Rhomboideus major.
http://en.wikipedia.org/wiki/Trapeziushttp://en.wikipedia.org/wiki/Latissimus_dorsihttp://en.wikipedia.org/wiki/Rhomboideus_majorhttp://en.wikipedia.org/wiki/Rhomboideus_majorhttp://en.wikipedia.org/wiki/Latissimus_dorsihttp://en.wikipedia.org/wiki/Trapezius -
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Muscles Connecting the pectoral
girdle to the Humerus
Deltoid muscle- 3 fibers, ant,middle,post @ CAS
Supraspinatus- abduct
Infraspinatus- lateral rotator, supraspinatus N.
Teres major- adduct, med rotate
Teres minor- axillary nerve, lateral rotate
Sub-scapularis- lower & upper subscapular N
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Deltoid 3 origins: @ C-A-S
Anterior head: Lateral third ofclavicle,
Middle head:
Acromion,
POSTERIOR HEAD
Spine of scapula
Insertion:
Middle of lateral surface of shaft
ofhumerus/deltoid tuberosity of the humerus
Nerve:
Axillary nerve c5, 6
Action: Anterior fibers flex and medially rotate arm;
Middle fibers: Abducts arm
Posterior fibers extend and laterally rotate arm
@ heard FM-ABout EL
Read as ant fiber flex-med rotate,med fiber abduct, postfiber extend and laterallly rotate
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Supraspinatus & Infraspinatus ORIGN:
Supraspinatus: Supraspinousfossa
Infraspinatus: Infraspinousfossa
INSERION: Greater tuberosity of humerus;
capsule of shoulder joint
NERVE: Suprascapular nerveC4, 5, 6
ACTION: Supraspinatus-above-abduct
Abducts arm andstabilizes shoulder joint
Infraspinatus-
Laterally rotates arm andstabilizes shoulder joint
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Teres major and minor Teres major
Origin Lower third of lateral border of scapula
Insertion: Medial lip of bicipital groove of humerus
Nerve: Lower subscapular nerveC6, 7
Action:
Medially rotates and adducts arm and stabilizesshoulder joint
Teres minor Origin:
Upper two thirds of lateral border of scapula
Insertion: Greater tuberosity of humerus; capsule of
shoulder joint
Nerve: Axillary nerve(C4), C5, 6
Action: Laterally rotates arm and stabilizes shoulder
joint
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Subscapularis
Origjn:
Subscapular fossa
Insertion:
Lesser tuberosity ofhumerus
Nerve:
Upper and lowersubscapular nervesC5, 6, 7
Action :
Medially rotates arm andstabilizes shoulder joint
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Rotator cuff muscles
the rotator cuff(rotor cuff) is a group ofmuscles and theirtendons that act tostabilize the shoulder.
Along with the teres majorand the deltoid,the four muscles of the rotator cuff makeup the six scapulohumeral(those thatconnect to the humerus and scapula andact on the glenohumeral joint) muscles ofthe human body.
http://en.wikipedia.org/wiki/Musclehttp://en.wikipedia.org/wiki/Tendonhttp://en.wikipedia.org/wiki/Shoulderhttp://en.wikipedia.org/wiki/Humerushttp://en.wikipedia.org/wiki/Scapulahttp://en.wikipedia.org/wiki/Human_bodyhttp://en.wikipedia.org/wiki/Human_bodyhttp://en.wikipedia.org/wiki/Scapulahttp://en.wikipedia.org/wiki/Humerushttp://en.wikipedia.org/wiki/Shoulderhttp://en.wikipedia.org/wiki/Tendonhttp://en.wikipedia.org/wiki/Muscle -
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Muscles composing rotator cuff
SITS muscles
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
Scapulo h umeral
muscles=6
SITS Teres major
deltoid
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THE AXILLA