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UPPER LIMB: muscle origins, insertions, innervations, blood supplies and actions

Region
Shoulder

Muscle
Trapezius

Origin
Vertebrae
(C7T12)

Insertion
Lateral third of
clavicle, Medial
surface of acromion,
spine of scapula

Innervation
Spinal accessory
nerve

Blood Supply
Transverse cervical
artery

Shoulder

Latissimus dorsi

Vertebrae (T3T8)

Deltoid

Lateral third of
clavicle, superior
surface of
acromion,, spine of
scapula

Thoracodorsal nerve
(C6C8)
Axillary nerve (C5,
C6)

Thoracodorsal artery

Shoulder

Intertubercle groove
of humerus
Deltoid tuberosity of
humerus (lateral)

Shoulder

Levator
scapulae

Vertebrae (C1C4)

Superior medial
border of scapula

Dorsal scapular
artery

Shoulder

Rhomboid
minor and major

Medial border of
scapula

Shoulder
(rotator cuff)

Supraspinatus

Minor: C7 and T1
vertebrae
Major: T2T5
vertebrae
Supraspinous fossa
of scapula

3rd and 4th cervical


nerves of cervical
plexus, dorsal
scapular nerve (C5)
Dorsal scapular
nerve (C4,C5)

Greater tubercle of
humerus

Suprascapular nerve
(C5, C6)

Suprascapular artery

Shoulder
(rotator cuff)

Infraspinatus

Infraspinous fossa
of scapula

Greater tubercle of
humerus

Suprascapular nerve
(C5, C6)

Suprascapular artery

Shoulder
(rotator cuff)

Teres minor

Lateral border of
scapula

Greater tubercle of
humerus

Axillary nerve (C5,


C6)

Circumflex scapular
artery

Shoulder

Teres major

Intertubercular
groove of humerus

Lower subscapular
nerve (C6, C7)

Circumflex scapular
artery

Shoulder
(rotator cuff)

Subscapularis

Dorsal surface of
inferior angle of
scapula
Subscapular fossa
Lateral border of

Lesser tubercle of
humerus

Upper and lower


subscapular nerves

Subscapular artery

Posterior circumflex
humeral artery

Dorsal scapular
artery

Action
Rotate scapula for full abduction
Upper fibers elevate shoulder
Central fibers retract shoulder
Lower fibers draw scapula
downward
Extends, adducts, medially
rotates the humerus
Abduction of the arm, movement
initiated with supraspinatus
Clavicular portion rotates arm
medially
Spinous portion rotates arm
laterally
Elevates the superior angle of the
scapula
Rotates scapula so that the
glenoid cavity is tilted inferiorly
Retract scapula, rotates it to
depress glenoid gavity
Fix scapula to thoracic wall
Draws humerus towards glenoid
fossa
Initiates abduction of shoulder
Lateral rotator of humerus
Braces head of humerus in the
glenoid fossa
Lateral rotator of humerus
Rotates arm laterally, weakly
adducts arm at shoulder
Draws humerus towards glenoid
fossa
Extends arm from flexed position
Adducts and medially rotates
arm at shoulder
Helps stabilize shoulder joint
Prevents anterior displacement of

scapula

(C5, C6)

humerus
Medially rotates and adducts
humerus
Adduction of the arm
Medial rotator of humerus

Shoulder

Pectoralis major

Clavicle, upper half


of sternum

Intertubercular
groove of humerus

Medial and lateral


pectoral nerves
(C5C8)

Thoracoacromial
artery- pectoral
branch

Shoulder

Pectoralis minor

3rd to 5th ribs

Superior surface of
coracoid process

Medial pectoral
nerve (C8,T1)

Thoracoacromial
artery- pectoral
branch

Stabilizes scapula by drawing it


inferiorly and anteriorly against
thoracic wall

Shoulder

Subclavius

1st rib

Inferior surface of
middle third of
clavicle

Nerve to subclavius
(C5, C6)

Thoracoacromial
artery- clavicular
branch

Anchors and depresses clavicle

Shoulder

Serratus anterior

1st8th ribs

Anterior surface of
medial border of
scapula

Long thoracic nerve


(C5C7)

Lateral thoracic
artery

Protracts scapula, holds it against


thoracic wall
Rotates scapula

Arm
(anterior)

Biceps brachii

Radial tuberosity

Musculocutaneous
nerve (C5, C6)

Brachial artery

Powerful supinator of forearm


Flexor of supinated forearm

Arm
(anterior)

Coracobrachiali
s

Short head:
coracoid process of
scapula
Long head:
Supraglenoid
tubercle of scapula
Coracoid process of
scapula

Medial surface of
humerus

Musculocutaneous
nerve (C6, C7)

Brachial artery

Flexes and adducts arm at the


shoulder

Arm
(anterior)

Brachialis

Distal anterior
humerus

Coronoid process
and tuberosity of the
ulna

Musculocutaneous
nerve (C5, C6)

Brachial artery

Powerful flexor of the forearm at


the elbow

Arm
(posterior)

Triceps bracii

Long head:
infraglenoid
tubercle of scapula
Lateral head:
posterior surface of
humerus

Olecranon of the
ulna , fascia of
forearm

Radial nerve
(C6C8)

Deep brachial artery

Extends forearm at the elbow


Long head of triceps can also
extend humerus at the shoulder
joint

Arm
(posterior)

Anconeus

Forearm
(anterior,
superficial)

Pronator teres

Forearm
(anterior,
superficial)

Flexor carpi
radialis

Forearm
(anterior,
superficial)
Forearm
(anterior,
superficial)
Forearm
(anterior,
intermediate)

Flexor
digitorum
superficialis

Forearm
(anterior,
deep)

Flexor
digitorum
profundus

Forearm
(anterior,
deep)

Pronator
quadratus

Medial head:
posterior surface of
humerus
Lateral epicondyle
of humerus

Lateral surface of
olecranon of ulna

Radial nerve
(C6C8)

Deep brachial artery

Extends forearm at elbow

Humeral head:
medial epicondyle
of humerus
Ulnar head:
coranoid process of
ulna
Medial epicondyle
of humerus

Lateral surface of
radius

Median nerve (C6,


C7)

Anterior ulnar
recurrent artery

Rotates the radius on the ulna


Flexor of forearm at elbow

Base of 2nd
metacarpal

Median nerve (C6,


C7)

Ulnar artery

Flexes hand at wrist joint


Aids in abduction

Palmaris longus

Medial epicondyle
of humerus

Palmar aponeurosis

Median nerve (C6,


C7)

Ulnar artery

Flexes hand at wrist joint


Tightens palmar aponeurosis

Flexor carpi
ulnaris

Humeral head:
medial epicondyle
of humerus
Ulnar head:
Olecranon of ulna
Humeroulnar head:
medial epicondyle
of humerus
Radial head:
superior anterior
radius
Proximal medial
anterior surface of
ulna, interosseus
membrane

Pisiform bone,
Hamate bone

Ulnar nerve (C7, C8)

Ulnar artery

Flexes and adducts had at the


wrist

Middle phalanges of
medial 4 digits
(indexlittle finger)

Median nerve
(C7T1)

Ulnar artery

Flexor of proximal
interphalangeal joints
Flexor of elbow, wrist,
metacarpophalangeal joints

Distal phalanges of
medial 4 digits
(indexlittle finger)

Anterior
interosseous artery

Flexor of distal interphalangeal


joints

Distal medial
surface of ulna

Distal lateral surface


of radius

Medial portion:
ulnar nerve (C8, T1)
Lateral portion:
median nerve (C8,
T1)
Anterior interosseus
nerve from median
nerve (C8,T1)

Anterior
interosseous artery

Pronator of the hand


Assisted by pronator teres

Forearm
(anterior,
deep)
Forearm
(posterior)

Flexor pollicus
longus

Anterior medial
surface of radius

Base of distal
phalanx of thumb

Anterior interosseous
nerve from median
nerve (C8, T1)
Radial nerve

Anterior
interosseous artery

Flexor of distal phalanx of thumb

Brachioradialis

Lateral surface of
distal radius

Forearm
(posterior)

Supinator

Lateral
supracondylar ridge
of the humerus
Lateral epicondyle
of humerus

Radial artery (?)

Flexes forearm

Proximal third of
radius

Deep branch of
radial nerve (C5, C6)

Recurrent
interosseous artery

Rotates radius to supinate the


forearm and hand

Forearm
(posterior)

Abductor
pollicis longus

Posterior surface of
ulna

Base of first
metacarpal bone

Posterior
interosseous nerve
(C7, C8)

Posterior
interosseous artery

Abducts, extends, laterally


rotates thumb at carpometacarpal
joint

Forearm
(posterior)

Extensor
pollicus brevis

Posterior surface of
radius, interosseous
membrane

Base of proximal
phalanx of thumb

Posterior
interosseous nerve
(C7, C8)

Posterior
interosseous artery

Extends proximal phalanx of


thumb at metacarpophalangeal
joint
*lateral boundary of anatomical
snuffbox

Forearm
(posterior)

Extensor carpi
radialis longus

Base of second
metacarpal

Radial nerve (C6,


C7)

Radial artery

Extends and abducts hand at


wrist joint

Forearm
(posterior)
Forearm
(posterior)

Extensor carpi
radialis brevis
Extensor
pollicus longus

Lateral
supracondylar ridge
of the humerus
Lateral epicondyle
of humerus
Posterior surface of
ulna, interosseous
membrane

Base of third
metacarpal
Base of distal
phalanx of thumb

Deep branch of
radial nerve (C7, C8)
Posterior
interosseous nerve
(C7, C8)

Radial artery

Extends and abducts hand at


wrist joint
Extends distal phalanx of thumb
at metacarpophalangeal and
interphalangeal joints
*medial boundary of anatomical
snuffbox

Forearm
(posterior)

Extensor
digitorum

Lateral epicondyle
of humerus

Extensor expansions
of fingers 25

Posterior
interosseous nerve
(C7, C8)

Posterior
interosseous artery

Extension at
metacarpophalangeal and
interphalangeal joints
Wrist extension when fingers are
extended

Forearm
(posterior)

Extensor indices

Posterior surface of
ulna, interosseous
membrane

Extensor expansion
of 2nd digit

Posterior
interosseous nerve
(C7, C8)

Posterior
interosseous artery

Extends all joints of the index


finger

Posterior
interosseous artery

Forearm
(posterior)

Extensor digiti
minimi

Lateral epicondyle
of humerus

Extensor expansion
of the fifth digit

Posterior
interosseous nerve
(C7, C8)

Recurrent
interosseous artery

Extends 5th digit at


metacarpophalangeal and
interphalangeal joints
Wrist extension when fingers are
extended

Forearm
(posterior)

Extensor carpi
ulnaris

Medial side of base


of 5th metacarpal

Posterior
interosseous nerve
(C7, C8)

Ulnar artery

Extends and adducts hand at


wrist joint

Hand
(thenar)

Abductor
pollicis brevis

Lateral epicondyle
of humerus
Posterior border of
ulna
Flexor retinaculum,
tubercle of scaphoid
and trapezium
bones

Lateral side of base


of proximal phalanx
of thumb

Recurrent branch of
median nerve (C8,
T1)

Superficial palmar
branch of radial
artery

Abducts thumb at
carpometacarpal and
metacarpophalangeal joints

Hand
(thenar)

Flexor pollicis
brevis

Lateral side of first


metacarpal bone

Recurrent branch of
median nerve (C8,
T1)

Superficial palmar
branch of radial
artery

Flexes proximal phalanx of


thumb

Hand
(thenar)

Opponens
pollicis

Superficial head:
flexor retinaculum,
trapezium
Deep head: floor of
carpal canal
Flexor retinaculum,
trapezium

Lateral side of first


metacarpal bone

Hand

Adductor
pollicis

Bases of 2nd and 3rd


metacarpals,
capitate bone

Superficial palmar
branch of radial
artery
Deep palmar arterial
arch

Pulls and rotates first metacarpal


in a medial fashion across palm,
opposing thumb against fingers
Adducts proximal phalanx of
thumb toward middle digit

Hand
(hypothenar)
Hand
(hypothenar)

Abductor digiti
minimi
Flexor digiti
minimi brevis

Pisiform bone

Deep branch of ulnar


nerve (C8, T1)
Deep branch of ulnar
nerve (C8, T1)

Ulnar artery

Abducts 5th digit

Hook of hamate
bone, flexor
retinaculum

Converge on
sesamoid bone,
attach to base of
proximal phalanx of
thumb
Base of proximal
phalanx of 5th digit
Base of proximal
phalanx of little
finger

Recurrent branch of
median nerve (C8,
T1)
Deep branch of ulnar
nerve (C8, T1)

Ulnar artery

Flexes proximal phalanx of 5th


digit at metacarpophalangeal
joint

Hand
(hypothenar)

Opponens digiti
minimi

Hook of hamate
bone, flexor
retinaculum

Palmar surface of
body of 5th
metacarpal

Deep branch of ulnar


nerve (C8, T1)

Ulnar artery

Hand

Lumbricals 1,2

Lateral tendons of

Lateral sides of

Median nerve (C8,

Superficial palmar

Abducts, flexes, laterally rotates


5th metacarpal, enhances cupping
of hand, grip, opposes little
finger to thumb
Flex metacarpophalangeal joint

flexor digitorum
profundis

extensor expansions
of digits 2-5

T1)

arterial arch

Hand

Lumbricals 3,4

Medial tendons of
flexor digitorum
profundis

Lateral sides of
extensor expansions
of digits 2-5

Deep branch of ulnar


nerve (C8, T1)

Superficial palmar
arterial arch

Hand

Palmar
interosseous
muscles (3 total)

Palmar surfaces of
metacarpal bones of
digits 2, 4, 5

Deep branch of ulnar


nerve (C8, T1)

Palmar metacarpal
arterial arch

Hand

Dorsal
interosseous
muscles (4 total)

Arise by 2 heads
from adjacent sides
of the metacarpal
bones

Extensor expansions
of digits and bases of
proximal phalanges
of digits 2, 4, 5
Base of the proximal
phalanx and
aponeurosis that
forms extensor
expansion of digits
24

Deep palmar branch


of ulnar nerve (C8,
T1)

Dorsal and palmar


metacarpal arterial
arch

Extend interphalangeal joint


Prevent extensor digitorum from
hyperextending wrist
Flex metacarpophalangeal joint
Extend interphalangeal joint
Prevent extensor digitorum from
hyperextending wrist
Adduct fingers at the
metacarpophalangeal joint
(towards middle finger)
Abducts fingers away from
middle finger
Flex fingers at
metacarpophalangeal joints
Extend 2 distal phalanges at
interphalangeal joint

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