154 PAR I Neuroanatomy and Neuroanatomic Localization

TABLE 16–4 Examination o the Upper Extremities by Action.

Action Muscle Nerve Roots

Shoulder elevation Trapezius CN 11 (spinal

accessory nerve)
Abduction o upper arm (raising arm like a chicken wing)
First 15 30 degrees Supraspinatus Suprascapular C5-C6
Beyond 15 30 degrees Deltoid Axillary C5-C6
Adduction o upper arm Teres major Lower subscapular C5-C6
External rotation o upper arm In raspinatus Suprascapular C5-C6
Teres minor Axillary C5-C6
Elbow f exion
With orearm supinated Biceps Musculocutaneous C5-C6
With orearm hal pronated Brachioradialis Radial C5-C6
(bottom o st on table)
Elbow extension Triceps Radial C7-C8
Wrist f exion Flexor carpi radialis Median C6-C7
Flexor carpi ulnaris Ulnar C8-T1
Wrist extension Extensor carpi radialis Radial C6-C7
Extensor carpi ulnaris Radial C7-C8
Four movements o the thumb
Abduction (thumb out 90 degrees rom Abductor pollicis brevis Median C8-T1
palm/ rst nger)
Opposition (thumb to th nger) Opponens pollicis Median C8-T1
Adduction (thumb to side o index nger) Adductor pollicis Ulnar C8-T1
Extension (thumbs up) Extensor pollicis longus and brevis Radial C7-C8
Flexion o the ngers at the PIP joint Flexor digitorum super cialis Median C7-C8-T1
Flexion o the ngers at the DIP joint
Index and middle nger Flexor digitorum pro undus Median C8-T1
1 and 2
Ring and th nger Flexor digitorum pro undus Ulnar C8-T1
3 and 4
All extensors o ngers and thumb Extensor digitorum communis Radial C7-C8
Extensor indicis proprius
Extensor digiti minimi
Extensor pollicis longus
Extensor pollicis brevis
Intrinsic non thumb muscles o the hand (all ulnar except rst and second lumbricals)
Adduction o ngers Palmar interossei Ulnar C8-T1
Abduction o ngers Dorsal interossei Ulnar C8-T1
Flexion at the MCP joint while extending at PIP/DIP joints
Index and middle nger Lumbricals 1 and 2 Median C8-T1
Ring and th nger Lumbricals 3 and 4 Ulnar C8-T1
Abbreviations: DIP: distal interphalangeal joint; MCP: metacarpal-phalangeal joint; PIP: proximal interphalangeal joint.