Upper limb
muscles, Blood Supply
and Innervation
-NXCD-
Topic:
Lecture :
Upper limb- Pectoral Girdle
Anatomical Structure:
Deltoid
Function:
Arm+ Shoulder:
-Flexion
- Extension
- Abduction
- Lateral Rotation
- Medial Rotation
Innervation / Blood Supply:
Blood Supply: Thoracoacromial Artery, Circumflex Humeral
Arteries and Profunda Brachii Artery of the deltoid branch
Nerve Supply: Axillary Nerve
Clinical Relevance:
Subscapularis
lnfraspinatug
A
?T
→
Su
Deltoid muscle tears
→
major
Traumatic dislocation of shoulder/ Rotator cuff Tears
S
↳
s
.
I
.
I
→
-
s
.
Teres
T
-
pras
/ minor
S
-
sits
=
Notes:
on
pinatas
shoulder
-NXCD-
Topic:
Lecture :
Upper limb- Pectoral Girdle
Anatomical Structure:
Supraspinatus
Rotator
cuff
Function:
Arm:
- Abduction of arm
and stabilises
humerus
Innervation / Blood Supply:
Blood Supply: Suprascapular Artery
Nerve Supply: Suprascapular Nerve
Clinical Relevance:
Antero-Posterior Shoulder Tear
Notes:
→
-NXCD-
Topic:
Lecture :
Upper limb- Pectoral Girdle
Anatomical Structure:
Function:
Infraspinatus
Arm:
- Abduction
- Lateral Rotation
- Stabilization of glenohumeral
joint
Innervation / Blood Supply:
Blood Supply: Suprascapular and Circumflex scapular
Artery
Nerve Supply: Suprascapular Nerve
Clinical Relevance:
Rotator cuff Injury
Notes:
-NXCD-
Topic:
Lecture :
Upper limb- Pectoral Girdle
Anatomical Structure:
Function:
Teres minor
Arm:
- Abduction
- Lateral Rotation
-Stabilizes Humerus
Innervation / Blood Supply:
Blood Supply: Posterior Circumflex, Humeral and
Circumflex Scapular Artery
Nerve Supply: Axillary Nerve
Clinical Relevance:
Rotator Cuff Injuries
Quadrangular Space Syndrome
Anterior Shoulder Dislocation
Humeral Neck Fracture
Brachial Plexus Injury
Thoracic Outlet/Inlet Syndrome
Notes:
-
-NXCD-
Topic:
Lecture :
Upper limb- Pectoral Girdle
Anatomical Structure:
Function:
Teres Major
Arm:
- Adduction of
humerus
- Medial Rotation of
humerus
- Deoress
Shoulder
•
Innervation / Blood Supply:
Blood Supply: Subscapular and Circumflex Scapular Artery
Nerve Supply: Lower subscapular Nerve
Clinical Relevance:
Isolated Teres major injury (Encountered only in baseball
pitchers. RARE)
Notes:
-NXCD-
Topic:
Lecture :
Upper limb- Pectoral Girdle
Anatomical Structure:
Function:
Subscapularis
Arm:
- Medial Rotation of
humerus
-Adduction of humerus
-Stabilizes Shoulder
Innervation / Blood Supply:
Blood Supply: Subscapular Artery
Nerve Supply: Upper Subscapular and Lower Subscapular
Nerve
Clinical Relevance:
Notes:
-NXCD-
Topic:
Lecture :
Upper Limb - Anterior Group (Arm)
Anatomical Structure:
Biceps Brachii
✗
Function:
Two heads
-
-
Long
-
Longus
short
↳
Brevis
Brevis
=
short
Longus_
=
Long
- Flexion of Elbow
- Flexion and Abduction of
Shoulder
- Supination of Radioulnar joint
✗
to
carry
Bowl
a
fE¥I
Innervation / Blood Supply:
muscular
CROSS SECTION
Anterior
f- Ventral
-
Blood Supply: Brachial Artery
Nerve Supply: Musculocutaneous Nerve
Bone
-
.
.
.
=
.
.
.
.
.
?
median
.
.
.
.
=
Tendinitis
Tendon rupture
Notes:
9
↳ muscalocutan
.
.
↳
Clinical Relevance:
-
cutaneous
.
ulnar
Posterior
Dorsal
.
.
→
Radial
Nerve
-NXCD-
Topic:
Lecture :
Upper Limb - Anterior Group (Arm)
Anatomical Structure:
Coracobrachialis
Function:
- Flexion of arm at
glenohumeral joint
- Adduction of humerus
"Kobach, on ,
-
Innervation / Blood Supply:
Blood Supply: Brachial Artery
Nerve Supply: Musculocutaneous Nerve
Clinical Relevance:
Notes:
Bicep
Brachii
-NXCD-
Topic:
Lecture :
Upper Limb - Anterior Group (Arm)
Anatomical Structure:
Brachialis
Function:
- Flexion at Elbow Joint
Innervation / Blood Supply:
Blood Supply: Radial recurrent and Brachial Artery
Nerve Supply: Musculocutaneous and Radial Nerve
Clinical Relevance:
Notes:
-NXCD-
Topic:
Lecture :
Upper Limb - Posterior Group (Arm)
Anatomical Structure:
Triceps Brachii
Function:
③ heads
- Extension of Arm
-
Innervation / Blood Supply:
Blood Supply: Deep Brachial and Posterior Circumflex
Humeral Artery
Nerve Supply: Radial Nerve
Clinical Relevance:
Triceps Reflex
Notes:
¥
-NXCD-
Topic:
Lecture :
Upper Limb - Forearm (Anterior Group: Superficial
Layer
Anatomical Structure:
Function:
Brachioradialis
- Flexion of elbow
- Supination and Pronation of
Radioulnar Joint to 90 degrees
Innervation / Blood Supply:
Blood Supply: Radial Recurrent Artery
Nerve Supply: Radial Nerve
Clinical Relevance:
Notes:
0¥
-NXCD-
Topic:
Lecture :
Upper Limb - Forearm (Anterior Group: Superficial
Layer
Anatomical Structure:
Function:
Pronator Teres
- Pronation of Forearm
- Flexes Elbow
Innervation / Blood Supply:
Blood Supply: Ulnar and Radial Artery
Nerve Supply: Median Nerve
Clinical Relevance:
Pronator Teres Syndrome
Notes:
-NXCD-
Topic:
Lecture :
Upper Limb - Forearm (Anterior Group: Superficial
Layer
Anatomical Structure:
Function:
Flexor Carpi Radialis
Hand:
- Flexion of wrist
- Abduction of wrist
Innervation / Blood Supply:
Blood Supply: Ulnar Artery
Nerve Supply: Median Nerve
Clinical Relevance:
Notes:
-NXCD-
Topic:
Lecture :
Upper Limb - Forearm (Anterior Group: Superficial
Layer
Anatomical Structure:
Function:
Palmaris Longus
Hand:
- Flexion of wrist
Innervation / Blood Supply:
Blood Supply: Ulnar Artery
Nerve Supply: Median Nerve
Clinical Relevance:
Popular Use for Tendon Grafts
Carpal Tunnel Syndrome Symptoms
Notes:
-NXCD-
Topic:
Lecture :
Upper Limb - Forearm (Anterior Group: Superficial
Layer
Anatomical Structure:
Function:
Flexor Carpi
Ulnaris
Hand:
- Flexion of Wrist
- Adduction of Wrist
Innervation / Blood Supply:
Blood Supply: Ulnar Artery
Nerve Supply: Muscular/ Motor branch of Ulnar Nerve
Clinical Relevance:
Cubital Tunnel Syndrome due to Ulnar Entrapment
Notes:
-NXCD-
Topic:
Lecture :
Upper Limb - Forearm (Anterior Group: Superficial
Layer
Anatomical Structure:
Flexor
Digitorum Digits
Superficialis
=
=
Fingers
Function:
/
Toes
Innervation / Blood Supply:
Blood Supply: Ulnar Artery
Nerve Supply: Median Nerve
Clinical Relevance:
Notes:
Hand:
- Flexion for ALL fingers at
PIP joints.
EXCEPT FOR THUMB
-NXCD-
Topic:
Lecture :
Upper Limb - Forearm (Anterior Group: Deep Layer
Anatomical Structure:
Function:
Flexor
Pollicis
Longus
Thumb:
- Flexion of Thumb
Innervation / Blood Supply:
Blood Supply: Anterior Interosseous Artery
Nerve Supply: Anterior Interosseous Nerve, branch of
median Nerve
Clinical Relevance:
Notes:
-NXCD-
Topic:
Lecture :
Upper Limb - Forearm (Anterior Group: Deep Layer
Anatomical Structure:
Function:
Flexor
Digitorum
Profundus
Hand:
- Flexion for ALL of hands.
EXCEPT FOR THUMB
Innervation / Blood Supply:
Blood Supply: Anterior Interosseous Artery
Nerve Supply: Anterior Interosseous Nerve, Ulnar Nerve
Clinical Relevance:
Notes:
-NXCD-
Topic:
Lecture :
Upper Limb - Forearm (Anterior Group: Deep Layer
Anatomical Structure:
Pronator
Quadratus
Function:
Forearm:
- Pronation of Forearm
Innervation / Blood Supply:
Blood Supply: Anterior Interosseous Artery
Nerve Supply: Median Nerve (Anterior Interosseous Nerve )
Clinical Relevance:
Notes:
-NXCD-
Topic:
Lecture :
Upper Limb - Forearm (Posterior Group: Superficial
Layer
Anatomical Structure:
Extensor Carpi
Radialis Longus
and Brevis
Innervation / Blood Supply:
Blood Supply: Radial Artery
Nerve Supply: Radial Nerve
Clinical Relevance:
Notes:
Function:
Hand:
- Extension of wrist joint
- Abduction of hands at the
wrist
-NXCD-
Topic:
Lecture :
Upper Limb - Forearm (Posterior Group: Superficial
Layer
Anatomical Structure:
Function:
Extensor
Digitorum
Hand:
- Extension of hand, wrist and
fingers.
EXCEPT FOR THUMB
Innervation / Blood Supply:
Blood Supply: Posterior Interosseous Artery
Nerve Supply: Posterior Interosseous Nerve
Clinical Relevance:
Notes:
-NXCD-
Topic:
Lecture :
Upper Limb - Forearm (Posterior Group: Superficial
Layer
Anatomical Structure:
Function:
Extensor
Digiti
Minimi
- Extension of Wrist and Little
Finger at all Joints
Innervation / Blood Supply:
Blood Supply: Posterior Interosseous Artery
Nerve Supply: Posterior Interosseous Nerve
Clinical Relevance:
Notes:
-NXCD-
Topic:
Lecture :
Upper Limb - Forearm (Posterior Group: Superficial
Layer
Anatomical Structure:
Function:
Extensor
Carpi
Ulnaris
Hand:
- Extension of wrist
- Adduction of wrist
Innervation / Blood Supply:
Blood Supply: Ulnar Artery
Nerve Supply: Posterior Interosseous Nerve
Clinical Relevance:
Tennis Elbow
Notes:
-NXCD-
Topic:
Lecture :
Upper Limb - Forearm (Posterior Group: Deep Layer
Anatomical Structure:
Function:
Supinator
- Supination of Forearm
Innervation / Blood Supply:
Blood Supply: Radial Recurrent Artery
Nerve Supply: Deep Branch of Radial Nerve
Clinical Relevance:
Notes:
-NXCD-
Topic:
Lecture :
Upper Limb - Forearm (Posterior Group: Deep Layer
Anatomical Structure:
Function:
Abductor
Pollicis
Brevis
- Abduction of Thumb across
CMP and MCP joint
- Assists in Opposition and
Extension of Thumb
Innervation / Blood Supply:
Blood Supply: Superficial Palmar Arch
Nerve Supply: Recurrent Branch of Median Nerve
Clinical Relevance:
Notes:
-NXCD-
Topic:
Lecture :
Upper Limb - Forearm (Posterior Group: Deep Layer
Anatomical Structure:
Extensor
Pollicis
Brevis
Function:
- Extends Thumb at MCP
joint
Innervation / Blood Supply:
Blood Supply: Posterior Interosseous Artery
Nerve Supply: Posterior Interosseous Nerve
Clinical Relevance:
Notes:
-NXCD-
Topic:
Lecture :
Upper Limb - Forearm (Posterior Group: Deep Layer
Anatomical Structure:
Function:
Extensor
Pollicis
Longus
- Extension of Thumb at
MCP and IP
Innervation / Blood Supply:
Blood Supply: Posterior Interosseous Artery
Nerve Supply: Posterior Interosseous Nerve (Branch of
Radial Nerve)
Clinical Relevance:
Tenosynovitis - Inflammation of Synovial Sheath
Notes:
-NXCD-
Topic:
Lecture :
Upper Limb - Forearm (Posterior Group: Deep Layer
Anatomical Structure:
Function:
Extensor
Indicis
- Extends Index Finger and
wrists
Innervation / Blood Supply:
Blood Supply: Posterior Interosseous Artery
Nerve Supply: Posterior Interosseous Nerve
Clinical Relevance:
Notes:
-NXCD-
Topic:
Lecture :
Upper Limb - Hand (Lateral Group: Thenar)
Anatomical Structure:
Abductor
Pollicis
Brevis
Function:
- Abduction of Thumb, acting
across CMP and MCP joints
- Assist in Opposition and
Extension of Thumb
Innervation / Blood Supply:
Blood Supply: Superficial Palmar Artery
Nerve Supply: Recurrent Branch of Median Nerve
Clinical Relevance:
Notes:
-NXCD-
Topic:
Lecture :
Upper Limb - Hand (Lateral Group: Thenar)
Anatomical Structure:
Function:
Flexor
Pollicis
Brevis
- Flexion of Thumb at MCP
joint
Innervation / Blood Supply:
Blood Supply: Superficial Palmar Arch
Nerve Supply: Recurrent branch of median Nerve and deep
branch of ulnar nerve
Clinical Relevance:
Notes:
-NXCD-
Topic:
Lecture :
Upper Limb - Hand (Lateral Group: Thenar)
Anatomical Structure:
Function:
Opponens
Pollicis
- Opposes Thumb
- Flexion of thumb at
CMP joint
Innervation / Blood Supply:
Blood Supply: Superficial Palmar Arch
Nerve Supply: Recurrent branch of median Nerve
Clinical Relevance:
Notes:
-NXCD-
Topic:
Lecture :
Upper Limb - Hand (Lateral Group: Thenar)
Anatomical Structure:
Adductor
Pollicis
Function:
- Adduction of Thumb at CMP
joint
Innervation / Blood Supply:
Blood Supply: Deep Palmar Arch
Nerve Supply: Deep branch of Ulnar Nerve
Clinical Relevance:
Froment’s sign used to test compromised adductor Pollicis
muscle
Notes:
-NXCD-
Topic:
Lecture :
Upper Limb - Hand (Medial Group: Hypothenar)
Anatomical Structure:
Function:
Abductor
Digiti
Minimi
- Abduction of Little Finger
Innervation / Blood Supply:
Blood Supply: Ulnar Artery
Nerve Supply: Deep branch of Ulnar Nerve
Clinical Relevance:
Notes:
-NXCD-
Topic:
Lecture :
Upper Limb - Hand (Medial Group: Hypothenar)
Anatomical Structure:
Function:
Flexor
Digiti
Minimi
Brevis
- Flexion of little finger at
MCP
Innervation / Blood Supply:
Blood Supply: Ulnar Artery
Nerve Supply: Deep branch of Ulnar Nerve
Clinical Relevance:
Notes:
-NXCD-
Topic:
Lecture :
Upper Limb - Hand (Medial Group: Hypothenar)
Anatomical Structure:
Opponens
Digiti
Minimi
Function:
- Opposes little finger
Innervation / Blood Supply:
Blood Supply: Ulnar Artery
Nerve Supply: Deep branch of Ulnar Nerve
Clinical Relevance:
Notes:
-NXCD-
Topic:
Lecture :
Upper Limb - Hand (Middle Group)
Anatomical Structure:
Function:
Lumbrical
Muscle
- Flexion at the MCP
- Extension at the IP
:*
Innervation / Blood Supply:
Blood Supply: Superficial Palmar Arch, Common Palmar Digital, Deep
Palmar and Dorsal digital Arteries
Nerve Supply: 3rd and 4th Deep branch of Ulnar Nerve and 1st and 2nd
Median Nerve
Clinical Relevance:
Notes:
-NXCD-
Topic:
Lecture :
Upper Limb - Hand (Middle Group)
Anatomical Structure:
Function:
Palmar
Interossei
Muscle
- Flexion at the MCP
- Extension at the IP
Adduction for ALL hand,
EXCEPT THUMB
Innervation / Blood Supply:
Blood Supply: Palmar Metacarpal Artery of deep Palmar
arch
Nerve Supply: Deep branch of Ulnar Nerve
Clinical Relevance:
Notes:
-NXCD-
Topic:
Lecture :
Upper Limb - Hand (Middle Group)
Anatomical Structure:
Dorsal
Interossei
Function:
- Flexion at the MCP
- Extension at the IP
- Abduction of ALL hands.
EXCEPT THUMB
Innervation / Blood Supply:
Blood Supply: Dorsal and Palmar Metacarpal Artery
Nerve Supply: Deep branch of Ulnar Nerve
Clinical Relevance:
First dorsal Interosseous Compartment Syndrome
Notes:
Arteries of Upper Limb
Axillary artery
Thoracoacromial
z
Lateral
Artery
Border
1st Rib
Ant
numeral man
,
y
Axillary
Lateral
Artery
Thoracic
artery
Right
Common
carotid
artery
Left
common
carotid
Artery
;
I
:
circum
Artery
1
superior
Thoracic
g
gon
%
Artery
subclavian
"
Ing
Left Subclavian
Right
posterior
numeral"
Artery
%
Brachia cephalic
Artery
Te
te
en
e
B
%
on
subscapular
artery
From here
it is now
Bff
Brachial
Artery
✓
D
%
-1
D
-
-
-
-
-
-
-
Divide
at
level
neck of radius
Radial
artery
ulnar
artery
of
Veins of the Upper Limb
•
Note: Deep veins ALWAYS accompanies arteries of the same region and will have the same name.
This means, if there is a thoracoacromial artery in the region, running parallel with it will be a
thoracoacromial vein
Lymphatic drainage of upper limb
Superficial Veins
-
-
-
y
•
¢
•
-
Arise
on
lateral
•
1
Superficial
•
'
t
1
•
:
t
i
•
1
g
t
e
f
Accompanies
Lymph
Nodes
found here !
lymph
cubital
Axillary lymph
↳ 5
.
.
.
-
•
to
pierces Fascia
Deep
Brachial
with
•
•
vein
✗
f
node
Lateral
!
Lymph
i
l
f
q
y
Basilio
+
vein
1
i
i
1
,
I
-
-
l
y
-
t
f
g
-
,
f
+
medial
cubital vein
Pectoral
Lymph
Subscapular Lymph
•
Central
Lymph
•
Apical
Lymph
=
t
t
main
node
subgroups
join
,
into
drain
i
'
\
Always
•
Deep
y
1
I
/
•
.
aspect
Dorsal
1
vein
Cephalic
vessels
Lymphatic
Nodes
Node
Node
supratrochlear
vessels
and
t
drains
axillary lymph
into
nodes
axillary lymph
nodes
Upper limb nerves- Brachial Plexus
Remember
mnemonic
Io
:
Drink
Told
Division
Trunk
Roots
Tzeer
Branches
Cords
Rhomboids
(
major
)
1- Minor
Dorsal
guyaneous
Scapular
Nerve
Levator
Branch
Forearm
Lateral
Scapular
Anterior
Division
Muscularcutaneous
Lateral cord
[ 5
¥al
coracobrachialis
Nerve
Brachia / is
Branch
motor
Pectoral
Biceps brachii
Nerve
Upper
•
•
•
/
Trunk
/
Nerve
•
to
guyaneous
Branch
of
Division
Axillary
Division
Posterior
cord CU
Motor
Branch
Deltoid
Teres Minor
,
M, L )
°
S
Trunk
•
a
Is
20
n
-
-0
→
<
n
0s
i
no
5
•
[7
a
z
<
o
on
n
n
<
n
a
S
,
Nerve
Motor
-
s
•
•
Latissimus
Dorsi
Subscapularis
Teres
First thoracic vertebra
{
•
triceps Brachii
•
•
•
•
•
•
subscapularis
°
cutaneous
comes
between
Branch
Major
muscle
Runs
of
Posterior Division
( 8
3
Limb
Lateral
•
s
e
s
-
Posterior Division
Posterior
of Hand ( + Lateral ) surfaces
Also supply dorsum
s
s
→
Anterior Muscle
Nerve
,
Upper
s
-0
on
Thoracic
Radial
surface of
Thumbs
I
0s
-
Generally supply
•
EE
o
s
cutaneous Branch
T
-1
Serratus
Deltoid
Nerve
Anterior
Long
surface
Lateral
3
posterior
Posterior
CG
middle
Head )
Long
subclavius
Subclavius
muscle
Shoulder Joint
be
Nerve
Supra scapular
supraspinatus
lnfraspinatus
csnort
Pectoralis
major muscle
From branch
lateral cord
be
medial
Medial
(
Anconeus
•
Extensor
Extensor
short )
Abductor
Extensor
•
Extensor
Digitorum
•
Extensor
Indias
Carpi
Radialis
/
longus
Brevis
•
Digit
Extensor
minimi
supinator
Carpi ulnaris
Pollicis
Pollicis
Longus
Longus /
ventrolateral
Dorsum of
cord
1-
.
Branch
Nerve
Long
Brachioradialis
Brevis
surface
digits
of
23,3
Palm
+
Digits
2+3
,
.
seventh cervical
vertebra
Branch
Motor
Lower
Trunk
•
•
Medial
I 7
Anterior Division
,
s
3
E
o
,
o
o
s
-.
§
-.
s
I
6
o
g
o
,
E
I
-
<
o
o
o
6
•
2 s
E I
+
✗
S
e
n
o
e
g
o
o
o
✗
@
E
3
n
.
2
o
-
c
•
Pectoralis
major
3
Pectoralis
minor
Cord
Ulnar
Flexor
Patman's
•
Flexor
•
Longus
is
Digitorum superficial
Radial half
of
Flexor
Digitorum
↳
Hand
cutaneous
Nerve
Branch
3
•
Dorsal
bp
ventral
p
of
e
-
-
E
,
S
Branch
+
o
g
•
-
b
•
c
§
Adductor
Pollicis Brevis
Ulnar
half of
Flexor
Carpi
flexor
.
I
•
•
•
•
Opponens
Flexor
•
•
Flexor Carpi Radialis
•
•
Compartment
pronator Teres / Quadratus
Digit
Digiti
Abductor
Digitorum
Ulnaris
minimi
minimi
Digiti
minimi
Profundis
•
Profundis
2+3
lumbricalis
Opponens
Pollicis
Flexor Pollicis
Abductor
Brevis
Brevis
Pollicis
Brevis
3