Muscles of the Upper Limb Muscle ROTATOR CUFF Supraspinatus Function Origin Insertion Innervation Initiate abduction + stabilise Medial 2/3 of supraspinous fossa Suprascapular nerve (C5,6) Infraspinatus Lat. Rotation + stabilise Medial 2/3 of infraspinous fossa Teres minor Lat. Rotation + stabilise Subscapularis Medial rotation, adduction + stabilise Upper 2/3 of post. And lat. Aspect of infraspinous fossa Subscapular fossa Superior facet on greater tubercle (humerus) Mid. Facet on greater tubercle (humerus) Inf. facet on greater tubercle (humerus) Lesser tubercle of humerus Teres major (not part of rotator…) ANTERIOR THORAX Pectoralis major Adduction and medial rotation Dorsal surface of scapula (towards inf. angle) Medial lip of intertubercular groove Upper + lower subscapular nerves (C5,6) Lower subscapular nerve (C5,6) Adduction + medial rotation (heads can function independently) Clavicular head – medial half of clavicle Sternocostal head – ant. Surface of sternum, rib 1-6 costal cartilages Surface of ribs 1-9 Intertubular groove Medial border of scapula (ant. Surface) Long thoracic nerve (C5-7) Ribs 3-5 Coracoid process Depress + stabilise clavicle 1st rib Inferior surface of clavicle Medial pectoral nerve (C8, T1) Subclavian nerve (C5,6) Descending: elevate scapula Middle: retract scapula Ascending: depress scapula Adduction, med. Rotation + extension Sup. Nuchal line external occipital protuberance, spinous processes C7-12 T12 Spine of scapula Spinal accessory nerve (CN XI) + C3-4 Spinous processes T712, thoracolumbar fascia + post. Iliac crest Transverse process C14 Ligamentum nuchae, spinous processes C7T1 Spinous processes of T2-5 Intertubercular groove Thoracodorsal nerve Medial border of scapula (superior) Medial border of scapula (upper) Dorsal scapular nerve + C3-4 Dorsal scapular nerve Medial border of scapula (lower) Dorsal scapular nerve Serratus anterior Pectoralis minor Subclavius POSTERIOR THORAX Trapezius Latissimus dorsi Protraction + rotation of scapula (Boxer/s muscle), accessory resp. muscle Depress scapula Levator scapulae Rhomboid minor Elevate scapula Rhomboid major Retract + elevate scapula Retract + elevate scapula Intertubercular groove Suprascapular nerve (C5,6) Axillary nerve (C5,6) Lat. + med. Pectoral nerves ARM Deltoid (anterior, lateral, posterior) ANTERIOR Coracobrachialis Abduction, flexion + extension Lat. Aspect of clavicle, acromion process + spine of scapula Deltoid tuberosity Axillary nerve Flex + adduct arm Tip of coracoid process Mid 1/3 of humerus Biceps (brachii) Secondary flexor + supination Radial tuberosity Brachialis Primary forearm flexor (MVP!) Long head: supraglenoid tubercle Short head: coracoid process (apex) Distal portion of ant. Humerus Musculocutaneous (C5-7) Musculocutaneous nerve (C5,6) Tuberosity of ulna Musculocutaneous nerve (C5,6) + sometimes radial (C7) POSTERIOR Triceps (brachii) Elbow extension Long head: infraglenoid tubercle (scapula) Medial + lateral heads: posterior surface of humerus Olecranon Radial nerve (C6-8) FOREARM ANTERIOR (SUPERFICIAL) Pronator teres Pronation Humeral head: medial epicondyle of humerus Ulnar head: prox. Ulna Medial epicondyle of humerus Medial epicondyle of humerus Medial epicondyle of humerus + post. Ulna Midshaft lateral surface of radius Median nerve Base of metacarpals 1&2 Palmar aponeurosis Median nerve Pisiform, hook of hamate and 5th metacarpal Middle phalanges Ulnar nerve Flexor carpi radialis Palmaris longus Flex + abduct wrist Flexor carpi ulnaris Flex + adduct wrist Flexor digitorum superficialis (middle) (DEEP) Pronator quadratus Flexor pollicis longus Flex proximal interphalangeal joints Medial epicondyle prox. Ulna & anteroproximal radius Pronation Distal ant. Ulna Distal ant. radius Median nerve Flex thumb Ant. Surface of radius + interosseous membrane Ant. + med. Ulna & interosseous membrane Base of distal phalanx of thumb Median nerve Distal phalanx Lateral: median Medial: ulnar Flexor of wrist Flexor digitorum Flex distal profundus interphalangeal joint Median nerve Median nerve FOREARM POSTERIOR (SUPERFICIAL) Brachioradialis (more prominent ant.) Anconeus Accessory forearm flexor Lateral condyle (humerus) Lateral distal radius Radial nerve Ulna abduction during pronation + accessory elbow extensor Wrist extension + abduction Wrist extension + abduction Digit extension Posterior lateral epicondyle Posterior proximal ulna Radial nerve Lateral condyle of humerus Lateral epicondyle of humerus Lateral epicondyle of humerus Radial nerve Extensor digiti minimi Extensor carpi ulnaris DEEP Supinator Extend little finger Lateral epicondyle of humerus Lateral epicondyle of humerus Dorsal surface base of 2nd metacarpal Dorsal surface base of 3rd metacarpal Extensor hoods at base of middle + distal phalanges (index to little finger) Extensor hood of little finger Base of 5th metacarpal Radial nerve Proximal lateral radius Radial nerve Abductor pollicis longus Extensor pollicis brevis Extensor pollicis longus Extensor indicis Thumb abduction + extension Thumb extension Posterior medial ulna Posterior radius/ulna Posterior radius Base of 1st metacarpal Radial nerve Radial nerve Thumb extension Posterior ulna Base of thumb, proximal phalanx Base of thumb, distal phalanx Index finger extension (pointing) Posterior ulna Extensor hoods at base of middle + distal phalanges Radial nerve Extensor carpi radialis longus Extensor carpi radialis brevis Extensor digitorum Adduct + extend wrist Forearm supination Radial nerve Radial nerve Radial nerve Radial nerve Muscles of the Lower Limb Muscle Function GLUTEAL REGION SUPERFICIAL Gluteus maximus Hip/thigh ext. + lateral rotation Gluteus medius Gluteus minimus Tensor fascia latae DEEP Piriformis Abduction + med. Rotation Abduction + med. Rotation Abduction + med. Rotation Quadratus femoris Lat. Rotation (extended femur) + abduction (flexed femur) Lat. Rotation + abduction Lat. Rotation + abduction Lat. Rotation + abduction Lateral rotation Iliacus Psoas major Flex hip Flex hip Obturator internus Superior gemellus Inferior gemellus THIGH ANTERIOR Sartorius Vastus lateralis Flex hip + (some) ext. rotation Flex thigh + extend knee Knee extension Vastus medialis Knee extension Vastus intermedius Pectineus Knee extension Rectus femoris MEDIAL Gracilis Adductor longus Adductor brevis Adductor magnus Obturator externus Flex + adduct thigh Adduct thigh + medial rotation (+ some flexion) Adduct + medially rotate thigh Adduct thigh Origin Insertion Innervation Posterior iliac line, dorsal surface of sacrum and coccyx Between ant. + post. Gluteal lines B/w inf. + ant. (?) Gluteal lines Iliac crest + ASIS Gluteal tuberosity and iliotibial band Inf. gluteal nerve Posterior surface of greater trochanter Ant. Surface of greater trochanter ITB – lateral condyle of tibia Sup. Gluteal nerve Ant. Surface of sacrum Greater trochanter (sup. Medial border) S1, S2 (ventral rami) Anterolateral wall of true pelvis Ext. surface of ischial spine Upper aspect of ischial tuberosity Lat. Aspect of ischium ant. to ischial tuberosity Iliac fossa T12-L5 vertebrae Greater trochanter (medial) Sup. Surface of ob. Internus tendon Inf. surface of ob. Internus tendon Quadrate tubercle on intertrochanteric crest Lesser trochanter Lesser trochanter Nerve to obturator internus Nerve to obturator internus Nerve to quadratis femoris L5, S1 ASIS Proximal medial tibia (pes anserinus) Patella / quadriceps femoris tendon Lateral patella Femoral nerve Medial patella Femoral nerve Patella Femoral nerve Pectineal line of femur Femoral nerve Body and inferior pubic ramus Proximal medial tibia Obturator nerve Body of pubis (inf) Linea aspera (mid 1/3) Pectineal line + linea aspera Linea aspera + adductor tubercle Trochanteric fossa Obturator nerve AIIS + superior acetabular rim Greater trochanter + lateral linea aspera Intertrochanteric line + medial linea aspera Proximal femoral shaft Pectineal line of pubis Body of pubis + inf, pubic ramus Adduct thigh + medially Pubic ramus + ischial rotates tuberosity Lateral rotation of Ext. surface of thigh obturator membrane Sup. Gluteal nerve Sup. Gluteal nerve Femoral nerve Femoral nerve Femoral nerve Femoral nerve Obturator nerve Obturator + sciatic nerve Obturator nerve POSTERIOR Semitendinosus Extend thigh + flex leg Ischial tuberosity Proximal media tibia Semimembranosus Extend thigh + flex leg Ischial tuberosity Biceps femoris Extend thigh + flex leg Long head: ischial tuberosity Short head: linea aspera Proximal medial tibial condyle Long head: head of fibula Short head: fibula and lateral tibia LEG ANTERIOR Tibialis anterior Dorsiflex + invert Proximal lateral tibia condyle Extensor hallucis longus Dorsiflex + extend big toe Extensor digitorum longus Dorsiflex + extend toe Medial fibula + interosseous membrane Lat. Tibia condyle + sup. ¾ of fibula Fibularis tertius Dorsiflex + eversion Distal part of fibula (medial surface) Plantarflex / stabilisation when standing Foot eversion Proximal lat. Fibula (head) Plantarflexion (foot) + knee flexion Plantarflexion LATERAL Fibularis longus Fibularis brevis POSTERIOR Gastrocnemius Soleus Plantaris Popliteus (oblique) Flexor digitorum longus Flexor hallucis longus Tibialis posterior Plantarflexion + knee flexion Weak knee flexor, unlocks knee by weak internal rotation Toe flexion (4) Sciatic (tibial) nerve Sciatic (tibial) nerve Long head: Sciatic (tibal) Short head: Sciatic (fibial) Med. + inf. v surfaces Deep fibular nerve of medial cuneiform and base of 1st metatarsal Base of distal Deep fibular nerve phalanx of big toe Base of middle + distal phalanges (4 smaller toes) Base of 5th metatarsal Deep fibular nerve Plantar medial cuneiform, 1st metatarsal base Base of 5th metatarsal Superficial fibular nerve Lateral + medial femoral condyles Post. Fibular head + soleal line of tibia Lat. Femoral supracondylar ridge Lateral femoral condyle Calcaneus via calcaneal tendon Calcaneus via calcaneal tendon Calcaneus via calcaneal tendon Proximal posterior tibia Tibial nerve Posterior tibia Bases of distal phalanges Base of distal phalanx of big toe Plantar surface of cuneiform + navicular joints + bases of metatarsals 2-4 Tibial nerve Distal lateral fibula Big toe flexion Posterior fibula Plantarflexion + invert foot Posterior tibia + fibula, and interosseous membrane Deep fibular nerve Superficial fibular nerve Tibial nerve Tibial nerve Tibial nerve Tibial nerve Tibial nerve FOOT – DORSUM Extensor digitorum brevis Superolateral surface Base of proximal of calcaneus phalanx of great toe + lat. sides of tendons of extensor digitorum longus Superolateral surface Base of proximal of calcaneus phalanx of great toe + lat. sides of tendons of extensor digitorum longus Deep fibular nerve Abduct + flex great toe at MTP Medial process of calcaneal tuberosity Medial plantar nerve (from tibial) Flexor digitorum brevis Flex lateral 4 toes at PIP Medial process of calcaneal tuberosity Abductor digiti minimi Abduct little toe at MTP Lateral + medical processes of calcaneal tuberosity Medial side of base of prox. Phalanx of great toe Sides of plantar surface of middle phalanges Lateral side of base of prox. Phalanx of little toe Flex toes (4) w/ flexor digitorum longus tendon Medial surface of calcaneus + lat. process of calcaneal tuberosity 1st: med. Side of tendon of FDL 2-4: adj. surfaces of adj. tendons of FDL Lat. side of flexor digitorum longus tendon Lat. plantar nerve from tibial nerve Medial free margins of extensor hoods of toes 2-5 1st: med. Plantar nerve (from tibial) 2-4: lat. Plantar (from tibial) Plantar surface of cuboid + lat. Cuneiform; tendon of tibialis posterior Transverse head: ligaments ass. w/ MTP joints of lateral 3 toes Oblique: bases of metatarsals 2-4 Base of metatarsal 5 Lat. + med. Sides of Med. plantar base of prox. Phalanx nerve (from tibial) of great toe Extensor hallucis brevis FOOT - SOLE 1ST LAYER Abductor hallucis 2ND LAYER Quadratus plantae Lumbricals 3RD LAYER Flexor hallucis brevis Adductor hallucis Extension of MTP joint of big toe + extension of others Extends MTP joint of big toe + 3 middle toes Flexion of MTP joint + extension of interphalangeal joints Flex MTP joint of great toe Adduct great toe at MTP joint Plantar interossei Medial plantar nerve (from tibial) Lateral plantar (from tibial) Lat. Side of base of prox. Phalanx of great toe Lat. Plantar nerve (from tibial) Lat. Side of base of prox. Phalanx of little toe Lat. Plantar nerve (from tibial) Abduction of toes (4) at Sides of adjacent MTP metatarsals Extensor hoods + bases of prox. Phalanges (2-4) Adduction of toes (4) at Medial sides of MTP metatarsals of toes 3-5 Extensor hoods + bases of prox. Phalanges (3-5) Lateral plantar nerve (from tibial) 1st + 2nd: also deep fibular Lat. Plantar nerve (from tibial) Flexor digiti minimi Flex little toe at MTP brevis joint 4TH LAYER Dorsal interossei Deep fibular nerve