Shoulder Muscle + Action
Elbow Flexion
Biceps, Brachialis, Brachioradialis
Forearm Supination
Biceps, Supinator
Wrist Flexion
Flexar Carpi Radialis & Ulnaris, Palmaris Longus
Wrist Extension
Extensor Carpi Radialis (Longus & Brevis) Extensor Carpi Ulnaris
ADDuction
Latissimus Dorsi Teres Major Infraspinatus Teres Minor Pectoralis Major Triceps Brachii
Shoulder Extension
Latissimus Dorsi, Teres Major, Posterior Deltoid, Pectoralis Major
Shoulder Internal Rotation
Latissimus Dorsi, Teres Major, Subscapularis, Pectoralis Major, Anterior Deltoid
Scapular Elevation
Upper Trapezius, Levator Scapula, Rhomboids Max/Min
Scapular Upward Rotation
Upper and Lower Tapezius, Serratus Anterior
trapezius M
innervation: Spinal Accessory CN XI Consists of 3 Parts MIDDLE: Origin: Spinous process T1-5 Insertion: Spine of scapula Action: aDDuction and Elevation of Scapula (aDDES)
axillary lymph nodes
the axillary lymph nodes are located in the axilla. Swollen lymph nodes are usually a sigh of inflammatory process in the proximity.
Axilla
A fat filled, pyramidal-shaped space between the upper arm and chest wall. It saves a a passageway for the brachial plexus and axillary vessels traveling between the neck and the upper extremity. Brachial artery: lowest border of the teres major
Shoulder Flexion
Anterior Deltoid, Pectoralis Major, Coracobrachialis, Biceps Brachii
ABDuction
Deltoid Supraspinatus
Medial Rotation - Internal Rotation - antagonists on Lateral Rotation
Deltoid (anterior) Latissimus Dorsi Teres Major Subscapularis Pectoralis Major
Horizontal ADDuction - Antagonists on aBDuction
Deltoid (anterior) Pectoralis Major
Flexion - antagonists on extension
Deltoid (anterior) Pectorals major (upper) Biceps Brachii Coracobrachialis Glenohumeral joint
Horizontal ABDuction - Antagonists on aDDuction
Deltoid (posterior)
Extension - Antagonists of flexion
Deltoid (posterior) Latissimus dorsi Teres Major Pectoralis major (lower) Triceps Brachii (long Head)
Extension
Deltoid (posterior) Latissimus dorsi Theres major Pectoralis major Triceps brachii (long head)
Wrist Ulnar Deviation
Flexor Capi Ulnaris, Extensor Carpi Unlaris
Wrist Radial Deviation
Flexor Carpi Radialis, Extensor Carpi Radialis
levator scapulae
INNERVATION: Dorsal Scapular Nerve Origin: Transversal process of C1-5 Insertion: Superior Angle of Scapula (SJ15) down the superior medial border to the spine of the scapula Action: Elevation and Downward rotation of the scapula (ElDoRo)
Shoulder External Rotation
Infaspinatus, Teres Minor, Posterroir Deltoid
rhomboid minor
InnerationL Dorsal Scapular nerve Origin: Spinous process C7-T1 Insertion: Medital Border of scapula AT scapular spine Action: aDDuction and Downward Rotation of the scapula (aDDaDRo)
posterior deltoid
Innervation: Accessory Nerve CN XI Origin; Spine of scapula Insertion: Deltoid Tuberosity Action: aBduction, Extension, lateral rotation of the arm
Anterior deltoid
Innervation: Accessory Nerve CN XI Origin; lateral 1/3 of clavicle Insertion: deltoid tuberosity Action: aBDuction, Flexion, Medial Rotation of the ARM
teres minor
Innervation: Auxillary nerve CN XI Origin: Superior 2/3 of lateral border of scapula Insertion: Greater tuberosity of humerus Action: Lateral Rotation, aDDuction and Extension of the arm.
Middle deltoid
Innervation: Axillary Nerve CN XI Origin: Acromion process Insertion: Deltoid tuberosity Action: aBDuction of the arm
rhomboid major
Innervation: Dorsal Scapular Nerve Origin: Spinous Process T2-T5 Insertion: Medial Border of scapula INTERIOR to scapular spine Action: aDDuction and Downward Rotation of the scapula (aDDaDRo)
serratus anterior
Innervation: Long THoracic Nerve Origin: ribs 1-8/9 Insertion: Anterior surface of the medial border and inferior angle of the scapula Action: aBDuction and ^Upward rotation of the scapula; when the scapula is fixed, it elevates ribs (let the pt reach out as if for a hug)
teres major
Innervation: Lower subscapular nerve Origin: inferior angle and 1/3 of lateral border of scapula, Insertion: bicipital groove of humerus Action: aDDuction, EXtension, Medial Rotation of the arm (aDDEx MeRo) Palpation: Latissimus dorsi and theres major both compromise the posterior portion of the axilla and can be palpated together at the posterior axillary fold.
biceps brachii
Innervation: Musculocutaneous nerve Origin: Short Head: Coracoid process of scapula Long Head: Supraglenoid tubercle of scapula Action: Flexion arm/elbow, Supinate the forearm
coracobrachialis
Innervation: Musculocutaneous nerve Origin: Coracoid process of scapula Insertion: middle of medial shaft of humerus Action:Flexion,, aDDuction of the arm (FlaDD)
triceps brachii
Innervation: Radial Nerve Origin: Long Head: Infraglenoid tubercle of scapula Middle Head: Posterior surface of the distal 2/3 of the humerus Lateral Head: Posterior surface of proximal 1/2 of the humerus Insertion: olecranon fossa of ulna Action: Extension of arm/elbow, Adduction shoulder
supraspinatus
Innervation: Suprascapular nerve Origin: Suproaspinous fossa Insertion: greater tuberosity of humerus Action: initial aBDuction of the arm
infraspinatus
Innervation: Suprascapular nerve Origin: infraspinatous fossa Insertion: greater tuberosity of humerus Action:lateral rotation and adduction of the arm
subscapularis
Innervation: Upper and Lower Subscapularis nerve Origin: Subscapularis fossa (anterior or coastal surface) of the scapula Insertion: Lesser tuberosity of humerus Action:Medial Rotation of the arm
pectoralis major
Innervation: lateral/medial pectoral nerves Origin: medial 2/3 of clavicle, sternum coastal cartilage of ribs 1-6 Insertion: bicipital groove and greater tubercle of humerus Action: Flexion, aDDuction, Medial Rotation of the arm (FlaDD MeRo)
pectoralis minor
Innervation: medial pectoral nerve Origin: ribs 3-5 at the costal cartilage Insertion: coracoid process of scapula Action: Deprsssion and Downward rotation of scapula. Stabilizes shoulder anteriorly. Elevates ribs 3-5 during forced respiration (COPD) when scapula is fixed
latissimus dorsi
Innervation: thoracodorsal nerve Origin: Spinous process of T7-L5, posterior superior surface of sacrum, thoracolumbar fascia, iliac crest, inferior three or four ribs Insertion: bicipital groove of humerus Action: aDDuction, EXtension, Medial Rotation of the arm (aDDEx MeRo) Palpation: Latissimus dorsi and theres major both compromise the posterior portion of the axilla and can be palpated together at the posterior axillary fold.
sternoclavicular joint
It is the articulation between the sternal end (manubrium) of the clavicle and the sternum. Unlike the slender, smooth AC joint, the sJ joint is wedge shaped and contains a small, impalpable fibrous disk. At rest, on;y the inferior portion of the sternal end makes contact with the sternum. When the clavicle is elevated, the sternal end pivots on the sternum.
Prime Movers
Latissimus dorsi, Pectoralis major, Pectorals minor, Deltoids, Triceps
Downward Rotation
Levator Scapulae, Rhomboid Major/Minor
Scapular Depression
Lower Trapezius, Pectoralis Minor, Serratus Anterior
Shoulder Abduction
Middle Deltoid, Suprascapularis
Scapular Retraction
Middle Trapezius, Rhomboids
Flexion
Pectoralis Major Corachobrachialis, Deltoid Anterior Biceps Brachii
Shoulder Horizontal Adduction
Pectoralis Major, Anterior Deltoid
Shoulder Adduction
Pectoralis Major, Latissimus Dorsi
Stabilizes Shoulder interiorly
Pectoralis Minor
Intertubercular Groove Muscles:
Pectoralis major, Teres major, Latissimus doorsi. This group of important prime movers of the shoulder joint shares numerous structural and functional features in common. During development two of the muscles, the pectoralis major and latissimus dorsi, migrated back onto the trunk wall to increase their mechanical efficiency and leverage at the shoulder joint. These are the two largest muscles of the superior limb. Functionally, they are powerful adductors and medial rotators of the humerus. In addition, they attach to the intertubercular groove of the humerus. The muscles also form the anterior and posterior walls of the axilla, or armpit. The large pectoralis major forms the anterior wall of the axilla, while the sheet-like latissimus dorsi and thick, round teres major form the posterior axillary wall.
Medial Rotation
Pectorals Major, Deltoid Anterior Theres Major Subscapularis Lattissimus Dorsi
Shoulder Muscles
Pectorals Major, Coracobrachialis, Deltoid, Supraspinatus, Infraspinatus, Teres minor, Subscapularis, Teres Major, Latissimus Dorsi
Shoulder Horizontal Abduction
Posterior Deltoid, Infraspinatus, Teres Minor
Forearm Pronation
Pronator Teres, Pronator Quadratus
Downward rotation of the Scapula
Rhomboid major Rhomboid Minor Levator Scapula Pectoralis Minor
Scapular Downward Rotation
Rhomboids, Levator Scapulae, Pectoralis Minor
Rotator cuff muscles
SITS: suprascapularis, Infrascapularis, teres minor, subscapularis Those muscles maintain an important structural and functional group that plays a critical role in stabilizing the shoulder joint. The four muscles have thick, flat tendons of insertion on the greater and lesser tubercles of the humerus and form a strong cuff around all but the inferior aspect of the glenohumeral (shoulder) joint. These tendons are intimately applied to the fibrous membrane of the joint capsule. Individually, each muscle contributes little to the total range of motion of the glenohumeral joint and as the group name indicates they produce 1. axial rotation movements of the joint. However, the muscles play a prominent role in stabilizing the joint and positioning the head of the humerus in the glenoid cavity. The coordinated function of these muscles positions and stabilizes the shoulder joint to provide optimal efficiency of the large primary movers of this joint. When the rotator cuff muscles are compromised by injury, the shoulder joint loses stability and becomes highly susceptible to dislocation.
aBDuction
Serratus Anterior Deltoid A/M/P Supraspinatus
ABDduction (protraction)
Serratus Anterior, Pectoralis Minor
Scapular Protraction
Serratus Anterior, Pectoralis Minor
Pectoralis minor
Stabilizes shoulder anteriorly, and Elevates ribs 3-5 during forced respiration (COPD) or when scapula is fixed
SITS
Suporascapularis, Infrascapularis, Teres Minor, Subscapularis
Upper limb osteology
The bones of the upper limb serve as the attachment sites for muscles as well as pathways for nerves and vessels
Arm Muscles
The muscles of the arm, or brachium are contained with 2 osteofascial compartments (anterior and posterior), in which muscles generally share common attachments, joint actions, innervations and blood supplies.
Pectoral Girdle Osteology
The pectoral girdle consists of the clavicle and scapula and forms the skeletal base to the upper limb. This girdle is modestly linked to the axial skeleton via bony or ligamentous attachments and instead relies on large muscular slings to suspend it from the trunk.
Shoulder Muscle
The prime movers of the shoulder produce the largest ranges of motion of any muscle in the entire body, while the shoulder stabilizers produce very minimal motion at the point but perform critical roles in supporting and stabilizing the joint. They form 3 distinct functional groups: the rotator cuff muscles, a large shoulder cap muscle (deltoid), and the inter tubercular groove muscles.
Upper limb
The proximal end of the superior appendage, the clavicle and scapula, is the pectoral or shoulder girdle. This girdle of bones provides a broad base of support and through muscles, rather than ligaments, helps anchor the limb to the axial skeleton. The humerus forms the skeletal framework for the next region of the appendage, the brachium. Distal to the brachium is the antebrachium containing the radius and ulna. The distal most region of the superior limb is the hand consisting of a eight carpal bones, five metacarpal bones, and fourteen phalanges.
Upper limb: Arteries
The subclavian arteries supply blood to the user limbs. The subclavian arteries become the axillary arteries at the lateral border of the 1st rib, which becomes the brachial arteries at the inferior border of the theres major muscle. In the cubital fossa, the brachial artery bifurcates into the radial and ulnar arteries, which supply the forearm and hand.
Pectoral Gridle Muscles
This group of muscles is an extensive group of muscles that play an important role in anchoring the superior limb to the trunk. These muscles arise from three distinct embryonic developments that attached the scapula and clavicle to the head, vertebral column, and ribs. 1. The trapezius and sternocleidomastoid muscles anchor the superior limb to the cranium 2. Second group of muscles (serratus anterior, levator scapulae, pectoralis minor, and subclavius) anchor the superior limb to the ribs and vertebral column. 3. The final muscles in this group (rhomboideus major and minor) attach to the vertebral column. For their size, these muscles produce visibly minor movements of the skeleton, but they have a much more significant function. However, even the most basic examination of the skeleton reveals that the upper limb is only weakly united with the axial skeleton. As a result of this, the major function of these prominent muscles of the pectoral girdle is to anchor the upper limb to the axial skeleton and hold it stable so the prime movers of the limb can function optimally. The functional connections these muscles form with the head and rib cage also produce respiratory functions, which have become less obvious in the human bipedal stance.
Depresses Scapula
Trap L, Pectoralis Minor
Extending
Trapezius Pectorals Major/Minor Latissimus Dorsi
Depression - antagonists on Elevation
Trapezius (lower) Serratus Anterior Pectoralis Minor
ADDuction - antagonists on ABDuction
Trapezius (middle) Rhomboid Major Rhomboid Minr Scapulothorasic Join
Elevation - antagonists on depression
Trapezius (upper) Rhomboid Major Rhomboid Minor Levator Scapula Scapulothorasic Joint
aDDuction
Trapezius L/M, Rhomboid Minor/Major, Pectoralis Major/Minor Teres Major/Minor Corachobrachialis Infraspinatus
Lateral Flexion
Trapezius U Levator Scapulae Infraspinatus Corachobrachialis Teres Minor Deltoid Posterior
Upward Rotation
Trapezius U,/L, Serratus Anterior
Elevates Scapula
Trapezius U/M Levator Scapulae
Upward Rotation of scapula
Trapezius Upper + Lower Serratus anterior
Shoulder Girdle muscles
Trapezius, Levator Scapula, Rhomboid minor/Major, Serratus Anterior, Pectoralis Minor
Elbow Extension
Triceps, Anconeus
Upper limb: Veins
Venous blood is drained from the upper limb through superficial and deep channels. Superficial veins drain cutaneous structures and are usually singular blood channels. Deep veins are bounded by deep fascia and intermuscular septa, draining blood from osseofascial compartments and returning blood to the heart via contraction of surrounding muscles and valves.
Axilla: Structures
anterior: pectoralis major posterior: latissimus dorsi, teres major, subscapularis medial: rib cage, serratus anterior posterior: humerus and biceps brachii, coracobrachialis
basilic and cephalic veins
cephalic vein: anterolateral surface of the arm basilic vain: on the anteromedial surface of the arm. Both veins are deep
coracoclavicular joint
composed of: trapezoid and conoid ligaments Both originate over the coracoid process of the scapula to the intferior surface of the clavicle. Together they provide stability for the acromioclavicular joint and form a strong bridge between scapula and clavicle.
glenohumeral joint
he most flexible joint in the entire human body, our shoulder joint is formed by the union of the humerus, the scapula (or shoulder blade), and the clavicle (or collarbone). Commonly thought of as a single joint, the shoulder is actually made up of two separate joints - the glenohumeral and acromioclavicular joints. These two joints work together to allow the arm both to circumduct in a large circle and to rotate around its axis at the shoulder. The glenohumeral joint is a ball-and-socket joint formed between the articulation of the rounded head of the humerus (the upper arm bone) and the cup-like depression of the scapula, called the glenoid fossa. The glenoid fossa forms a very shallow socket, so the muscles, ligaments, and cartilage of the shoulder joint reinforce its structure and help to prevent dislocations. A ring of cartilage known as the labrum surrounds the glenoid fossa to extend the size of the socket while maintaining flexibility. To further reinforce the shoulder, the four muscles of the rotator cuff extend from the scapula and surround the head of the humerus to both rotate the arm and prevent dislocation.
trapezius L
innervation: Spinal Accessory CN XI Consists of 3 Parts: LOWER Origin: Spinous Process T16-12 Insertion: Spine of scapula Action: Depression, aDDuction, and ^Rotation of Scapula (DaDDURoS)
trapezius U
innervation: Spinal Accessory CN XI Consists of 3 Parts: UPPER: Origin: EOP, Superior nuchal line, C7 spinous process, Insertion: lateral third of clavicle, accordion process Action: Elevates Scapula, (ES) ^upward rotation of scapula, (UROS) Extends head/neck, (FlEx H/N) Flexes head laterally to side of contraction Rotates head and neck away from side of contraction (HANRA)
coracoacromial joint
it attaches acromion to the coracoid process of the same scapula, and creates an arch across the top of the shoulder. This arch helps to protect the rotator cuff tendons and subacromial bursa from direct trauma by the acromion. The wide band lies deep to the deltoid, yet is still accessible.
brachial plexus
medial lateral and posterior cords surrounds axillary artery
shoulder girdle
scapula, clavicle
Shoulder
scapula, humerus
acromioclavicular joint
small articulation between acromion of scapula and the lateral end of the clavicle. The anterior and superior surfaces of this thin crevice can be palpated directly.
subacromial brusa
sub deltoid bursa- fluid sacs.