muscles of the arm and hand - ngkin.files.wordpress.com€¦ · 3 layers of muscles: deep,...
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Muscles of the Arm and HandPSK 4U
MR. S. KELLY
NORTH GRENVILLE DHS
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Biceps BrachiiOrigin: scapula
Insertion: radius, fascia of forearm (bicipital aponeurosis)
Action: supination and elbow flexion
Innervation: musculocutaneous
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BrachialisOrigin: humerus
Insertion: ulna
Action: elbow flexion (assists biceps brachii by instigating this movement)
Lies deep to biceps brachii
Innervation: musculocutaneous, radial
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Triceps Brachii (long, medial, and lateral heads)
Origin: scapula and posterior humerus
Insertion: proximal posterior ulna
Action: elbow extension; shoulder extension and adduction (when elbow is extended)
Innervation: axillary, radial
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Forearm Muscles: acting on elbow, wrist, and finger joints
FLEXOR-PRONATORS
Originate via a common flexor tendon from medial epicondyle of humerus (common flexor origin)
EXTENSOR-SUPINATORS
Originates via common extensor tendon from lateral epicondyle of humerus (common extensor origin)
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More on the Forearm3 layers of muscles: deep, intermediate, and superficial
A layer of fascia separates deep layer of muscles from intermediate and superficial
Flexor retinaculum, aka transverse carpal ligament: roof of the carpal tunnel
Flexor tendons and median nerve pass through the carpal tunnel
FR increases effectiveness of tendons by preventing bowstringing, changing direction of forces when necessary
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SupinatorOrigin: lateral epicondyle of humerus, ulna, radial collateral ligament
Insertion: proximal 1/3 of radius
Action: prime mover in supination of forearm (aided by biceps brachii)
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PronatorsPRONATOR QUADRATUS
Origin: distal anterior ulna
Insertion: distal anterior radius
Action: prime mover in pronation of the forearm (assisted by pronator teres)
Innervation: median
PRONATOR TERES
Origin: common flexor tendon, proximal ulna
Insertion: lateral radius
Action: pronation of forearm, weak elbow flexor
Innervation: median
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Pronators
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Flexor Digitorum ProfundusOrigin: ulna, interosseus membrane
Insertion: phalanges, after penetrating tendons of FDS
Action: flexes fingers 1-4
Innervation: anterior interosseus, ulnar
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Flexor Policis LongusOrigin: radius, interosseus membrane
Insertion: distal phalanx of thumb
Action: thumb flexion
FPL is unique to humans: not present (or does very little) in other primates
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Flexor Digitorum SuperficialisOrigin: ulnar collateral ligament of elbow, CFO
Insertion: intermediate phalanges of 4 fingers
Action: flexes PIP, MP, wrist joints
Innervation: median
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Palmaris LongusAbsent in about 14% of population
Absence does not affect grip strength
Disadvantage: absence means lack of popular source for tendon graft
Test: touch pads of thumb and 5th
finger + flex wrist… 2 or 3 tendons?
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BrachioradialisOrigin: lateral humerus
Insertion: styloid process of radius
Action: a flexor that also works to pronate AND supinate (in supination, it pronates as it flexes, and vice versa)
Innervation: median
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Abductor Policis LongusOrigin: ulna, radius, interosseus membrane
Insertion: 1st metacarpal, trapezium, abductor policis brevis tendon
Action: abduction of thumb, keeps trapezium stable with APB
Innervation: radial
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Extensor DigitorumOriginates on lateral epicondyle
Inserts on medial 4 digits
Extends phalanges and wrist joint
Insertion splits on 4 digits to medial and lateral sides.
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Anatomical Snuff BoxExtensor policis longus tendon (posterior border)
Anterior (lateral) border: extensor policis brevis and abductor policislongus
Skeletal components: scaphoid and trapezium
Importance: blood supply of scaphoid is retrograde, therefore proximal fractures require attention to prevent necrosis
Name: comes from the practice of placing powdered tobacco on this surface for sniffing. Don’t ask why… almost sounds as stupid as vaping, no?
Significance (other than arcane tobacco practices): pain and tenderness in this area are often indicative of scaphoid or other carpal fractures.
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Anatomical Snuff Box borders
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Primary Hand Grip Muscles (identification only)