Muscles of Upper Limb

I. Muscles Connecting Upper Limb To Axial Skeleton

Muscle Origin Insertion Nerve Supply Action

1. Trapezius • Medial 1/3 of superior nuchal line. • Poterior border of • Spinal • Elevation of shoulder by
• External occipital protuberance. lateral 1/3 of clavicle. accessory upper fibres .
• Ligamentum nuchae • Media border of nerve. • Rotation of glenoid cavity
• Spinous process of C7. acromion process. upwards during abdction
• Spinous processes of all thoracic vertebrae • The upper lip of crest of shoulder by upper &
of spine of scapula lower fibres.
• Retraction of the scapula
by middle fibers
2. Pectoralis a) Clavicular head: front of medial 2/3 of clavicle. • Lateral lip of bicipital • Lateral and • Clavicular head :Flexion
major b) Sterno-Costal head: front of sternum, upper 6 costal groove . medial of shoulder joint .
cartilages and external abdominal oblique aponeurosis pectoral • Sternocostal head :
. nerves Adduction and medial
* N.B: rotation of shoulder joint
. (play important role in
.In the deltopectoral groove (between clavicular head & swimming).
deltoid muscle ) runs cephalic vein .
• Its lower border form the anterior fold of the axilla .

3. Pectoralis • Outer surface of 3,4,5 ribs • Coracoid process • Medial • Draws the scapula
minor * N.B: 1. It divides axillary artery into 3 parts. Pectoral downwards and forwards
2. It divides axillary lymph nodes into 3 levels. nerve
 1. Muscles Connecting Upper Limb to axial skeleton

(Continue)

Muscle Origin Insertion Nerve Supply Action

4. Serratus • Outer surface of upper 8 ribs. • Anterior aspect of • Nerve to serratus anterior • Protraction of scapula .
anterior medial border of (Long Thoracic nerve ). • Rotates the glenoid cavity upwards
scapula. during abduction of shoulder joint.
• Keep the scapula in contact with the
chest wall (its paralysis leading to
winging of scapula)

5. Latissimus • Posterior part of iliac crest . • Floor of bicipital • Nerve to latissimus dorsi. • Adduction, extension and medial
dorsi • Spinous process of all lumbar groove. rotation of shoulder ( play an important
vertebrae. role in swimming ).
• Spinous process of lower 6
thoracic vertebrae.
• Thoraco-lumbar fascia
• Lower 3 ribs.
• Dorsal surface of inferior angle
of scapula

6- Subclavius 7- Levator scapulae . 8- Rhomboids minor . 9- Rhomboids major .

 II . Muscles of Scapular Region

Muscle Origin Insertion Nerve Supply Action

1- supraspinatus. • Supraspinous fossa • Upper facat of • Suprascapular • Initiation of abduction of shoulder
greater tuberosity nerve . ( 0 – 15 degree ).
of humerus
2- Infraspinatus. • Infraspinous fossa • Middle facet of • Suprascapular • Lateral rotation of shoulder.
greater tuberosity. nerve .
3- Teres minor • Upper 2/3 of dorsal surface of • Lowest facet of the • Circumflex • Adduction & lateral rotation of
lateral border of scapula. greater tuberosity ( axillary) nerve . shoulder.
4- Ters major • Lower 1/3 of dorsal surface of • Medial lip of • Lower • Adduction , extension and medial
lateral border of scapula. bicipital groove subscapular rotation of shoulder ( play an
* N.B: lower border of this muscle is nerve . important role in swimming like
related to the end of axillary artery & latissmus dorsi ) .
begining of brachial artery.
5- Subscapularis • Subscapular fossa . • Lesser tuberosity of • Upper and lower • Adduction and medial rotation of
* N.B. Anterior surface of this muscle humerus subscapular shoulder.
is related to subscapular vesseles & nerves .
lymph nodes.
6- Deltoid • Anterior border of lateral 1/3 of • Deltoid tuberosity •Circumflex a) Anterior fibres : flexion & medial
clavicle . of humerus ( axillary) nerve rotation of shoulder.
• Lateral border of acromion process. • Injury of axillary b) Posterior fibres: extension & lateral
• Lower border of crest of spine of nerve leading to rotation of shoulder.
scapula. flat shoulder. c) Middle fibres: Abduction of shoulder (
15 -90 degree )
 III. Muscles of Arm

A. Muscles of front of arm

Muscle Origin Insertion Nerve supply Action.

1-Bicepe Brachii a. Long head: supraglenoid • Postreior part of radial • All muscles of front of • Flexion of supinated
tubercle (intra-capsular extra- tulerosity & deep fascia of arm are supplied by forearm .
synavial). upper part of medial side of musculo-cutaneous • Supination of flexed
b. Short hesd: coracoid process. forearm . nerve exept lateral ½ of pronated forearm at
radioulnar joints.
• Week flexor of shoulder .
2-Caracobrachialis • Coracoid process (with short head •Middle of medial surface of brachialis (supplied by • Flexion & adduction of
of biceps) humerus radial nerve i.e double shoulder.
3- Brachialis • Lower 1/ 2 of humerus • Ulnar tuberosity. nerve supply ) • Main flexor of elbow.

B. Muscle of Back of Arm

Muscle Origin Insertion Nerve supply Action.

Triceps Brachii a. Long head: infra-glenoid tubrcle • Superior surface of • Radial nerve ( long head is • Main extensor of elbow.
(extra-capsular) olecranon process supplied in axilla while
b. Lateral head : Back of shaft of of ulna . lateral & medial heads are
humerus above spiral groove. supplied in spiral groove).
c. Medial head: Back of shaft of humerus
below spiral groove.
 IV. Muscles of Forearm.

A. Muscles of Front of Forearm (Flexors).

a. Superficial group

• All muscles arise from the front of medial epicondyl of humerus (Common flexor origin i.e. C.F.O.)
• All muscles arise by 2 heads except flexor carpi radialis and palmaris longus.
• All muscles are supplied by median nerve except flexor carpi ulnaris which is supplied by ulnar nerve .
• Common action : flexion of elow and flexion of wrist (except pronator teres).
•The muscles are arranged from lateral to medial as follows:

Muscle Origin Insertion Action.

1- Pronator teres a) Humeral head: from lower part of medial • Rough area in the middle of • Flexes elbow & pronation of
supracondylar ridg & C.F.O. lateral surface of radius (Pronator forearm at radioulnar joints
b) Ulnar head: medial border of coronoid process. tuberosity) (main action) .

2- Flexor carpi • C.F.O. • Base of 2 nd & 3 rd metacarpal • Flexes elbow, flexion & radial
radialis bones. deviation of the wrist. This muscle
with number 5 are main flexors of
wrist

3- Palmaris longus •C.F.O , may be abscent. It has a long tendon which • Palmar aponeurosis • Common action .
can be used as a tendon graft.
4- Flexor a) Humero-ulnar head: C.F.O. & medial border of • By 4 tendons into sides of middle • Flexes elbow, wrist ,
digitorum coronoid process. phalanges of medial 4 fingers metacarpophalangeal & proximal
superficialis b) Radial head: anterior oblique line of radius i.e. it interphalangeal joints of medial
has 2 heads arising from 3 bones. 4 fingers
5- Flexor carpi a) Humoral head: C.F.O. • Pisiform bone & base. of 5th • Flexes elbow, flexion & ulnar
ulnaris b) Ulnar head : From medial border of olecranon & metacarpal bone deviation of the wrist (main
upper 2/3 of posterior border of ulna action). One of main flexor of
wrist .

io
 A. Muscles of Front of Forearm (Flexors).

b. Deep group

• Common origin : interosseous membrane and upper 2/3 of corresponding bone ( except pronator quadrates )

• All muscles are supplied by anterior interosseous nerve (branch of median nerve ) except medial 1/2 of Flexor digitorum profundus which is
supplied by Ulnar nerve.
• Common action : Flexion of wrist and all joints of fingers related( except pronator quadrates ) .

Origin Insertion Action.

1- Flexor digitorum • Upper 2/3 of anterior & • By 4 tendons into base of • Flexion of wrist & all joints of medial 4 fingers.
profundus medial surface of shaft of terminal phalanges of medial
ulna & interosseous 4 fingers.
membrane.
2- Flexor pollices • Upper 2/3 of anterior surface • Base of terminal phalanx of • Flexion of wrist & all joints of thumb.
longus. of shaft of radius & thumb.
interosseous membrane .
3- Pronator • Lower 1/4 of front of ulna • Lower 1/4 of front of radius • Pronation at radioulnar joints .
quadratus.
 B. Muscles of Back of Forearm (Extensors).

a. Superficial group

• Most of these muscles arises from the back of lateral epicondyle of the humerus i.e. common extensor origin (C.E.O) except brachioradialis and
extensor carpi radialis longus .
• All these muscles are supplied by posterior interosseous nerve (a branch of radial nerve ) except brachioradialis and extensor carpi radialis
longus which are supplied by radial nerve.
• Common action : Extension of elbow and wrist ( except brachioradialis )
• Extensor carpi radialis longus & brevis and extensor carpi ulnaris are the main extensor of wrist .
• These muscles are arranged from lateral to medial as follows:

Muscle Origin Insertion Action

1- Brachioradiaslis. • Upper 2/3 of lateral • Lateral surface of radius above the • Intiate pronation &supination to midprone
supracondylar ridge styloid process . position at radioulnar joints .
• Flexion of elbow in the midprone position.
2- Extensor carpi radiaslis longus • Lower 1/3 of lateral • Base of 2 nd. metacarpal bone • Common action +radial deviation
supracondylar ridge ( abduction ) of wrist.
3- Extensor carpi radialis brevis. • C.E.O. • Base of 3 rd. metacarpal bone • As No. 2.
4- Extensor digitorum. • C.E.O. • By 4 tendons into extensor • Common action + extension of metacarpo-
expansion on dorsum of proximal phalangeal joints of medial 4 fingers .
phalanges of medial 4 fingers.
5- Extensor digiti minimi. • C.E.O. • Extensor expension of little finger. • Common action + Extensor of metacarpo-
phalangeal joints of little finger.
6. Extensor carpi ulnaris. • C.E.O. • Base of 5 th. matacarpal bone • Common action + ulnar deviation
( adduction ) of the wrist.
7. Anconeus • Separately from • Lateral aspect of back of olecranon • Assists triceps in extension of elbow .
lateral epicondyle .
 b. Deep group
• All these muscles are supplied by posterior interosseous nerve ( branch of radial nerve ) .
• These muscles are arranged from above downwards as follows :

• All arises from back of interosseous membrane and back of shaft of radius or back of shaft of ulna ( except supinator ) .

Muscles Origin Insertion Action.

1- Supinator • Supinator fossa & supinator crest of • Anterior, lateral & posterior • supination of forearm at radioulnar joints.
ulna. surface of upper 1/3 of radius
2- Abductor pollices • Posterior surface of radius , ulna & • Base of 1st . metacarpal bone. • Abduction of thumb .
longus interosseous membrane.
3- Extensor pollices • Posterior surface of radius & • Base of proximal phalanx of • Extension of proximal phalanx of thumb.
brevis interosseous membrane. thumb.
4- Extensor pollices • Posterior surface of ulna & interossous • Base of terminal phalanx of • Extension of all joints of thumb.
longus membramne. thumb.
5- Extensor indicis • Posterior surface of ulna. • Extensor expansion of index • Extension of proximal phalanx of index
finger. finger.
 V. Muscles of hand

A. Muscles of Thenar Eminence

• Common origin of thenar muscles are lateral part of flexor retinaculum, scaphoid & trapezium.
• All are supplied by median nerve except adductor pollices which is supplied by ulnar nerve .
• All are muscles of thumb and inserted in the base of proximal plalanx of thumb except opponens pollices .

Muscle Origin Insertion Action.

1- Abductor pollices brevis • Common origin • Common insertion • Abduction of thumb.
(Superficial & lateral)

2- Flexor pollices brevis • Common origin • Common insertion • Flexion of proximal phalanx of thumb.
(Superficial & medial) i.e metacarpo-phalangeal joint of the
thumb
3- Opponens pollices • Common origin • 1 st. metacarpal bone. • Opposition of thumb against other
(deep to No. 1 & 2) finger.

4- Adductor pollices. •It has 2 heads: • Common insertion • Adduction of thumb.

(Most medial muscle) a)Transverse head: from 3rd .
metacarpal bone.
b)Oblique head: from 2nd. &3 rd.
metacarpal bone.
 B. Muscles of hypothenar eminence

• Common origin: Medial part of flexor retiaculum & pisiform bone & hook of hamate.
• All are muscles of little fingers .
• Common insertion : all inserted in base of proximal phalanx of little finger ( except opponens digiti minim ) .
• All muscles are supplied by ulnar nerve .
Muscle Origin Insertion Action
1- Abductor digiti minimi • Common origin • Common insertion • Abdution of little finger .
2- Flexor digiti minimi • Common origin • Common insertion • Flexion of proximal phalanx of little finger.
3- Opponens digiti minim • Common origin • 5 th metacarpal bone • Pull. 5 th. metacarpal bone forewards.

Lumbrical muscles & Interossei

• All muscles are supplied by ulnar nerve except lateral 2 lumbricals are supplied by media nerve .
• Common insertion : Extensor expansion of medial 4 fingers then extend to the back of terminal phalanges of medial 4 fingers .
• Common action: put the hand in writting position (flexion of metacarpo-phalangeal joint & extension of interphalangeal joints of medial 4
fingers )
Origin Insertion Action
1. 4 Lumbricals • Tendons of flexor • Common insertion • Common action
digitorum profundus
2. 3 Palmar & 4 dorsal • Sides of metacarpal • Common insertion • Common action .
interossei bones. • palmar interossei : Adduction of index ,
ring & little fingers .
• dorsal interossei :abduction of middle 3
fingers .