Muscles O, I, A, N

8/4/2019 Muscles O, I, A, N

1/44

1

SUMMARY OF SHOULDER (GLENOHUMERAL) JOINT MOVEMENTS

AND MUSCLES PRODUCING THOSE MOVEMENTS

MOVEMENTS* MUSCLES ORIGIN INSERTION NERVE

SUPPLY

SEGMENTAL

NERVE

ROOTS**

Flexion Deltoid (anteriorfibers)

Lateral third ofposterior clavicle

Deltoid tuberosity(middle of lateral

humeral surface)

Axillary nervefrom posterior cord

of brachial plexus

C5, C6

Pectoralis major

(clavicular head)

Anterior surface

of medial half of

clavicle

Lateral lip of

bicipital

(intertubercular)

groove of humerus

Lateral pectoral

nerve from lateral

cord of brachial

plexus

C5, C6

Deltoid (middle

fibers)

Lateral margin &

superior surface of

acromion

Deltoid tuberosity

(middle of lateral

humeral surface)

Axillary nerve

from posterior cord

of brachial plexus

C5, C6

Biceps brachii

Long head

Supraglenoid

tubercle of

scapula;Posterosuperiorlabrum

Tuberosity of radius

and bicipital

aponeurosis intodeep fascia offorearm

Musculocutaneous

nerve from lateral

cord of brachialplexus

C5, C6

Biceps brachii

Short head

Tip of coracoid

process of scapula

Tuberosity of radius

and bicipital

aponeurosis into

deep fascia of

forearm

Musculocutaneous

nerve from lateral

cord of brachial

plexus

C5, C6

Coracobrachialis Tip of coracoid

process of scapula

Middle third of

medial surface of

humerus

Musculocutaneous

nerve from lateral

cord of brachial

plexus

C5, C6, C7

Extension Latissimus dorsi Posterior 1/3 ofiliac crest, T7-T12spinous processes,

thoracolumbar

fascia, lower 3-4ribs, and inferior

angle of scapula

Floor of bicipital

(intertubercular)groove of humerus

Thoracodorsal

nerve fromposterior cord of

brachial plexus

C6, C7, C8

Teres major Lower one-third

of lateral border of

scapula (dorsal

surface) near

inferior angle

Medial lip of

bicipital

(intertubercular)

groove of humerus

Lower subscapular

nerve from

posterior cord of

brachial plexus

C6, C7

Deltoid (posterior

fibers)

Spine of scapula Deltoid tuberosity

(middle of lateral

humeral surface)

Axillary nerve

from posterior cord

of brachial plexus

C5, C6

Pectoralis major

(sternocostal

head)

Anterior surface

of sternum, upper

six costal

cartilages, and

aponeurosis of

external oblique

muscle

Lateral lip of

bicipital

(intertubercular)

groove of humerus

Medial and lateral

pectoral nerves

from medial and

lateral cords of

brachial plexus

C7, C8, and T1

TricepsLong head

Infraglenoidtubercle of

scapula

Olecranon processof ulna

Radial nerve fromposterior cord of

brachial plexus

C6, C7, C8


2/44

2

Abduction Deltoid (middlefibers)

Lateral margin

and superior

surface of

acromion

Deltoid tuberosity

(middle of lateral

humeral surface)

Axillary nerve

from posterior

cord of brachial

plexus

C5, C6

Supraspinatus Supraspinous

fossa of scapula

Superior facet of

greater tubercle of

humerus; capsule

of shoulder joint

Suprascapular

nerve from upper

trunk of brachial

plexus

C5, C6

Deltoid (anterior

and posterior

fibers)

Lateral third of

posterior clavicle;

Spine of scapula

Deltoid tuberosity

(middle of lateral

humeral surface)

Axillary nerve

from posterior

cord of brachial

plexus

C5, C6

Infraspinatus Infraspinous

fossa of scapula

Middle facet of

greater tubercle of

humerus; capsule

of shoulder joint

Suprascapular

nerve from upper

trunk of brachial

plexus

C5, C6

Subscapularis Subscapular fossa Lesser tubercle of

humerus

Upper and lower

subscapular nerves

from posterior

cord of brachial

plexus

C5, C6

Adduction Deltoid(posterior fibers)

Spine of scapula Deltoid tuberosity(middle of lateral

humeral surface)

Axillary nervefrom posterior

cord of brachial

plexus

C5, C6

Pectoralis major

(sternocostal

head)

Anterior surface

of sternum, upper

six costal

cartilages, and

aponeurosis of

external oblique

muscle

Lateral lip of

bicipital

(intertubercular)

groove of humerus

Medial and lateral

pectoral nerves

from medial and

lateral cords of

brachial plexus

C7, C8, and T1

Latissimus dorsi Posterior 1/3 of

iliac crest, T7-

T12 spinous

processes,

thoracolumbar

fascia, lower 3-4

ribs, and inferior

angle of scapula

Floor of bicipital

(intertubercular)

groove of humerus

Thoracodorsal

nerve from

posterior cord of

brachial plexus

C6, C7, C8


of lateral border

of scapula (dorsal

surface) near

inferior angle

Medial lip of

bicipital

(intertubercular)

groove of humerus

Lower subscapular

nerve from

posterior cord of

brachial plexus

C6, C7

Triceps

Long head

Infraglenoid

tubercle of

scapula

Olecranon process

of ulna

Radial nerve from

posterior cord of

brachial plexus

C6, C7, C8

Corachobrachialis Tip of coracoid

process of

scapula

Middle third of

medial surface of

humerus

Musculocutaneous

nerve from lateral

cord of brachial

plexus

C5, C6, C7


3/44

3

Transverse

(Horizontal)

Abduction

(Extension)

Deltoid

(posterior fibers)


(middle of lateral

humeral surface)

Axillary nerve

from posterior

cord of brachial

plexus

C5, C6


iliac crest, T7-

T12 spinous

processes,

thoracolumbar

fascia, lower 3-4

ribs, and inferior

angle of scapula

Floor of bicipital

(intertubercular)

groove of humerus

Thoracodorsal

nerve from

posterior cord of

brachial plexus

C6, C7, C8


of lateral borderof scapula (dorsal

surface) near

inferior angle

Medial lip of

bicipital(intertubercular)

groove of humerus

Lower subscapular

nerve fromposterior cord of

brachial plexus

C6, C7


fossa of scapula

Middle facet of

greater tubercle of

humerus; capsule

of shoulder joint

Suprascapular

nerve from upper

trunk of brachial

plexus

C5, C6

Teres minor Upper two-thirds

of lateral border

of scapula

Inferior facet of

greater tubercle of

humerus; capsule

of shoulder joint

Axillary nerve

from posterior

cord of brachial

plexus

C5, C6

Transverse

(Horizontal)

Adduction(Flexion)

Pectoralis major

(sternocostal and

clavicular heads)

Anterior surface

of sternum, upper

six costal

cartilages, and

aponeurosis of

external oblique

muscle; Anterior

surface of medial

half of clavicle

Lateral lip of

bicipital

(intertubercular)

groove of humerus

Medial and lateral

pectoral nerves

from medial and

lateral cords of

brachial plexus

C5, C6, C7, C8,

and T1

Deltoid (anterior

fibers)

Lateral third of

posterior clavicle

Deltoid tuberosity

(middle of lateral

humeral surface)

Axillary nerve

from posterior

cord of brachial

plexus

C5, C6

Corachobrachialis Tip of coracoid

process of

scapula

Middle third of

medial surface of

humerus

Musculocutaneous

nerve from lateral

cord of brachial

plexus

C5, C6, C7

Biceps brachii

Long head

Supraglenoid

tubercle of

scapula;

Posterosuperior

labrum

Tuberosity of

radius and bicipital

aponeurosis into

deep fascia of

forearm

Musculocutaneous

nerve from lateral

cord of brachial

plexus

C5, C6

Biceps brachiiShort head

Tip of coracoidprocess of

scapula

Tuberosity ofradius and bicipital

aponeurosis into

deep fascia of

forearm

Musculocutaneousnerve from lateral

cord of brachial

plexus

C5, C6


4/44

4

Lateral

Rotation


fossa of scapula

Middle facet of

greater tubercle of

humerus; capsule

of shoulder joint

Suprascapular

nerve from upper

trunk of brachial

plexus

C5, C6

Teres minor Upper two-thirds

of lateral border

of scapula

Inferior facet of

greater tubercle of

humerus; capsule

of shoulder joint

Axillary nerve

from posterior

cord of brachial

plexus

C5, C6

Deltoid

(posterior fibers)


(middle of lateral

humeral surface)

Axillary nerve

from posterior

cord of brachial

plexus

C5, C6

Supraspinatus Supraspinous

fossa of scapula

Superior facet of

greater tubercle of

humerus; capsule

of shoulder joint

Suprascapular

nerve from upper

trunk of brachial

plexus

C5, C6

Medial

rotation

Subscapularis Subscapular fossa Lesser tubercle of

humerus

Upper and lower

subscapular nerves

from posterior

cord of brachial

plexus

C5, C6

Latissimus dorsi Posterior 1/3 ofiliac crest, T7-

T12 spinous

processes,

thoracolumbar


angle of scapula

Floor of bicipital(intertubercular)

groove of humerus

Thoracodorsalnerve from

posterior cord of

brachial plexus

C6, C7, C8


of lateral border

of scapula (dorsal

surface) near

inferior angle

Medial lip of

bicipital

(intertubercular)

groove of humerus

Lower subscapular

nerve from

posterior cord of

brachial plexus

C6, C7

Pectoralis major

(sternocostal and

clavicular heads)

Anterior surface

of sternum, upper

six costal

cartilages, and

aponeurosis of

external oblique

muscle; Anterior

surface of medial

half of clavicle

Lateral lip of

bicipital

(intertubercular)

groove of humerus

Medial and lateral

pectoral nerves

from medial and

lateral cords of

brachial plexus

C5, C6, C7, C8,

and T1

Deltoid (anterior

fibers)

Lateral third of

posterior clavicle

Deltoid tuberosity

(middle of lateral

humeral surface)

Axillary nerve

from posterior

cord of brachial

plexus

C5, C6

*Circumduction is a combination of all the movements described

**The predominant segmental nerve supply is indicated by boldface type

The primary muscles that produce each movement are shown in boldface type


5/44

5

SUMMARY OF STERNOCLAVICULAR AND ACROMIOCLAVICULAR

JOINT MOVEMENTS AND MUSCLES PRODUCING THOSE MOVEMENTS

MOVEMENTS MUSCLES ORIGIN INSERTION NERVE SUPPLY SEGMENTAL

NERVE

ROOTS*

Elevation Trapezius(Upper Fibers) Externaloccipitalprotuberance

and medial 1/3

of superiornuchal line,

ligamentum

nuchae, andspinous process

of C7

Lateral third ofposteriorclavicle

Spinal part ofaccessory nerve

XI cranial nerve(spinal part);C3, C4

Levator

scapulae

Transverse

processes ofC1-C4

vertebrae

Superior part of

medial borderof scapula near

superior angle

C3 and C4; Dorsal

scapular nervefrom C5 root

C3, C4, C5

Rhomboid

major

spines of T2-T5

vertebrae

Medial border

of scapula fromlevel of spine of

scapula to

inferior angle

C4; Dorsal


C4, C5

Rhomboid

minor

Ligamentum

nuchae andspines of C7-T1

vertebrae

Medial border

of scapula atlevel of spine of

scapula

C4; Dorsal


C4, C5

Depression Pectoralisminor

Third, fourth,and fifth ribs

Coracoidprocess of

scapula

Medial pectoralnerve from medial

cord of brachial

plexus

C8, T1

Trapezius

(Lower Fibers)

Spinous

processes of

T6-T12

Spine of scapula Spinal part of

accessory nerve

XI cranial nerve

(spinal part);

C3, C4

Subclavius Junction of firstrib and itscostal cartilage

Inferior surfaceof middle thirdof clavicle

Nerve tosubclavius fromupper trunk of

brachial plexus

C5, C6


6/44

6

Protraction

(Abduction)

Serratus

anterior

External

surfaces of

lateral uppereight ribs

Anterior surface

of medial

border andinferior angle of

scapula

Long thoracic

nerve from C5-C7

roots

C5, C6, C7

Pectoralis

minor

Third, fourth,

and fifth ribs

Coracoid

process ofscapula

Medial pectoral

nerve from medialcord of brachialplexus

C8, T1

Retraction

(Adduction)

Trapezius

(Middle

Fibers)

Spinous

processes of

T1-T5

Acromion and

spine of scapula

Spinal part of

accessory nerve

XI cranial nerve

(spinal part);

C3, C4

Rhomboid

major

spines of T2-T5

vertebrae

Medial border

of scapula from

level of spine ofscapula to

inferior angle

Dorsal scapular

nerve from C5

root

C4, C5

Rhomboid

minor

Ligamentum

nuchae andspines of C7-T1

vertebrae

Medial border

of scapula atlevel of spine of

scapula

C4; Dorsal


C4, C5

Trapezius

(Upper Fibers)

External

occipitalprotuberance

and medial 1/3

of superiornuchal line,ligamentum

nuchae, and

spinous processof C7

Lateral third of

posteriorclavicle

Spinal part of

accessory nerve

XI cranial nerve

(spinal part);C3, C4

Trapezius(Lower Fibers)

Spinousprocesses of

T6-T12

Spine of scapula Spinal part ofaccessory nerve

XI cranial nerve(spinal part);

C3, C4

Levatorscapulae

Transverseprocesses of

C1-C4vertebrae

Superior part ofmedial border

of scapula nearsuperior angle

C3 and C4; Dorsalscapular nerve

from C5 root

C3, C4, C5


7/44

7

Upward

Rotation

Trapezius

(Upper Fibers)

External

occipital

protuberanceand medial 1/3

of superior

nuchal line,

ligamentumnuchae, and

spinous process

of C7

Lateral third of

posterior

clavicle

Spinal part of

accessory nerve

XI cranial nerve

(spinal part);

C3, C4

Trapezius

(Lower Fibers)

Spinousprocesses of

T6-T12

Spine of scapula Spinal part ofaccessory nerve

XI cranial nerve(spinal part);

C3, C4

Serratus

anterior

External

surfaces of

lateral uppereight ribs

Anterior surface

of medial

border andinferior angle of

scapula

Long thoracic

nerve from C5-C7

roots

C5, C6, C7

Downward

Rotation

Pectoralis

minor

Third, fourth,

and fifth ribs

Coracoid

process ofscapula

Medial pectoral

nerve from medialcord of brachial

plexus

C8, T1

Rhomboid

major

spines of T2-T5

vertebrae

Medial border

of scapula from

level of spine ofscapula to

inferior angle

C4; Dorsal

scapular nerve

from C5 root

C4, C5

Rhomboid

minor

Ligamentum

nuchae andspines of C7-T1vertebrae

Medial border

of scapula atlevel of spine ofscapula

C4; Dorsal


C4, C5

Levator

scapulae

Transverse

processes of

C1-C4vertebrae

Superior part of

medial border

of scapula nearsuperior angle

C3 and C4; Dorsal

scapular nerve

from C5 root

C3, C4, C5


iliac crest, T7-

T12 spinous

processes,thoracolumbar


angle of scapula

Floor of bicipital

(intertubercular)

groove of

humerus

Thoracodorsal

nerve from

posterior cord of

brachial plexus

C6, C7, C8

*The predominant segmental nerve supply is indicated by boldface type



8/44

8

SUMMARY OF ELBOW (HUMEROULNAR AND HUMERORADIAL) JOINT

MOVEMENTS AND MUSCLES PRODUCING THOSE MOVEMENTS


NERVE

ROOTS*

Flexion Biceps brachii Long Head:Supraglenoidtubercle of

scapula and

posterosuperior

labrum;

Short Head: Tip

of coracoid

process of scapula

Tuberosity ofradius and

bicipital

aponeurosis into

deep fascia of

forearm


cord of brachial

plexus

C5, C6

Brachialis Distal half of

anterior surface

of humerus

Coronoid

process and

ulnar tuberosity

Musculocutaneous

nerve from lateral

cord of brachial

plexus

C5, C6

Brachioradialis Proximal two-thirds of lateral

supracondylar

ridge of humerus

Base of styloid

process of radius

Radial nerve from

posterior cord of

brachial plexus

C5, C6, C7

Pronator teres Humeral Head:

Medial

epicondyle of

humerus; Ulnar

Head: Coronoid

process of ulna

Lateral surface

of middle third

of radius

Median nerve from

medial and lateral

cords of brachial

plexus

C6, C7

Extension Triceps Long Head:

infraglenoidtubercle of

scapula;

Lateral Head:

Upper half of

posterior surface

of humerus

(superior to

radial groove);

Medial Head:

lower half of

posterior surface

of shaft ofhumerus

(inferior to radial

groove)

Olecranon

process of ulna

Radial nerve from

posterior cord ofbrachial plexus

C6, C7, C8

Anconeus Lateral

epicondyle of

humerus

Lateral surface

of olecronon and

superior part of

posterior surface

of ulna

Radial nerve from

posterior cord of

brachial plexus

C7, C8, T1




9/44

9

SUMMARY OF RADIOULNAR JOINT MOVEMENTS



NERVE

ROOTS*

Supination Biceps brachii Long Head:Supraglenoidtubercle of

scapula and

posterosuperior

labrum;

Short Head: Tip

of coracoid

process of

scapula

Tuberosity ofradius and

bicipital

aponeurosis into

deep fascia of

forearm


cord of brachial

plexus

C5, C6

Supinator Lateral

epicondyle of

humerus, radialcollateral and

anular ligament,

supinator fossa,

and crest of ulna

Lateral, posterior,

and anterior

surfaces ofproximal third of

radius

Deep branch of

radial nerve

C6, C7

Brachioradialis Proximal two-

thirds of lateral

supracondylar

ridge of humerus

Base of styloid

process of radius

Radial nerve from

posterior cord of

brachial plexus

C5, C6, C7

Extensor carpi

radialis longus

Lateral

supracondylar

ridge of humerus

Posterior surface

of base of second

metacarpal bone

Radial nerve from

posterior cord of

brachial plexus

C6, C7

Pronation Pronator teres Humeral Head:Medialepicondyle of

humerus; Ulnar

Head: Coronoidprocess of ulna

Lateral surface ofmiddle third of

radius

Median nerve frommedial and lateral

cords of brachial

plexus

C6, C7

Pronator

quadratus

Anterior surface

of shaft of ulna

Anterior surface

of shaft of radius

Anterior

interosseous branch

of median nerve

C8, T1

Brachioradialis Proximal two-

thirds of lateral

supracondylar

ridge of humerus

Base of styloid

process of radius

Radial nerve from

posterior cord of

brachial plexus

C5, C6, C7

Flexor carpi

radialis

Medial

epicondyle of

humerus

Bases of second

and third

metacarpal bones

Median nerve from

medial and lateral

cords of brachial

plexus

C6, C7




10/44

10

SUMMARY OF RADIOCARPAL (WRIST) AND MIDCARPAL JOINT

MOVEMENTS AND MUSCLES PRODUCING THOSE MOVEMENTS

MOVEMENTS MUSCLES ORIGIN INSERTION NERVE

SUPPLY

SEGMENTAL

NERVE

ROOTS*

Flexion Flexor carpiradials Medialepicondyle ofhumerus

Bases of secondand third

metacarpal bones

Median nervefrom medial and

lateral cords of

brachial plexus

C6, C7

Flexor carpi

ulnaris

Humeral Head:

medial

epicondyle of

humerus;

Ulnar Head:

olecranon

process,

posterior border

of ulna

Pisiform bone,

hook of the

hamate, base at

fifth metacarpal

bone

Ulnar nerve from

medial cord of

brachial plexus

C7, C8, T1

Flexor digitorum

superficialis

Humeroulnar

Head: Medial

epicondyle of

humerus,

coroniod process

of ulna;

Radial Head:

oblique line

anterior surface

shaft of radius

Base of middle

phalanx of

medial four

fingers

Median nerve

from medial and

lateral cords of

brachial plexus

C7, C8, T1

Flexor digitorum

profundus

Anteromedial

surface of shaft

of ulna;

interosseous

membrane

Base of distal

phalanges of

medial four

fingers

Ulnar nerve

(medial half) and

anterior

interosseus

branch of median

nerve (lateral

half)

C8, T1

Palmaris longus Medial

epicondyle of

humerus

Distal half of

flexor

retinaculum and

palmaraponeurosis

Median nerve

from medial and

lateral cords of

brachial plexus

C7, C8

Flexor pollicis

longus

Anterior surface

of radius and

adjacent

interosseous

membrane

Base of distal

phalanx of

thumb

Anterior

interosseous

branch of median

nerve

C8, T1


11/44

11

Extension Extensor carpiradialis longus

Lateral

supracondylar

ridge of humerus

Base of second

metacarpal bone

Radial nerve from

posterior cord of

brachial plexus

C6, C7

Extensor carpi

radialis brevis

Lateral

epicondyle of

humerus

Base of third

metacarpal bone

Deep branch of

radial nerveC7, C8

Extensor carpiulnaris Lateralepicondyle of

humerus

Base of fifthmetacarpal bone Posteriorinterosseous

nerve the

continuation of

the deep branch

of radial nerve

C7, C8

Extensor

digitorum

Lateral

epicondyle of

humerus

Extensor

expansion

(transverse fibers

of dorsal hood,

central and lateral

bands, oblique

retinacularligaments) of

middle and distal

phalanges of

medial four digits

Posterior

interosseous

nerve the

continuation of

the deep branch

of radial nerve

C7, C8

Extensor indicis Posterior surface

of ulna and

interosseous

membrane

Extensor

expansion

(transverse fibers

of dorsal hood,

central and lateral

bands, oblique

retinacular

ligaments) of

index finger

Posterior

interosseous

nerve the

continuation of

the deep branch

of radial nerve

C7, C8

Extensor digiti

minimi

Lateral

epicondyle of

humerus

Extensor

expansion

(transverse fibers

of dorsal hood,

central and lateral

bands, oblique

retinacular

ligaments) of

little finger

Posterior

interosseous

nerve the

continuation of

the deep branch

of radial nerve

C7, C8

Extensor pollicis

longus

Posterior surface

of middle third of

ulna and

interosseous

membrane

Base of distal

phalanx of thumb

Posterior

interosseous

nerve the

continuation of

the deep branchof radial nerve

C7, C8


12/44

12

Abduction

(radial

deviation)

Flexor carpi

radials

Medial

epicondyle of

humerus

Bases of second

and third

metacarpalbones

Median nerve

from medial and

lateral cords ofbrachial plexus

C6, C7

Extensor carpi

radialis longus

Lateralsupracondylar

ridge ofhumerus

Base of secondmetacarpal bone

Radial nervefrom posterior

cord of brachialplexus

C6, C7

Extensor carpi

radialis brevis

Lateral

epicondyle ofhumerus

Base of third

metacarpal bone

Deep branch of

radial nerve

C7, C8

Abductor

pollicis longus

Posterior surface

of radius(middle third)

and ulna;

interosseousmembrane

Base of first

metacarpal

Posterior

interosseousnerve the

continuation of


C7, C8

Extensor pollicislongus

Posterior surfaceof middle third

of ulna and


Base of distalphalanx of

thumb

Posteriorinterosseous

nerve the

continuation ofthe deep branch

of radial nerve

C7, C8

Extensor pollicis

brevis

Posterior surface

of radius and


Base of

proximal

phalanx ofthumb

Posterior

interosseous

nerve thecontinuation of

the deep branch

of radial nerve

C7, C8

Adduction

(ulnar

deviation)

Flexor carpi

ulnaris

Humeral Head:

medialepicondyle of

humerus;

Ulnar Head:

olecranonprocess,

posterior border

of ulna

Pisiform bone,

hook of thehamate, base at

fifth metacarpal

bone

Ulnar nerve

from medialcord of brachial

plexus

C7, C8, T1

Extensor carpi

ulnaris

Lateral

epicondyle ofhumerus

Base of fifth

metacarpal bone

Posterior

interosseousnerve thecontinuation of


C7, C8

*The predominant segmental nerve supply is indicated by boldface typeThe primary muscles that produce each movement are shown in boldface type


13/44

13

SUMMARY OF CARPOMETACARPAL JOINT MOVEMENTS OF THE

THUMB AND MUSCLES PRODUCING THOSE MOVEMENTS


SUPPLY

SEGMENTAL

NERVEROOTS*

FlexionFlexor pollicis

brevis**Superficial

Head:Trapezium and

flexor

retinaculum;Deep Head:

Trapezoid and

capitate

Lateral (radial)

side of base ofproximal

phalanx of

thumb

Superficial

Head:Recurrent

branch of

median nerve;Deep Head:

Deep branch of

ulnar nerve

C8, T1

Adductor

pollicis

Oblique Head:

capitate and

bases of 2nd and

3rd metacarpals;

TransverseHead:

3rd metacarpal

bone (distal 2/3

of palmar

surface)

Medial side of

base ofproximal

phalanx of

thumb

Deep branch of

ulnar nerve

C8, T1

Opponens

pollicis

Flexor

retinaculum andtrapezium

Lateral side of

shaft ofmetacarpal

bone of thumb

Recurrent

branch ofmedian nerve

C8, T1

Flexor pollicis

longus

Anterior surface

of radius andadjacentinterosseous

membrane

Base of distal

phalanx ofthumb (palmarsurface)

Anterior

interosseousbranch ofmedian nerve

C8, T1

Extension Extensorpollicis longus

Posterior

surface ofmiddle third of

ulna and


Base of distal

phalanx ofthumb (dorsal

surface)

Posterior


continuation of


C7, C8

Extensor

pollicis brevis

Posterior

surface ofradius and


Base of

proximalphalanx of

thumb (dorsalsurface)

Posterior


continuation ofthe deep branch

of Radial nerve

C7, C8

Abductor

pollicis longus

Posterior

surface of

radius (middlethird) and ulna;

interosseous

membrane

Base of first

metacarpal

Posterior

interosseous


the deep branch

of radial nerve

C7, C8


14/44

14

Abduction Abductor pollicislongus

Posterior surface

of radius (middle

third) and ulna;

interosseous

membrane

Base of first

metacarpal

Posterior

interosseous nerve

the continuation

of the deep branch

of radial nerve

C7, C8

Abductor pollicis

brevis

Scaphoid,

trapezium, andflexor retinaculum

Lateral side of

base of proximalphalanx of thumb

Recurrent branch

of median nerve

C8, T1

Opponens pollicis Flexorretinaculum and

trapezium

Lateral side ofshaft of 1

st

metacarpal

Recurrent branchof median nerve

C8, T1

Adduction Adductor pollicis Oblique head:capitate and bases

of 2nd

and 3rd

metacarpals;

Transverse head:

3rd

metacarpal

(distal 2/3 ofpalmar surface)

Medial side of

base of proximal

phalanx of thumb

Deep branch of

ulnar nerve

C8, T1

1st

Dorsal

Interosseus

Originates from

opposing sides ofadjacent

metacarpal bones

I & II (bipennate

muscles)

Base of proximal

phalanx of 2

nd

digit (radial side)

and extensor

expansion

(oblique fibers of

dorsal hood,

central and lateral

bands, oblique

retinacular

ligaments)

Deep branch of

ulnar nerve

C8, T1

Extensor pollicis

longus

Posterior surface

of middle third ofulna and


Base of distal

phalanx of thumb(dorsal surface)

Posterior

interosseous nerve the continuation

of the deep branchof radial nerve

C7, C8

Opposition*** Opponens pollicis Flexor

retinaculum and

trapezium

Lateral side of

shaft of

metacarpal bone

of thumb

Recurrent branch

of median nerve

C8, T1

Flexor pollicisbrevis

**Superficial Head:Trapezium and

flexor

retinaculum;Deep Head:

Trapezoid and

capitate

Lateral (radial)side of base of

proximal phalanx

of thumb

Superficial Head:Recurrent branch

of median nerve;

Deep Head:

Deep branch ofulnar nerve

C8, T1

Abductor pollicis

brevis

Scaphoid,

trapezium, and

flexor retinaculum

Lateral side of

base of proximal

phalanx of thumb

Recurrent branch

of median nerve

C8, T1


** The deep portion of the flexor pollicis brevis is sometimes called the first palmar interosseous muscle due to its similar

innervation and position on the thumb

***The opponens digiti minimi, which originates on the flexor retinaculum and hamate, inserts into the medial border of the 5th

metacarpal, and is innervated by the deep branch of the ulnar nerve (C8, T1), works synergistically with the opponens pollicis

to complete opposition.



15/44

15

SUMMARY OF METACAROPHALANGEAL JOINT MOVEMENTS



SUPPLY

SEGMENTAL

NERVE

ROOTS*

Flexion Flexordigitorum

superficialis

(2nd, 3rd, 4th,

& 5th fingers)

Humeroulnar Head:Medial epicondyle ofhumerus, coroniod

process of ulna;

Radial Head: obliqueline anterior surface

shaft of radius

Base of middlephalanx of medialfour fingers

Mediannerve frommedial and

lateral cords

of brachialplexus

C7, C8, T1

Flexor

digitorum

profundus

(2nd, 3rd, 4th,& 5th fingers)

Anteromedial surface

of shaft of ulna;


Base of distal

phalanges of medial

four fingers

Ulnar nerve

(medial

half) andanterior

interosseusbranch of

mediannerve

(lateral half)

C8, T1

Flexor digiti

minimi

(little finger)

Hook of Hamate and

Flexor retinaculum

Medial side of base

of proximalphalanx of little

finger

Deep branch

of ulnarnerve

C8, T1

Lumbricals

(1-4)

(2nd, 3rd, 4th,

& 5th fingers)

Lumbricals 1-2:

Arises from a singlehead (unipennate) on

the radial side of thelateral two tendons

(1st and 2nd) of the

flexor digitorumprofundus (along

index and ring

fingers);

Lumbricals 3-4:Arises from double

heads (bipennate) ofthe medial threetendons (2nd, 3rd, and

4th

) of the flexordigitorum profundus

(3rd lumbrical between

long and ring fingers;4th lumbrical between

ring and little fingers)

Lateral (radial)

sides of extensorexpansion (oblique

fibers of dorsalhood, central and

lateral bands,

oblique retinacularligaments) of

medial four fingers

(digits 2-5):

1st

lumbrical todigit 2; 2nd

lumbrical to digit 3;3

rdlumbrical to

digit 4; 4th

lumbrical to digit 5

Lumbricals

1-2 (mediannerve)

Lumbricals

3-4

(deepbranch of

ulnar nerve)

C8, T1


16/44

16

PalmarInterossei

(1-3)**

(2nd, 4

th, &

5th

fingers)

Sides of palmar

surface of 2nd

, 4th

, and5th metacarpals: 1st

(ulnar side of 2nd

digit); 2nd

(radial sideof 4th digit); 3rd (radial

side of 5th digit)

Extensor expansion

(oblique fibers ofdorsal hood, central

and lateral bands,

oblique retinacularligaments) and

bases of proximal

phalanges of digits2, 4, and 5: 1

st

(ulnar side of digit

2); 2nd (radial side

of digit 4); 3rd

(radial side of digit

5)

Deep branch

of ulnarnerve

C8, T1

Dorsi

Interossei

(1-4)

(2nd, 3rd, &4

thfingers)

Each originates from

opposing sides of two

adjacent metacarpalbones I & II (1st), II

& III (2nd), III & IV(3

rd), IV & V (4

th) -

bipennate muscles

Extensor expansion

(oblique fibers of

dorsal hood, centraland lateral bands,

oblique retinacularligaments) andbases of proximal

phalanges of digits

2-4: 1st (radial side

of digit 2); 2nd


3); 3rd (ulnar side of

digit 3); 4th

(ulnarside of digit 4)

Deep branch

of ulnar

nerve

C8, T1

Flexor

pollicislongus

(thumb)

Anterior surface of

radius and adjacentinterosseous

membrane

Base of distal

phalanx of thumb(palmar surface)

Anterior

interosseousbranch of

mediannerve

C8, T1

Flexor

pollicis

brevis**

(thumb)

Superficial Head:Trapezium and flexor

retinaculum;

Deep Head:Trapezoid and

capitate

Lateral (radial) sideof base of proximal

phalanx of thumb

SuperficialHead:

Recurrent

branch ofmedian

nerve;

Deep Head:

Deep branchof ulnar

nerve

C8, T1

Adductor

pollicis

(thumb)

Oblique Head: capitate

and bases of 2nd and 3rd

metacarpals;

Transverse Head:

3rd metacarpal bone

(distal 2/3 of palmar

surface)

Medial side of base

of proximalphalanx of thumb

Deep branch

of ulnarnerve

C8, T1


17/44

17

Extension Extensordigitorum

(2nd, 3

rd, 4

th,

& 5th

fingers)

Lateral epicondyle of

humerus

Extensor expansion

(transverse fibers of dorsal

hood, central and lateral

bands, oblique retinacular

ligaments) of middle and

distal phalanges of medial

four digits

Posterior

interosseous

nerve the

continuation of

the deep branch

of radial nerve

C7, C8

Extensor

digiti

minimi

(little finger)


humerus

Extensor expansion

(transverse fibers of

dorsal hood, central and

lateral bands, oblique

retinacular ligaments) of

little finger

Posterior

interosseous

nerve the

continuation of

the deep branch

of radial nerve

C7, C8

Extensor

indicis

(2nd

finger)

Posterior surface of ulna

and interosseous

membrane

Extensor expansion


dorsal hood, central and

lateral bands, oblique

retinacular ligaments) of

index finger

Posterior

interosseous

nerve the

continuation of

the deep branch

of radial nerve

C7, C8

Extensor

pollicis

longus

(thumb)

Posterior surface of

middle third of ulna and

interosseous membrane

Base of distal phalanx of

thumb (dorsal surface)

Posterior

interosseous


the deep branch

of radial nerve

C7, C8

Extensor

pollicis

brevis

(thumb)


radius and interosseous

membrane

Base of proximal phalanx

of thumb (dorsal surface)

Posterior

interosseous

nerve the

continuation of

the deep branch

of radial nerve

C7, C8

Abduction Abductordigiti

minimi

(little finger)

Pisiform bone Medial side of base of

proximal phalanx of little

finger

Deep branch of

ulnar nerve

C8, T1

Dorsi

Interossei

(1-4)

(2nd, 3

rd, &

4th

fingers)



adjacent metacarpal

bones I & II (1st), II &

III (2nd), III & IV (3rd),

IV & V (4th) - bipennate

muscles

Extensor expansion

(oblique fibers of dorsal

hood, central and lateral

bands, oblique retinacular

ligaments) and bases of

proximal phalanges of

digits 2-4: 1st

(radial side

of digit 2); 2nd

(radial side

of digit 3); 3rd

(ulnar side

of digit 3); 4th

(ulnar side

of digit 4)

Deep branch of

ulnar nerve

C8, T1

Adduction PalmarInterossei

(1-3)**

(2nd, 4

th, &

5th

fingers)

Sides of palmar surface

of 2nd

, 4th

, and 5th

metacarpals: 1st (ulnar

side of 2nd digit); 2nd

(radial side of 4th digit);

3rd (radial side of 5th

digit)

Extensor expansion

(oblique fibers of dorsal

hood, central and lateralbands, oblique retinacular

ligaments) and bases of

proximal phalanges of

digits 2, 4, and 5: 1st

(ulnar

side of digit 2); 2nd

(radial

side of digit 4); 3rd

(radial

side of digit 5)

Deep branch of

ulnar nerve

C8, T1


** The deep portion of the flexor pollicis brevis is sometimes called the first palmar interosseous muscle due to its similar innervation

and position on the thumb



18/44

18

SUMMARY OF PROXIMAL (PIP) AND DISTAL (DIP) INTERPHALANGEAL JOINT

MOVEMENTS OF THE FINGERS, INTERPHALANGEAL (IP) JOINT MOVEMENTS

OF THE THUMB, AND THE MUSCLES PRODUCING THOSE MOVEMENTS


SUPPLY

SEGMENTAL

NERVE ROOTS*

Flexion

Flexor

digitorumsuperficialis

(PIP)

(2nd, 3rd, 4th, &

5th

fingers)

Humeroulnar Head:

Medial epicondyle ofhumerus, coroniod

process of ulna;

Radial Head: oblique

line anterior surface

shaft of radius

Base of middle

phalanx of medialfour fingers

Median nerve

from medialand lateral

cords of

brachial

plexus

C7, C8, T1

Flexor

digitorum

profundus

(PIP & DIP)

(2nd, 3

rd, 4

th, &

5th fingers)

Anteromedial surface

of shaft of ulna;

interosseous

membrane

Base of distal

phalanges of medial

four fingers

Ulnar nerve

(medial half)

and anterior

interosseus

branch of

median nerve

(lateral half)

C8, T1

Flexor

pollicis

longus

(IP)

(thumb)

Anterior surface of

radius and adjacent


Base of distal

phalanx of thumb

(palmar surface)

Anterior

interosseous

branch ofmedian nerve

C8, T1


(PIP & DIP)

(2nd, 3

rd, 4

th, &

5th fingers)


humerus

Extensor expansion


dorsal hood, central

and lateral bands,

oblique retinacular

ligaments) of middle

and distal phalangesof medial four digits

Posterior

interosseous

nerve

continuation

of deep

branch of

radial nerve

C7, C8

Extensor

indicis

(PIP & DIP)

(2nd

finger)


ulna and interosseous

membrane

Extensor expansion



and lateral bands,

oblique retinacular

ligaments) of index

finger

Posterior

interosseous

nerve

continuation

of deep

branch of

radial nerve

C7, C8

Extensor

digiti minimi

(PIP & DIP)

(little finger)


humerus

Extensor expansion



and lateral bands,oblique retinacular

ligaments) of little

finger

Posterior

interosseous

nerve

continuationof deep

branch of

radial nerve

C7, C8

Extensor

pollicis

longus

(IP)

(thumb)


middle third of ulna

and interosseous

membrane

Base of distal

phalanx of thumb

(dorsal surface)

Posterior

interosseous

nerve

continuation

of deep

branch of

radial nerve

C7, C8


19/44

19

Lumbricals

(1-4)

(PIP & DIP)

(2nd, 3rd, 4th,

& 5th fingers)

Lumbricals 1-2:

Arises from a single

head (unipennate) on

the radial side of the

lateral two tendons

(1st and 2nd) of the

flexor digitorum

profundus (alongindex and ring

fingers);

Lumbricals 3-4:

Arises from double

heads (bipennate) of

the medial three

tendons (2nd, 3rd, and

4th) of the flexor

digitorum profundus

(3rd lumbrical

between long and ring

fingers; 4th lumbricalbetween ring and little

fingers)

Lateral (radial)

sides of extensor

expansion (oblique

fibers of dorsal

hood, central and

lateral bands,

oblique retinacular

ligaments) ofmedial four fingers

(digits 2-5):

1st lumbrical to

digit 2; 2nd

lumbrical to digit

3; 3rd lumbrical to

digit 4; 4th

lumbrical to digit 5

Lumbricals

1-2 (median

nerve)

Lumbricals

3-4

(deep branch

of ulnar nerve

C8, T1

Palmar

Interossei

(1-3)**

(PIP & DIP)

(2nd, 4th, & 5th

fingers)

Sides of palmar

surface of 2nd, 4th, and

5th metacarpals: 1st

(ulnar side of 2nd

digit); 2nd (radial side

of 4th digit); 3rd (radial

side of 5th digit)

Extensor expansion

(oblique fibers of


and lateral bands,

oblique retinacular

ligaments) and

bases of proximal

phalanges of digits

2, 4, and 5: 1st

(ulnar

side of digit 2); 2nd(radial side of digit

4); 3rd (radial side of

digit 5)

Deep branch

of ulnar nerve

C8, T1

Dorsi

Interossei

(1-4)

(PIP & DIP)

(2nd, 3rd, and

4th fingers)



adjacent metacarpal

bones I & II (1st), II

& III (2nd), III & IV

(3rd), IV & V (4th) -

bipennate muscles

Extensor expansion

(oblique fibers of


and lateral bands,

oblique retinacular

ligaments) and

bases of proximal

phalanges of digits

2-4: 1st (radial sideof digit 2); 2nd


3); 3rd

(ulnar side of

digit 3); 4th (ulnar

side of digit 4)

Deep branch

of ulnar nerve

C8, T1


** The deep portion of the flexor pollicis brevis is sometimes called the first palmar interosseous muscle due to its

similar innervation and position on the thumb



20/44

20

SUMMARY OF HIP JOINT MOVEMENTS


MOVEMENTS*

MUSCLES ORIGIN INSERTION NERVESUPPLY

SEGMENTALNERVE

ROOTS**

FlexionIliacus

***Iliac crest, iliac fossa, ala

of sacrum, and anterior

sacroiliac ligaments

With psoas into

lesser trochanter

of femur

Femoral

nerve

L2, L3

Psoas major

and minor***Transverse processes,

bodies, and intervertebral

discs of 12th thoracic and

1st

lumbar (psoas minor)

and 2nd

through 5th

lumbar vertebrae (psoas

major)

With iliacus into

lesser trochanter

of femur

Lumbar

plexus

Psoas major:

(L1, L2, L3)

Psoas minor:

(L1, L2)

Rectus femoris Straight head: anterior

inferior iliac spine

Reflected head: ilium

above acetabulum

Quadriceps

tendon into

patella, then via

ligamentum

patellae into

tubercle of tibia

Femoral

nerve

L2, L3, L4

Sartorius Anterior superior iliac

spine and superior part of

notch inferior to it

Upper medial

surface of shaft

of tibia (pes

anserinus)

Femoral

nerve

L2, L3

Adductor

longus

Body of pubis, medial to

pubic tubercle and

inferior to pubic crest

Middle third of

linea aspera on

posterior surface

of femur

Obturator

nerve,

anterior

division

L2, L3, L4

Pectineus Superior ramus of pubis Upper end of

linea aspera of

shaft of femur,

just inferior to

lesser trochanter

Femoral

nerve (may

receive

branch from

obturator

nerve)

L2, L3

Tensor fasciae

latae

Anterior superior iliac

spine and anterior part of

iliac crest

Iliotibial tract

that attaches to

lateral condyle of

tibia (Gerdy

tubercle)

Superior

gluteal

nerve

L5, S1

Adductor brevis Body and inferior ramus

of pubis

Pectineal line and

proximal portion

of linea aspera on

posterior femur

Obturator

nerve,

anterior

division

L2, L3, L4

Adductor

magnus

(Adductor

Portion)

Inferior ramus of pubis,

ramus of ischium

Gluteal

tuberosity, entire

length of linea

aspera, & medial

supracondylarline

Obturator

nerve,

posterior

division

L2, L3, L4

Gluteus medius

(anterior fibers)

Outer surface of ilium

between anterior and

posterior gluteal lines

Lateral surface of

greater trochanter

of femur

Superior

gluteal

nerve

L5, S1


21/44

21

Extension Gluteus maximus Outer posteriorsurface of ilium

(posterior to glutealline), dorsal sacrum

and coccyx,

sacrotuberous

ligament

Iliotibial tract

and gluteal

tuberosity offemur

Inferior

gluteal

nerve

L5, S1, S2

Biceps femoris

(long head)

Ischial tuberosity Lateral side ofhead of fibula;

Tendon is split

at this site byfibular

collateral

ligament of

knee

Tibialportion of

sciatic

nerve

L5, S1, S2

Semitendinosus Ischial tuberosity Upper part ofmedial surface

of shaft of tibia(pes anserinus)

Tibialportion of

sciaticnerve

L5,S1, S2

Semimembranosus Ischial tuberosity Posterior part ofmedial condyle

of tibia;

Reflectedattachment

forms obliquepopliteal

ligament (to

lateral femoral

condyle)

Tibialportion of

sciatic

nerve

L5,S1, S2

Adductor magnus-

hamstring (ischial)

portion

Ischial tuberosity Adductor

tubercle offemur

Tibial

portion ofsciatic

nerve

L4

Gluteus medius

(posterior fibers)

Outer surface of

ilium between

anterior andposterior gluteal

lines

Lateral surface

of greater

trochanter offemur

Superior

gluteal

nerve

L5, S1


22/44

22

Abduction Gluteus medius Outer surfaceof ilium

betweenanterior and

posterior

gluteal lines

Lateral surface

of greater

trochanter offemur

Superior

gluteal nerveL5, S1

Gluteus minimus Outer surfaceof iliumbetween

anterior and

inferior gluteallines

Anterior surfaceof greatertrochanter of

femur

Superiorgluteal nerve

L5, S1

Tensor fasciae

latae

Anteriorsuperior iliac

spine and

anterior part ofiliac crest

Iliotibial tractthat attaches to

lateral condyle

of tibia (Gerdytubercle)

Superiorgluteal nerve

L5, S1

Sartorius Anteriorsuperior iliac

spine andsuperior part of

notch inferior

to it

Upper medialsurface of shaft

of tibia (pesanserinus)

Femoral nerve L2, L3

Piriformis Anterior

surface ofsacrum (S2-S4

segments) and

sacrotuberous

ligament

Upper border of

greatertrochanter of

femur

Nerve to

piriformisS1, S2

Gluteus maximus

(upper fibers)

Outer posterior

surface of ilium

(posterior togluteal line),

dorsal sacrum

and coccyx,sacrotuberous

ligament

Iliotibial tract

and gluteal

tuberosity offemur

Inferior gluteal

nerve

L5, S1, S2


23/44

23

Adduction Adductor longus Body of pubis,medial to pubic

tubercle andinferior to

pubic crest

Middle third of

linea aspera on

posteriorsurface of femur

Obturator

nerve, anteriordivision

L2, L3, L4

Adductor brevis Body and

inferior ramusof pubis

Pectineal line

and proximalportion of lineaaspera on

surface of

posterior femur

Obturator


L2, L3, L4

Gracilis Body and

inferior ramusof pubis

Upper part of

shaft of tibia onmedial surface

(pes anserinus)

Obturator

nerve

L2, L3

Adductor magnus

(Adductor

Portion)

Inferior ramusof pubis, ramus

of ischium

Glutealtuberosity,

entire length oflinea aspera,

and medialsupracondylar

line

Obturatornerve, posterior

division

L2, L3, L4

Adductor magnus-

hamstring (ischial)

portion

Ischial

tuberosity

Adductor

tubercle of

femur

Tibial portion

of sciatic

nerve

L4

Pectineus Superior ramusof pubis

Upper end oflinea aspera of

shaft of femur,

just inferior tolesser trochanter

Femoral nerve(may receive

branch from

obturatornerve)

L2, L3

Obturator externus Outer surfaceof obturator

membrane and

pubic and

ischial rami

Medial surfaceof greater

trochanter and

trochanteric

fossa of femur

Obturatornerve

L3, L4

Gluteus maximus

(lower fibers)

Outer posterior

surface of ilium(posterior to

gluteal line),dorsal sacrumand coccyx,

sacrotuberousligament

Iliotibial tract

and glutealtuberosity of

femur

Inferior gluteal

nerve

L5, S1, S2


24/44

24

Lateral

rotation

Gluteus maximus Outer posterior

surface of ilium

(posterior to

gluteal line),

dorsal sacrum

and coccyx,

sacrotuberousligament

Iliotibial tract

and gluteal

tuberosity of

femur

Inferior gluteal

nerve

L5, S1, S2

Iliacus*** Iliac crest, iliac

fossa, ala of

sacrum, and

anterior

sacroiliac

ligaments

With psoas into

lesser trochanter

of femur


Psoas major and

minor***Transverse

processes,

bodies, and

intervertebral

discs of 12th

thoracic and 1st

lumbar (psoas

minor) and 2nd

through 5th

lumbar

vertebrae (psoas

major)

With iliacus into

lesser trochanter

of femur

Lumbar plexus Psoas major:

(L1, L2, L3)

Psoas minor:

(L1, L2)

Sartorius Anterior

superior iliac

spine and

superior part ofnotch inferior to

it

Upper medial

surface of shaft

of tibia (pes

anserinus)


Piriformis Anterior surface

of sacrum (S2-

S4) and

sacrotuberous

ligament

Upper border of

greater

trochanter of

femur

Nerve to

piriformis

S1, S2

Obturator externus Outer surface of

obturator

membrane;

pubic and

ischial rami

Medial surface

of greater

trochanter and

trochanteric

fossa of femur

Obturator

nerve

L3, L4

Obturator internus Inner surface of

obturator

membrane

Superomedial

surface of

greater

trochanter and

trochanteric

fossa of femur

Nerve to

obturator

internus

L5, S1


25/44

25 Gemellus superior Spine of

ischium

Superomedial

surface of

greater

trochanter

(trochanteric

fossa); Blends

with tendon of

obturatorinternus

Nerve to

obturator

internus

L5, S1

Gemellus inferior Ischial

tuberosity

Superomedial

surface of

greater

trochanter

(trochanteric

fossa); Blends

with tendon of

obturator

internus

Nerve to

quadratus

femoris

L5, S1

Quadratus femoris Lateral border

of ischialtuberosity

Quadrate

tubercle onintertrochanteric

crest of femur

and area inferior

to it

Nerve to

quadratusfemoris

L5, S1

Gluteus medius

(posterior fibers)

Outer surface of

ilium between

anterior and

posterior gluteal

lines

Lateral surface

of greater

trochanter of

femur

Superior

gluteal nerve

L5, S1

Biceps femoris (long

head)

Ischial

tuberosity

Lateral side of

head of fibula;Tendon is split

at this site by

fibular collateral

ligament of knee

Tibial portion

of sciatic nerve

L5, S1, S2


26/44

26

Medial

rotation

Gluteus medius

(anterior fibers)

Outer surface of

ilium between

anterior and

posterior gluteal

lines

Lateral surface

of greater

trochanter of

femur

Superior

gluteal nerve

L5, S1

Gluteus minimus Outer surface of

ilium betweenanterior and

inferior gluteal

lines

Anterior surface

of greatertrochanter of

femur

Superior

gluteal nerve

L5, S1

Tensor fasciae latae Anterior

superior iliac

spine and

anterior part of

iliac crest

Iliotibial tract

that attaches to

lateral condyle

of tibia (Gerdy

tubercle)

Superior

gluteal nerve

L5, S1

Semitendinosus Ischial

tuberosity

Upper part of

medial surface

of shaft of tibia

(pes anserinus)

Tibial portion

of sciatic nerve

L5,S1, S2

Semimembranosus Ischial

tuberosity

Posterior part of

medial condyle

of tibia;

Reflected

attachment

forms oblique

popliteal

ligament (to

lateral femoral

condyle)

Tibial portion

of sciatic nerve

L5,S1, S2

Adductor magnus(Adductor

Portion)****

Inferior ramusof pubis, ramus

of ischium

Glutealtuberosity, entire

length of linea

aspera, and

medial

supracondylar

line

Obturatornerve, posteriordivision

L2, L3, L4

Adductor longus**** Body of pubis,

medial to pubic

tubercle and

inferior to

pubic crest

Middle third of

linea aspera on

posterior

surface of femur

Obturator


L2, L3, L4

*Circumduction is a combination of all the movements described

**The predominant segmental nerve supply is indicated by boldface type

***Often the iliacus and Psoas major and minor are collectively referred to as the iliopsoas muscle

****The role of the adductor muscles as medial rotators vary according to hip position in select positions the

adductors may either medially or laterally rotate the hipThe primary muscles that produce each movement are shown in boldface type


27/44

27

SUMMARY OF KNEE (TIBIOFEMORAL) JOINT MOVEMENTS



SUPPLY

SEGMENTAL

NERVE

ROOTS*

FlexionBiceps femoris

(Two heads)

Long Head:

Ischial tuberosityShort Head:

Linea aspera of

femur, entire

length of lateral

lip, and lateral

supracondylar

line)

Lateral side of

head of fibula;Tendon is split

at this site by

fibular collateral

ligament of knee

Long Head:

Tibial portion ofsciatic nerve

Short Head:

Common

peroneal

(fibular) portion

of sciatic nerve

L5, S1, S2

Semimembranosus Ischial tuberosity Posterior part of

medial condyle

of tibia;

Reflectedattachment

forms oblique

popliteal

ligament (to

lateral femoral

condyle)

Tibial portion of

sciatic nerve

L5,S1, S2

Semitendinosus Ischial tuberosity Upper part of

medial surface

of shaft of tibia

(pes anserinus)

Tibial portion of

sciatic nerve

L5,S1, S2

Sartorius Anterior superior

iliac spine andsuperior part of

notch inferior to

it

Upper medial

surface of shaftof tibia (pes

anserinus)


Gracilis Body and inferior

ramus of pubis

Upper part of

shaft of tibia on

medial surface

(pes anserinus)

Obturator nerve L2, L3

Popliteus Lateral surface of

lateral condyle of

femur and lateral

meniscus

Posterior surface

of shaft of tibia

above soleal line

Tibial nerve L4, L5, S1

Gastrocnemius Lateral head from

lateral condyle of

femur; Medial

head above

medial condyle

and popliteal

surface of femur

Via tendo

calcaneus into

posterior surface

of calcaneus

Tibial nerve S1, S2

Plantaris Lateral

supracondylar

ridge of femur

Posterior surface

of calcaneus

Tibial nerve S1, S2


28/44

28

Extension Rectus femoris Straight head:anterior inferior

iliac spine;

Reflected head:

ilium above

acetabulum

Quadriceps tendon

into patella, then

via ligamentum

patellae into

tubercle of tibia

Femoral nerve L2, L3, L4

Vastus lateralis Greater trochanter

and lateral lip oflinea aspera

Quadriceps tendon

into patella, thenvia ligamentumpatellae into

tubercle of tibia


Vastus medialis Intertrochanteric

line and medial lip

of linea aspera

Quadriceps tendon

into patella, then

via ligamentum

patellae into

tubercle of tibia


Vastus intermedius Anterior and lateral

surfaces of femur

Quadriceps tendon

into patella, then

via ligamentum

patellae intotubercle of tibia


Medial

rotation

Semimembranosus Ischial tuberosity Posterior part of

medial condyle of

tibia;

Reflected

attachment forms

oblique popliteal

ligament (to

lateral femoral

condyle)

Tibial portion of

sciatic nerve

L5,S1, S2

Semitendinosus Ischial tuberosity Upper part of

medial surface of

shaft of tibia (pesanserinus)

Tibial portion of

sciatic nerve

L5,S1, S2

Sartorius Anterior superior

iliac spine &

superior part of

notch inferior to it

Upper medial

surface of shaft of

tibia (pes

anserinus)


Gracilis Body and inferior

ramus of pubis

Upper part of

shaft of tibia on

medial surface

(pes anserinus)

Obturator nerve L2, L3

Popliteus Lateral surface of

lateral condyle of

femur and lateralmeniscus

Posterior surface

of shaft of tibia

above soleal line

Tibial nerve L4, L5, S1

Lateral

rotation

Biceps femoris

(Two heads)

Long Head: Ischial

tuberosity

Short Head:

Linea aspera of

femur, entire length

of lateral lip, and

lateral

supracondylar line

Lateral side of

head of fibula;

Tendon is split at

this site by fibular

collateral ligament

of knee

Long Head:

Tibial portion of

sciatic nerve

Short Head:

Common

peroneal (fibular)

portion of sciatic

nerve

L5, S1, S2




29/44

29

SUMMARY OF ANKLE (TALOCRUAL) JOINT MOVEMENTS



SUPPLY

SEGMENTAL

NERVE

ROOTS*

Dorsiflexion Tibialisanterior Lateral condyleand superiorhalf of lateral

surface of tibia

and interosseousmembrane

Medial andinferior surfacesof medial

cuneiform and

base of firstmetatarsal bone

Deep peroneal(fibular) nerve

L4, L5

Extensor

digitorum

longus

Lateral condyleof tibia and

superior three-

fourths of

medial surfaceof fibula and

interosseous

membrane

Extensorexpansion of

middle and

distal phalanges

of lateral fourtoes


L5, S1

Extensor

hallucis longus

Middle part ofanterior surface

of fibula and


Dorsal aspect ofbase of distal

phalanx of great

toe (hallux)


L5, S1

Peroneus(Fibularis)

tertius

Inferior third ofanterior surface

of fibula andinterosseous

membrane

Dorsum of baseof fifth

metatarsal


L5, S1


30/44

30

Plantar

flexion

Gastrocnemius Lateral head

from lateral

condyle offemur and

medial head

from above

medial condyleand popliteal

surface of femur

Via tendo

calcaneus into

posterior surfaceof calcaneus

Tibial nerve S1, S2

Soleus Shafts of tibia

and fibula

Via tendo

calcaneus intoposterior surface

of calcaneus

Tibial nerve S1, S2

Plantaris Lateral

supracondylar

ridge of femur

Posterior surface

of calcaneus

Tibial nerve S1, S2

Peroneus

(Fibularis)longus

Head and

superior two-thirds of lateral

surface of fibula

Base of first

metatarsal andthe medial

cuneiform

Superficial

peroneal(fibular) nerve

L5, S1, S2

Peroneus(Fibularis)

brevis

Inferior two-thirds of lateral

surface of fibula

Base of fifthmetatarsal bone

Superficialperoneal

(fibular) nerve

L5, S1, S2

Tibialis

posterior

Posterior surface

of tibia inferior

to soleal lineand posterior

surface of

fibula;Interosseousmembrane

Tuberosity of

navicular; 1st,

2nd

, and 3rd

cuneiforms, and

cuboid; Bases of

2nd, 3rd, and 4thmetatarsals

Tibial nerve L4, L5

Flexor

digitorum

longus

Medial part of

posterior surface

of tibia inferior

to soleal lineand by a broad

tendon to fibula

Bases of distal

phalanges of

lateral four toes

Tibial nerve S2, S3

Flexor hallucislongus

Inferior two-thirds of

posterior surfaceof fibula andinferior part of


Base of distalphalanx of big

toe

Tibial nerve S2, S3



31/44

31

SUMMARY OF SUBTALAR (TALOCALCANEAL) JOINT MOVEMENTS

AND MUSCLES PRODUCING THOSE MOVEMENTSMOVEMENTS MUSCLES ORIGIN INSERTION NERVE

SUPPLY

SEGMENTAL

NERVE

ROOTS*

Inversion

andAdduction

Tibialis anterior Lateral condyle

and superior halfof lateral surface

of tibia and

interosseous

membrane

Medial and

inferior surfacesof medial

cuneiform and

base of first

metatarsal bone

Deep peroneal

(fibular) nerve

L4, L5

Tibialis

posterior

Posterior surface

of tibia inferior

to soleal line and

posterior surface

of fibula;

Interosseous

membrane

Tuberosity of

navicular; 1st,

2nd, and 3rd

cuneiforms, and

cuboid; Bases of

2nd, 3rd, and 4th

metatarsals

Tibial nerve L4, L5

Flexor digitorumlongus

Medial part ofposterior surface

of tibia inferior

to soleal line and

by a broad

tendon to fibula

Bases of distalphalanges of

lateral four toes

Tibial nerve S2, S3

Flexor hallucis

longus

Inferior two-

thirds of

posterior surface

of fibula and

inferior part of


Base of distal

phalanx of big

toe

Tibial nerve S2, S3

Eversion

and

Abduction

Peroneus

(Fibularis)

longus

Head and

superior two-

thirds of lateral

surface of fibula

Base of first

metatarsal and

the medial

cuneiform

Superficial

peroneal (fibular)

nerve

L5, S1, S2

Peroneus

(Fibularis)

brevis

Inferior two-

thirds of lateral

surface of fibula

Base of fifth

metatarsal bone

Superficial

peroneal (fibular)

nerve

L5, S1, S2

Peroneus

(Fibularis)

tertius

Inferior third of

anterior surface

of fibula and

interosseous

membrane

Dorsum of base

of fifth

metatarsal

Deep peroneal

(fibular) nerve

L5, S1

Extensor

digitorum longus

Lateral condyle

of tibia and

superior three-

fourths of medial

surface of fibula

and interosseous

membrane

Extensor

expansion of

middle and distal

phalanges of

lateral four toes

Deep peroneal

(fibular) nerve

L5, S1




32/44

32

SUMMARY OF METATARSOPHALANGEAL (MP) AND INTERPHALANGEAL (IP)

JOINT MOVEMENTS OF THE TOES & MUSCLES PRODUCING THOSE MOVEMENTS


SUPPLY

SEGMENTAL

NERVE ROOTS*

FlexionFlexor

digitorumlongus

(MP & IP)

Medial part of posterior

surface of tibia inferiorto soleal line and by abroad tendon to fibula

Bases of distal

phalanges of lateralfour toes

Tibial nerve S2, S3

Flexor

digitorum

brevis

(MP & IP)

Medial tubercle of

calcaneus; Plantar

aponeurosis and

intermuscular septa

Four tendons to

four lateral toes-

inserted into

borders of middle

phalanx; tendons

perforated by those

of flexor digitorum

longus

Medial plantar

nerve

S2, S3

Flexor digiti

minimi brevis(MP)

Base of fifth metatarsal

bone

Lateral side of base

of proximalphalanx of little toe

Superficial

branch of lateralplantar nerve

S2, S3

Flexor hallucis

longus

(MP & IP)

Inferior two-thirds of

posterior surface of

fibula and inferior part

of interosseous

membrane

Base of distal

phalanx of big toe

Tibial nerve S2, S3

Flexor hallucis

brevis (MP)

Lateral surfaces of

cuboid and lateral

cuneiforms; Tibialis

posterior insertion

Medial tendon into

medial side of base

of proximal

phalanx of big toe;

lateral tendon into

lateral side of base

of proximalphalanx of big toe

Medial plantar

nerve

S2, S3

Lumbricals

(MP) (1-4)

Tendons of flexor

digitorum longus

Dorsal extensor

expansion; bases of

proximal

phalanges of lateralfour toes

First lumbrical:

medial plantar

nerve; remainder:

lateral plantarnerve

S2, S3

Dorsi interossei

(MP)(1-4)

Adjacent sides of

metatarsal 1-5

Bases of proximal

phalanges:

1st

- medial side of

2nd

toe; 2nd

through

4th

- lateral sides of

2nd

, 3rd

, and 4th

toes; dorsal

extensor expansion

Lateral plantar

nerve

S2, S3

Plantar

interossei (MP)(1-3)

Inferior surfaces of

third, fourth, and fifthmetatarsal bones

Medial side of

bases of proximalphalanges of lateral

three toes

Lateral plantar

nerve

S2, S3

Quadratus

plantae (IP)

Medial and lateral sides

of plantar surface of

calcaneus

Posterolateral

margin of tendons

of flexor digitorum

longus

Lateral plantar

nerve

S2, S3


33/44

33


longus

(MP & IP)

Lateral condyle of

tibia and superiorthree-fourths of

medial surface of

fibula andinterosseous

membrane

Extensor

expansion ofmiddle and

distal phalanges

of lateral fourtoes

Deep peroneal

(fibular) nerve

L5, S1

Extensordigitorum

brevis

(MP & IP of

toes 2-4);

Extensor

hallucis

brevis (MPof big toe) -

part of

extensor

digitorum

brevis

Anterior part ofupper surface of

calcaneus; Inferiorextensor retinaculum

By three tendonsthat merge into

the extensordigitorum longus

tendons to the

second, third,

and fourth toes;

Into the base ofthe proximal

phalanx of bigtoe


L5, S1

Extensor

hallucis

longus

(MP & IP)

Middle part ofanterior surface of

fibula and

interosseous

membrane

Dorsal aspect ofbase of distal

phalanx of great

toe (hallux)


L5, S1

Lumbricals

(IP)

(1-4)

Tendons of flexor

digitorum longus

Dorsal extensor

expansion; bases

of proximal

phalanges oflateral four toes

First lumbrical:

medial plantar

nerve;

remainder:lateral plantar

nerve

S2, S3

Dorsi

interossei

(IP) (1-4)

Adjacent sides of

metatarsal 1-5

Bases of proximal

phalanges:

1st - medial side of

2nd toe; 2nd through

4th

- lateral sides of

2nd, 3rd, and 4th toes,and also dorsal

extensor expansion

Lateral plantar

nerve

S2, S3

Plantar

interossei(IP) (1-3)


third, fourth, andfifth metatarsal

bones

Medial side of

bases ofproximal

phalanges of

lateral three toes

Lateral plantar

nerve

S2, S3


34/44

34

Abduction Dorsiinterossei

(1-4)

Adjacent sides of

metatarsal 1-5

Bases of

proximal

phalanges:1st - medial side

of 2nd toe; 2nd

through 4th

-

lateral sides of2nd, 3rd, and 4th

toes, and also

dorsal extensorexpansion

Lateral plantar

nerve

S2, S3

Abductor

digiti minimi

Medial and lateral

tubercles of

calcaneus; Plantar

aponeurosis andintermuscular septa

Lateral side of

base of proximal

phalanx of fifth

toe

Lateral plantar

nerve

S2, S3

Abductor

hallucis

Medial tuberosity of

calcaneus; Flexorretinaculum and

plantar aponeurosis

Medial side of

base of proximalphalanx of big

toe

Medial plantar

nerve

S2, S3

Adduction Plantarinterossei

(1-3)


third, fourth, and

fifth metatarsalbones

Medial side of

bases of

proximalphalanges of

lateral three toes

Lateral plantar

nerve

S2, S3

Adductor

hallucis

Oblique Head: Bases

of metatarsals 2-4;

Transverse Head:

Plantar ligaments ofmetatarsophalangeal

joints

Tendons of both

heads attach to

lateral side of

base of proximalphalanx of big

toe

Deep branch of

lateral plantar

nerve

S2, S3



35/44

35

SUMMARY OF CERVICAL INTERVERTEBRAL, ATLANTO-OCCIPITAL,

AND ATLANTOAXIAL JOINT MOVEMENTS



SUPPLY

Flexion Sternocleidomastoid Sternal Head: Anteriorsurface of manubriumof sternum;

Clavicular Head:

Superior surface ofmedial third of clavicle

Mastoid process of

temporal bone andoccipital bone

Spinal part of

Cranial nerve XI(spinal accessory

nerve)

and C2-C3

Scalenus anterior Transverse processes ofthird, fourth, fifth, and

sixth cervical vertebrae

First rib Anterior rami ofcervical nerves

(C4-C6)

Scalenus medius Transverse processes of

upper six cervical

vertebrae

First rib Anterior rami of

cervical nerves

(C3-C8)

Scalenus posterior Transverse processes of

lower cervical

vertebrae

Second rib Anterior rami of

cervical nerves

(C6-C8)

Longus colli Medial part: bodies of

3rd

thoracic to 5th

cervical vertebrae;

superolateral part:

anterior tubercles of

transverse processes of3rd to 5th cervical

vertebrae; inferolateral

part: bodies of 1st

to 3rd

thoracic vertebrae

Medial part: bodies of

2nd

to 4th

cervicalvertebrae;

superolateral part: the

anterior tubercle of the

atlas;inferolateral part: the

anterior tubercles of the

transverse processes of5th and 6th cervical

vertebrae

Ventral primary

rami of C2-C6spinal nerves

Longus capitis Anterior tubercles of

transverse processes of

third to sixth cervicalvertebrae

basilar process of

occipital bone

Ventral primary

rami of C1-C3

spinal nerves

Rectus capitis

anterior

Base of skull, justanterior to occipital

bone

Anterior surface oflateral mass of C1

vertebral (atlas)

Branches fromloop between C1

and C2

Rectus capitislateralis

Jugular process ofoccipital bone

Transverse process ofC1 vertebral (atlas)

Branches fromloop between C1

and C2

Platysma Deep fascia over

pectoralis major and

deltoid

Inferior border of body

of mandible angle of

mouth, skin, andsubcutaneous tissues of

lower face

Facial nerve

(Cranial nerve

VII) - cervicalbranch


36/44

36

Extension Iliocostaliscervicis

Angles of 3-6 ribs Posterior tubercles of transverse

processes of C4-C6 vertebrae

Dorsal rami of spin

nerves (C4-T3)

Longissimus

cervicis

Transverse processesof T1-T5 vertebrae

Transverse processes and articularprocesses of C2-C6 vertebrae

Dorsal rami of spinnerves (C3-T3

Longissimus

capitis

Transverse processes

of T1-T5 and articular

processes of C4-C7

Mastoid process of temporal bone Dorsal rami of spin

nerves (C3-C8)

Spinalis cervicis

(often absent) -Smallest and

thinnest of

erector spinae

Inferior part of nuchal

ligament, spinousprocesses of C7-T2

vertebrae

Spinous processes of C2 vertebrae;

occasionally spinous processes of C3and C4 vertebrae

Dorsal rami of spin

nerves (C4-C8)

Spinalis capitis

(blends with

semispinalis

capitis)

Articular processes of

C4-C6 vertebrae


of C7-T6 vertebrae

Occipit (back of head) between

superior and inferior nuchal lines of

occipital bone

Dorsal rami of spin

nerves (C3-T1)

Semispinalis

capitis

Arises from transverseprocesses of C7 and

T1-T6

Fibers run superomedially to occipitalbone, spanning 4-6 segments

Dorsal rami of spinnerves (C2-T1)

Semispinalis

cervicis

Arises from transverse

processes of T1-T5vertebrae

Fibers run superomedially to spinous

processes of C2-C5, spanning 4-6segments

Dorsal rami of spin

nerves (C2-T5)

Splenius capitis Inferior part of nuchal

ligament, spinous

processes of C7-T3

vertebrae, &

supraspinous ligament

Fibers run superolaterally to mastoid

process of temporal bone and inferior

to lateral third of superior nuchal line

of occipital bone

Dorsal rami of spin

nerves (C3-C6)

Splenius cervicis Spinous processes ofT3-T6 vertebrae

Posterior tubercles of transverseprocesses of C1-C3 or C4 vertebrae

Dorsal rami of spinnerves (C4-C8)

Trapezius

(Upper Fibers)

External occipital

protuberance and

medial 1/3 of superior

nuchal line, ligamentum

nuchae, and spinousprocess of C7

Lateral third of posterior clavicle XI cranial nerve

(Spinal part of

accessory nerve);

C3, C4

Obliquus capitis

superior

Transverse process of

atlas

lateral third of inferior nuchal line dorsal branch of C1

(suboccipital)

Rectus capitis

posterior major

spinous process of axis middle of inferior nuchal line of

occipital bone

dorsal branch of C1

(suboccipital)

Rectus capitis

posterior minor

From posterior

tubercle of atlas

medial third of inferior nuchal line of

occipital bone

dorsal branch of C1

(suboccipital)

Multifidi cervicis Transverse processes of

T1-T3, and articular

processes of C4-C7

vertebrae

Fibers pass superomedially to spinous

processes of vertebrae above,

spanning 2-4 segments

Dorsal rami of spin

nerves (C4-T1)

Rotatores cervicis Arise from transverse

processes of cervicalvertebrae

Pass superomedially to attach to

junction of lamina and transverseprocesses, or spinous processes of

vertebrae above their origin, spanning

1-2 segments

Dorsal rami of spin

nerves (C3-C8)

Levator scapulae Transverse processes

of C1-C4 vertebrae

Superior part of medial border of

scapula near superior angle

C3 and C4; dorsal

scapular nerve from

C5 root

Interspinales

cervicis

Superior surfaces of

spinous processes of

C1-T1

Inferior surfaces of spinous processes

of vertebrae superior to vertebrae of

origin

Dorsal rami of spin

nerves (C3-C8)

Intertransversarii

cervicis


of cervical vertebrae

Transverse processes of adjacent

vertebrae

Dorsal/ventral rami o

spinal nerves (C3-C8


37/44

37

Lateral

Flexion*

Iliocostalis cervicis Angles of 3-6 ribs Posterior tubercles of

transverse processes of C4-

C6 vertebrae

Dorsal rami of

spinal nerves

(C4-T3)

Longissimus cervicis Transverse processes

of T1-T5 vertebrae

Transverse processes and

articular processes of C2-

C6 vertebrae

Dorsal rami of

spinal nerves

(C3-T3)

Longissimus capitis Transverse processes

of T1-T5 and C4-C7

articular processes

Mastoid process of

temporal bone

Dorsal rami of

spinal nerves

(C3-C8)

Spinalis capitis (blends

with semispinalis capitis)

Articular processes of

C4-C6 vertebrae

Transverse processes of

C7-T6 (T7) vertebrae

Occipit (back of head)

between superior and

inferior nuchal lines of

occipital bone

Dorsal rami of

spinal nerves

(C3-T1)

Semispinalis capitis Arises from transverse

processes of C7 and

T1-T6

Fibers run superomedially

to occipital bone, spanning

4-6 segments

Dorsal rami of

spinal nerves

(C2-T1)

Semispinalis cervicis Arises from transverse

processes of T1-T5

vertebrae

Fibers run superomedially

to spinous processes of C2-

C5, spanning 4-6 segments

Dorsal rami of

spinal nerves

(C2-T5)

Rectus capitis lateralis Jugular process ofoccipital bone Transverse process of C1vertebral (atlas) Branches from loobetween C1 and C2

Splen

Date post:	07-Apr-2018
Category:	Documents
Upload:	ptkid
View:	220 times
Download:	0 times

Muscles O, I, A, N

Documents