UL Bone

anatomy

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 trapezius Ms superior surface muscles origin

muscles insersion

ligament attachment

posterior

sternocleidomastoid Ms
deltoid Ms
anterior

UL Bone deltoid Ms
inferior surface pectoralis major Ms

anatomy anterior
pectoralis major Ms

costoclavicular lig.

posterior

subclavius Ms

sternohyoid Ms
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UL Bone
anatomy

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 UL Bone
anatomy

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UL Bone
anatomy

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 Pectoral Pectoralis Major
Region Attachments: The distal attachment of both heads is
UL MS into the intertubercular sulcus of the humerus.
Clavicular head – originates from the anterior surface
of the medial clavicle.
Sternocostal head – originates from the anterior
surface of the sternum, the superior six costal
cartilages and the aponeurosis of the external oblique
muscle.
Function: Adducts and medially rotates the upper limb,
and draws the scapula anteroinferiorly. The clavicular
head also acts individually to flex the upper limb.
Innervation: Lateral and medial pectoral nerves.

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 Pectoral Pectoralis Minor
O: 3rd-5th ribs,
Region
UL MS inserts into the coracoid process of the
scapula.
Function: Stabilises the scapula by drawing it
anteroinferiorly against the thoracic wall.
Innervation: Medial pectoral nerve.

Serratus Anterior
O: lateral aspects of ribs 1-8.
attach to the costal (rib facing) surface of the
medial border of the scapula.
Function: Rotates the scapula, allowing the arm
to be raised over 90 degrees. It also holds the
scapula against the ribcage.
Innervation: Long thoracic nerve.

Subclavius
O: junction of the 1st rib and its costal cartilage
inserting into the inferior surface of the middle
third of the clavicle.
Function: Anchors and depresses the clavicle.
Innervation: Nerve to subclavius.

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 Intrinsic Muscles
shoulder originate from the scapula and/or clavicle, and attach to the humerus

UL MS There are six muscles in this group – the deltoid, teres major, and the four
rotator cuff muscles (supraspinatus, infraspinatus, subscapularis and teres
minor).

Deltoid
O: lateral third of the clavicle, the acromion and the spine of
the scapula.
It attaches to the deltoid tuberosity
Innervation: Axillary nerve.
Actions: Anterior fibres – flexion and medial rotation.
Posterior fibres – extension and lateral rotation.
Middle fibres – the major abductor of the arm (takes over
from the supraspinatus, which abducts the first 15 degrees).

Teres Major
O: posterior surface of the inferior angle of the scapula.
It attaches to the medial lip of the intertubercular groove of
the humerus.
Innervation: Lower subscapular nerve.
Actions: Adducts and extends at the shoulder, and medially
rotates the arm.
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 Intrinsic Muscles Rotator Cuff Muscles
shoulder
UL MS Supraspinatus
O: supraspinous fossa of the scapula,
attaches to the greater tubercle of the humerus.
Innervation: Suprascapular nerve.
Subscapularis Actions: Abducts the arm 0-15o, and assists deltoid for 15-90o
O: subscapular fossa of the scapula.
It attaches to the lesser tubercle of the humerus.
Infraspinatus
Innervation: Upper and lower subscapular nerves.
O: infraspinous fossa of the scapula,
Actions: Medially rotates the arm.
attaches to the greater tubercle of the humerus.
Innervation: Suprascapular nerve.
Teres Minor
Actions: Laterally rotates the arm.
O: posterior surface of the scapula, adjacent to its lateral border.
It attaches to the greater tubercle of the humerus.
Innervation: Axillary nerve.
Actions: Laterally rotates the arm.

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 shoulder
Extrinsic Muscles Superficial
originate from the torso, and attach to the bones

UL MS of the shoulder (clavicle, scapula or humerus).

Trapezius
Latissimus Dorsi Originates : skull, nuchal ligament , spinous
Attachments:  spinous processes of processes of C7-T12. clavicle, acromion, and
T7-T12, the scapula spine.
iliac crest, thoracolumbar fascia and Innervation: Motor innervation is from the
the inferior three ribs. accessory nerve. It also receives
The fibres converge into a tendon proprioceptor fibres from C3 and C4 spinal
that attaches to the intertubercular nerves.
sulcus of the humerus.
Actions: upper fibres of the trapezius elevate
Innervation: Thoracodorsal nerve.
the scapula and rotates it during abduction
Actions: Extends, adducts, and
of the arm.
medially rotates the upper limb.
The middle fibres retract the scapula and
the
lower fibres pull the scapula inferiorly.

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 shoulder
Extrinsic Muscles Deep
originate from the torso, and attach to the bones

UL MS of the shoulder (clavicle, scapula or humerus).

Levator Scapulae
O: transverse processes of the C1-C4 vertebrae
and attaches to the medial border of the scapula.
Innervation: Dorsal scapular nerve.
Actions: Elevates the scapula.

Rhomboid Major
O: spinous processes of T2-T5 vertebrae.
Attaches to the medial border of the scapula, between
the scapula spine and inferior angle.
Innervation: Dorsal scapular nerve.
Actions: Retracts and rotates the scapula.

Rhomboid Minor
O: spinous processes of C7-T1 vertebrae.
Attaches to the medial border of the scapula, at the
level of the spine of scapula.
Innervation: Dorsal scapular nerve.
Actions: Retracts and rotates the scapula.

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 Anterior Compartment
ARM
UL MS BBC (biceps, brachialis, coracobrachialis.)
all innervated by the musculocutaneous nerve
Arterial supply: muscular branches of the brachial artery:

Biceps Brachii:
Long head O: supraglenoid tubercle of
the scapula
short head O: coracoid process of the scapula
Both heads insert into the radial tuberosity
Function: Supination of the forearm + flexes
elbow

Coracobrachialis (deep under biceps Ms)

O: coracoid process of the scapula.
attaches the medial side of the humeral shaft,
at the level of the deltoid tubercle.
F: Flexion of the arm at the shoulder, and weak
adduction

Brachialis (deep under biceps Ms)

O: medial and lateral surfaces of the humeral shaft
inserts into the ulna tuberosity
F: Flexion at the elbow.
Innervation: Musculocutaneous nerve, with contributions from
the radial nerve
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 ARM Posterior Compartment
UL MS Arterial supply: profunda brachii artery.

Triceps Brachii
Long head O: infraglenoid tubercle.
Lateral head O: humerus, superior to the radial groove.
Medial head O: humerus, inferior to the radial groove.
Distally, the heads converge onto one tendon and insert into the olecranon of the
ulna.
Function: Extension of the arm at the elbow.
Innervation: Radial nerve.
Note: In some individuals, the long head of the triceps brachii is innervated by the
axillary nerve.

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surface anatomy

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 Anterior Compartment Superficial
forearm all originate from a common tendon,

UL MS which arises from the medial epicondyle of the humerus

Flexor Carpi Ulnaris

O: medial epicondyle + It also has a long origin from the ulna.
attaches to the pisiform carpal bone.
Actions: Flexion and adduction at the wrist.
Innervation: Ulnar nerve.

Palmaris Longus (This muscle is absent in about 15% of the

population)
O: medial epicondyle, attaches to the flexor retinaculum of the
wrist.
Actions: Flexion at the wrist.
Innervation: Median nerve.

Flexor Carpi Radialis

O: medial epicondyle, attaches to the base of metacarpals II and III.
Actions: Flexion and abduction at the wrist.
Innervation: Median nerve.

Pronator Teres
two origins: medial epicondyle+coronoid process of the ulna.
It attaches laterally to the mid-shaft of the radius.
Actions: Pronation of the forearm.
Innervation: Median nerve.
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 Anterior Compartment Intermediate
forearm
UL MS The flexor digitorum superficialis
is the only muscle of the intermediate compartment. It can
sometimes be classed as a superficial muscle, but in most cadavers
it lies between the deep and superficial muscle layers.

The muscle is a good anatomical landmark in the forearm – the

median nerve and ulnar artery pass between its two heads, and
then travel posteriorly.

O: It has two heads – one originates from the

medial epicondyle of the humerus+ the other
from radius.
The muscle splits into four tendons at the
wrist, which travel through the carpal tunnel,
and attaches to the middle phalanges of the
four fingers.
Actions: Flexes the metacarpophalangeal joints
and proximal interphalangeal joints at the 4
fingers, and flexes at the wrist.
Innervation: Median nerve.

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 Anterior Compartment Deep
forearm
UL MS Flexor Digitorum Profundus
O: ulna and associated interosseous
membrane.
Flexor Pollicis Longus (This muscle lies At the wrist, it splits into four tendons, that pass
laterally to the FDP.) through the carpal tunnel and attach to the
O: anterior surface of the radius, and distal phalanges of the four fingers.
surrounding interosseous membrane. Actions: It is the only muscle that can flex the
Attaches to the base of the distal phalanx of distal interphalangeal joints of the fingers. It
the thumb. also flexes at metacarpophalangeal joints and at
Actions: Flexes the interphalangeal joint and the wrist.
metacarpophalangeal joint of the thumb. Innervation: The medial half (acts on the little
Innervation: Median nerve (anterior and ring fingers) is innervated by the ulnar
interosseous branch). nerve. The lateral half (acts on the middle and
index fingers) is innervated by the anterior
interosseous branch of the median nerve.

Pronator Quadratus
O: anterior surface of the ulna
attaches to the anterior surface
of the radius.
Actions: Pronates the forearm.
Innervation: Median nerve
(anterior interosseous branch).
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 Posterior Compartment Superficial
forearm Brachioradialis
UL MS The brachioradialis is a paradoxical muscle. Its origin and innervation are
characteristic of an extensor muscle, but it is actually a flexor at the elbow.
The muscle is most visible when the forearm is half pronated, and flexing
at the elbow against resistance.
O: proximal aspect of the lateral supracondylar ridge of
humerus
attaches to the distal end of the radius, just before the radial
styloid process.
Actions: Flexes at the elbow.
Innervation: Radial nerve.

Extensor Carpi Radialis Longus and Brevis

ECRL O: supracondylar ridge,
ECRB O: lateral epicondyle.
Their tendons attach to metacarpal bones II and III.
Actions: Extends and abducts the wrist.
Innervation: Radial nerve.

Extensor Digitorum Communis

The extensor digitorum is the main extensor of the fingers. To test the
function of the muscle, the forearm is pronated, and the fingers
extended against resistance.
O: lateral epicondyle.
inserts into the extensor hood of each finger.
Actions: Extends medial four fingers at the MCP and IP joints.
Innervation: Radial nerve (deep branch).
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 Posterior Compartment Superficial
forearm
UL MS Extensor Digiti Minimi
O: lateral epicondyle of the humerus.
It attaches, with the extensor digitorum tendon, into
the extensor hood of the little finger.
Actions: Extends the little finger, and contributes to
extension at the wrist.
Innervation: Radial nerve (deep branch).

Extensor Carpi Ulnaris

O: lateral epicondyle of the humerus
attaches to the base of metacarpal V.
Actions: Extension and adduction of wrist.
Innervation: Radial nerve (deep branch).

Anconeus
The anconeus is situated medially and superiorly in the extensor compartment
of the forearm.
It is blended with the fibres of the triceps brachii, and the two muscles can be
indistinguishable.
O: lateral epicondyle
attaches to the posterior and lateral part of the olecranon.
Actions: Extends and stablises the elbow joint. Abducts the
ulna during pronation of the forearm.
Innervation: Radial nerve.

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 Posterior Compartment Deep
forearm Supinator

UL MS It has two heads of origin. One originates from the lateral epicondyle of the humerus, the
other from the posterior surface of the ulna.
They insert together into the posterior surface of the radius.
Actions: Supinates the forearm.
Innervation: Radial nerve (deep branch).

Abductor Pollicis Longus

O: interosseous membrane and the adjacent posterior surfaces of the radius and ulna. It attaches to the lateral side of the
base of metacarpal I.
Actions: Abducts the thumb.
Innervation: Radial nerve (posterior interosseous branch).

Extensor Pollicis Brevis

O: posterior surface of the radius and interosseous membrane. attaches to the base of the proximal phalanx of the thumb.
Actions: Extends at the metacarpophalangeal and carpometacarpal joints of the thumb.
Innervation: Radial nerve (posterior interosseous branch).

Extensor Pollicis Longus

O: posterior surface of the ulna and interosseous membrane. It attaches to the distal phalanx of the thumb.
Actions: Extends all joints of the thumb: carpometacarpal, metacarpophalangeal and interphalangeal.
Innervation: Radial nerve (posterior interosseous branch).

Extensor Indicis Proprius

O: posterior surface of the ulna and interosseous membrane, distal to the extensor pollicis longus. Attaches to the
extensor hood of the index finger.
PTMej Actions: Extends the index finger.
Innervation: Radial nerve (posterior interosseous branch).
 Posterior Compartment Deep
forearm
UL MS

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 Posterior Compartment Deep
forearm surface anatomy
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 extrinsic muscles 
are located in the anterior and posterior compartments of the
forearm. They control crude movements and produce a
UL MS Hand forceful grip.

intrinsic muscles of the hand are located within the hand

itself. They are responsible for the fine motor functions of
the hand.
include the adductor pollicis, palmaris brevis, interossei,
lumbricals, thenar and hypothenar muscles.

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 Thenar Muscles
The thenar muscles are three short muscles located at the base of the
Hand thumb. The muscle bellies produce a bulge, known as the thenar eminence.

UL MS They are responsible for the fine movements of the thumb.

The median nerve innervates all the thenar muscles.

Opponens Pollicis
The opponens pollicis is the largest of the thenar muscles, and lies
underneath the other two.
O: tubercle of the trapezium, and the associated flexor retinaculum.
It inserts into the lateral margin of the metacarpal of the thumb (i.e.
the first metacarpal).
Actions: Opposes the thumb, by medially rotating and flexing the
metacarpal on the trapezium.
Innervation: Median nerve.

Abductor Pollicis Brevis

O: tubercles of the scaphoid and trapezium, and from the associated
flexor retinaculum.
Attaches to lateral side of proximal phalanx of the thumb.
Actions: Abducts the thumb.
Innervation: Median nerve.

Flexor Pollicis Brevis

O: tubercle of the trapezium and from the associated flexor retinaculum.
Attaches to the base of the proximal phalanx of the thumb.
Actions: Flexes the metacarpophalangeal (MCP) joint of the thumb.
Innervation: Median nerve. The deep head is innervated by the deep branch of the
PTMej ulnar nerve.
 Hypothenar Muscles
The hypothenar muscles produce the hypothenar eminence – a muscular protrusion
Hand on the medial side of the palm, at the base of the little finger. These muscles are similar

UL MS to the thenar muscles in both name and organisation.

The ulnar nerve innervates the muscles of the hypothenar eminence

Opponens Digiti Minimi
O: hook of hamate and associated flexor retinaculum,
inserts into the medial margin of metacarpal V.
Actions: It rotates the metacarpal of the little finger
towards the palm, producing opposition.
Innervation: Ulnar nerve.

Abductor Digiti Minimi (The most superficial

of the hypothenar muscles.)
O: pisiform and the tendon of the flexor carpi
ulnaris.
It attaches to the base of the proximal
phalanx of the little finger.
Actions: Abducts the little finger.
Innervation: Ulnar nerve.

Flexor Digiti Minimi Brevis

O: hook of hamate and adjacent
flexor retinaculum
inserts into the base of the
proximal phalanx of the little
finger.
Actions: Flexes the MCP joint of th
PTMej little finger.
Innervation: Ulnar nerve.
 Lumbricals
Hand These are four lumbricals in the hand, each associated with a finger. They are very crucial to
finger movement, linking the extensor tendons to the flexor tendons.

UL MS Denerveration of these muscles is the basis for the ulnar claw and hand of benediction.

Attachments: Each lumbrical originates from a tendon of the flexor digitorum profundus.
They pass dorsally and laterally around each finger, 
inserts into the extensor hood.
Actions: The flex at the MCP joint, and extend at the interphalangeal (IP) joints of each finger.
Innervation: The lateral two lumbricals (of the index and middle fingers) are innervated by the median nerve. The
medial two lumbricals (of the little and ring fingers) are innervated by the ulnar nerve.

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 Interossei
located between the metacarpals. They can be divided into two groups: the dorsal and
Hand palmar interossei.

UL MS In addition to their actions of abduction (dorsal interossei) and adduction (palmar interossei)
of the fingers, the interossei also assist the lumbricals in flexion and MCP joints and
extension at the IP joints.

Dorsal Interossei
The most superficial of all dorsal muscles, these can
be palpated on the dorsum of the hand. There are
four dorsal interossei muscles.
O: lateral and medial surfaces of the metacarpals.
attach into the extensor hood and proximal phalanx
of each finger.
Actions: Abduct the fingers at the MCP joint.
Innervation: Ulnar nerve.

Palmar Interossei
These are located anteriorly on the hand.
There are three palmar interossei muscles –
although some texts report a fourth muscle at
the base of the proximal phalanx of the thumb.
O:medial or lateral surface of a metacarpal
attaches into the extensor hood and proximal
phalanx of same finger.
Actions: Adducts the fingers at the MCP joint.
PTMej Innervation: Ulnar nerve.
 Other Muscles in the Palm
Hand
UL MS
Palmaris Brevis
This is a small, thin muscle, found very superficially in the
subcutaneous tissue of the hypothenar eminence.
O: palmar aponeurosis and flexor retinaculum
attaches to the dermis of the skin on the medial margin of the
hand.
Actions: Wrinkles the skin of the hypothenar eminence and
deepens the curvature of the hand, improving grip.
Innervation: Ulnar nerve.

Adductor Pollicis
This is large triangular muscle with two heads. The radial
artery passes anteriorly through the space between the two
heads, forming the deep palmar arch.
Attachments: One head originates from metacarpal III. The
other head originates from the capitate and adjacent areas
of metacarpals II and III.
Both attach into the base of the proximal phalanx of the
thumb.
Actions: Adductor of the thumb.
Innervation: Ulnar nerve.

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 Hand surface anatomy
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