Upper limb muscles

1
Muhammad Ramzan-Ul-
Rehman

5 Pectoralis major
 Origin:
1. Medial half of the clavicle
2. The sternum.
3. Upper six costal cartilage.
 Insertion:
Lateral lip of bicipital groove of the humerus.
 Nerve Supply:
Medial and lateral pectoral nerves.
 Action:
A. Adduction, flexion and medial rotation of the arm.
B. Climbing.
C. It is an accessory muscle of inspiration.

7 Pectoralis minor
 Origin:
3rd, 4th and 5th ribs near their cartilage.
 Insertion:
Anterior border of the coracoid process of the scapula.
 Nerve Supply:
Medial pectoral nerves.
 Action:
A. Depression and protraction of the scapula.
B. If the insertion is fixed, it elevates the 3rd, 4th and 5th ribs.
C. It rotates the scapula downward (with rhomboids).

9 Subclavius
 Origin:
The upper surface of the first costal cartilage.
 Insertion:
Middle third of the inferior surface of the clavicle.
 Nerve Supply:
Nerve to subclavius (from upper trunk of brachial
plexus).
 Action:
A. It depresses the clavicle.
B. It steadies the clavicle during movement of the
shoulder girdle.

11 Layers of Back Muscles
First Layer:
Trapezius and latissimus dorsi.
Second Layer:
Levator scapulae, rhomboid minor and
rhomboid major.
Third Layer:
Serratus posterior superior and serratus
posterior inferior.

15 Trapezius
 Origin:
1. Medial third of superior nuchal line of occipital b.
2. External occipital protuberance.
3. Ligamentum nuchae.
4. Spine of the seventh cervical vertebra.
5. Spines and supraspinous ligaments of all thoracic
vertebrae
 Insertion:
1. Upper fibers into the posterior aspect of the lateral
third of the clavicle.
2. Middle fibers into the medial border of the acromion
process of the scapula.
3. Lower fibers into the spine of the scapula.

17 Trapezius
 Nerve Supply:
 Motor fibers from the spinal part of accessory nerve.
 Proprioceptive sensory fibers from the third and fourth cervical nerves.
 Action:
A. Upper fibers: elevates the scapula.
B. Middle fibers: retracts the scapula.
C. Lower fibers: depresses the scapula.
D. With serratus anterior: rotates the scapula upward (for abduction of the arm
more than 90°.
E. When scapula is fixed: both side muscles extend the head.

18 Latissimus dorsi
 Origin:
1. Spines of the lower 6 thoracic vertebrae.
2. Lower 3 or 4 ribs.
3. Lumbar fascia and posterior part of iliac crest.
4. Inferior angle of the scapula.
 Insertion:
Floor of the bicipital groove of the humerus.
 Nerve Supply:
Thoracodorsal nerve.
 Action:
A. Adduction, extension and medial rotation of the arm.
B. Climbing.

20 Levator scapulae
 Origin:
The transverse processes of the upper four cervical vertebrae.
 Insertion:
Dorsal lip of the medial border of the scapula above the level of its spine.
 Nerve Supply:
From the ventral rami of the 3rd and 4th cervical nerves and form dorsal scapular
nerve (C5).
 Action:
A. Elevation of the scapula.
B. If the scapula is fixed, it bends the head to the same side.

22 Rhomboid minor
 Origin:
1. Lower part of ligamentum nuchae.
2. Spine of seventh cervical vertebra.
3. Spine of first thoracic vertebra.
 Insertion:
Dorsal lip of the medial border of the scapula opposite the root of its spine.
 Nerve Supply:
Dorsal scapular nerve (C5).
 Action:
B. With rhomboid major and pectoralis minor, it rotates the scapula downward.

24 Rhomboid major
 Origin:
1. From 2nd to 5th spines of the thoracic vertebrae.
2. And their supraspinous ligaments.
 Insertion:
Dorsal lip of the medial border of the scapula
below the level of its spine.
 Nerve Supply:
Dorsal scapular nerve (C5).
 Action:
B. With rhomboid major and pectoralis minor, it
rotates the scapula downward.

25
Muscles:.
Deltoid.
Supraspinatus.
Infraspinatus
Teres Minor.
Teres Major.
Subscapularis.
Serratus Anterior.
Muscles of
the scapular
region

27 Deltoid
 Origin:
1. Anterior fibers from the lateral third of the
anterior border of the clavicle.
2. Middle fibers from the lateral border of the
acromion process of the scapula.
3. Posterior fibers from the lower border of the
spine of the scapula.
 Insertion:
Into the deltoid tuberosity, on the middle of
the lateral surface of the shaft of the
humerus.

29 Deltoid
 Nerve Supply:
From the axillary nerve (C5,6).
 Action:
A. Anterior fibers: flexes and medially
rotates the arm.
B. Posterior fibers: extends and laterally
rotates the arm.
C. Middle fibers: abducts the arm till the
level of the head (from 15° to 90°).

30 Supraspinatus
 Origin:
From the supraspinous fossa of the scapula.
 Insertion:
Into the upper facet (impression) of the greater
tuberosity of the humerus and upper part of the
capsule of the shoulder joint.
 Nerve Supply:
From the suprascapular nerve (C5,6).
 Action:
A. Starts abduction of the arm (from 0° to 15°).
B. Stabilizes and supports the shoulder joint (rotator
cuff muscle).

32 Infraspinatus
 Origin:
From the infraspinous fossa of the scapula.
 Insertion:
Into the middle facet (impression) of the greater
tuberosity of the humerus and posterior part of
the capsule of the shoulder joint.
 Nerve Supply:
From the suprascapular nerve (C5,6).
 Action:
A. Laterally rotates the arm.
B. Stabilizes and supports the shoulder joint
(rotator cuff muscle).

34 Teres minor  Origin:
From the upper 2/3 of the dorsal lip of the lateral
border of the scapula.
 Insertion:
Into the lower facet (impression) of the greater
tuberosity of the humerus and posterior part of
the capsule of the shoulder joint.
 Nerve Supply:
From the axillary nerve (C5,6).
 Action:
A. Laterally rotates the arm.
B. Stabilizes and supports the shoulder joint
(rotator cuff muscle).

36 Teres major
 Origin:
The lower third of the posterior surface of the
lateral border of the scapula.
 Insertion:
The medial lip of the bicipital groove of the
humerus.
 Nerve Supply:
Lower subscapular nerve.
 Action:
It adducts, extends and medial rotates the arm.

38 Subscpularis
 Origin:
The medial 2/3 of the subscapular fossa of the
anterior surface of the scapula and from the
inner surface of the subscapular fascia.
 Insertion:
The lesser tuberosity of the humerus.
 Nerve Supply:
Upper and lower subscapular nerves.
 Action:
A. It adducts and medial rotates the arm.
B. It stabilizes the shoulder joints.

41 Serratus anterior
 Origin:
By 8 digitations from the outer surface of the upper 8 ribs.
 Insertion:
To the anterior surface of the medial border of the
scapula, mainly near the inferior angle.
 Nerve Supply:
Long thoracic nerve (from root of brach. plex.).
 Action:
A. It protracts the scapula anteriorly and fixes it to the
thoracic wall.
B. With the trapezius, it rotates the scapula upward.
C. It acts as a strong accessory muscle of inspiration.

47
Rotator cuff Muscles
They are the supraspinatus, infraspinatus,
teres minor and subscapularis muscle.
They surround the shoulder joint, except form
the inferior aspect (weak point).
Their tone helps in holding the head of
humerus in the glenoid cavity.
They maintain the stability of the shoulder
joint.

50 Biceps brachii
 Origin:
1. Long head: from the supraglenoid tubercle of the scapula.
2. Short head: from the tip of coracoid process of the scapula.
 Insertion:
1. Into the posterior part of the radial tuberosity of the
radius.
2. Forms the bicipital aponeurosis which is inserted into the
deep fascia of the upper part of the medial side of the
forearm.
 Nerve Supply:
From musculocutaneous nerve.
 Action:
1. Supination of the forearm at the radio-ulnar joints.
2. Flexion of the forearm at the elbow joint.
3. Weak flexion of the shoulder joint.

52 Coracobrachialis
 Origin:
From the tip of coracoid process of the scapula (with short head of biceps).
 Insertion:
Into the middle third of the medial side of the shaft of the humerus.
 Nerve Supply:
From musculocutaneous nerve.
 Action:
1. Flexion of the shoulder joint.
2. Weak adduction of the shoulder joint.

54 Brachialis
 Origin:
From the lower half of the anterior surface of the shaft of the humerus and the
adjoining parts of the medial and lateral intermuscular septa.
 Insertion:
Into the anterior surface of the coronoid process of the ulna.
 Nerve Supply:
1. Majority of the muscle from musculocutaneous nerve.
2. Small lateral part by the radial nerve.
 Action:
Strong flexion of the elbow joint.

57 Triceps muscle
 Origin:
1. Long head: from the infraglenoid tubercle of the scapula.
2. Lateral head: from the upper half of the posterior surface
of the shaft of the humerus, above and lateral to the spiral
groove.
3. Medial head: from the lower half of the posterior surface of
the shaft of the humerus, below and medial to the spiral
groove.
 Insertion:
Into the upper surface of the olecranon process of the ulna.
 Nerve Supply:
From the radial nerve (through many branches at the axilla and
the spiral groove).
 Action:
Extension of the forearm at the elbow joint.

62
Muscles of the Anterior Compartment
of the forearm
A. Superficial Layer: (1) Pronator teres, (2)
flexor carpi radialis, (3) palmaris longus,
(4) flexor digitorum superficialis and (5)
flexor carpi ulnaris.
B. Deep Layer: (1) Flexor pollicis longus,
(2) flexor digitorum profundus and (3)
pronator quadratus.

64 Pronator teres
 Origin:
1. Humeral head: from the medial epicondyle of the humerus (common flexor
origin).
2. Ulnar head: from the medial border of the coronoid process of the ulna.
 Insertion:
o Into the pronator tuberosity on the lateral surface of the middle part of the
shaft of the radius.
 Nerve Supply:
From the median nerve.
 Action:
1. Pronation of the forearm at the radio-ulnar joints.
2. Flexion of the forearm at the elbow joint.

66 Flexor carpi radialis
 Origin:
• From the medial epicondyle of the humerus
(common flexor origin).
 Insertion:
• Into palmar surface of the bases of the 2nd
and 3rd metacarpal bones.
 Nerve Supply:
From the median nerve.
 Action:
1. Flexion of the hand at the wrist joint.
2. Abduction of the hand at the wrist joint.

68 Palmaris longus
 Origin:
• From the medial epicondyle of the
humerus (common flexor origin).
 Insertion:
• Into the palmar aponeurosis and flexor
retinaculum.
 Nerve Supply:
• From the median nerve.
 Action:
• Flexion of the hand at the wrist joint.

70
Flexor digitorum superficialis
 Origin:
1. Humero-ulnar head: from the medial epicondyle of the
humerus (common flexor origin) and from the medial
border of the coronoid process of the ulna.
2. Radial head: from the oblique line on the anterior surface
of the shaft of the radius.
 Insertion:
• Its tendon divides into 4 tendons which are inserted into
the sides of the middle phalanges of the medial 4 fingers.
 Nerve Supply:
 Action:
1. Flexion of the proximal interphalageal joints and
metacarpophalangeal joints of the medial 4 fingers.
2. Helps of flexion of the hand at the wrist joint.

72 Flexor carpi ulnaris
 Origin:
1. Humeral head: from the medial epicondyle of the
humerus (common flexor origin).
2. Ulnar head: from the medial aspect of the olecranon
process and form the posterior border of the shaft of
the ulna.
 Insertion:
• Into the pisiform, hook of hamate and base of the 5th
metacarpal bone.
 Nerve Supply:
• From the ULNAR nerve.
 Action:
1. Flexion of the hand at the wrist joint.
2. Adduction of the hand at the wrist joint.

74 Flexor pollicis longus
 Origin:
• From the anterior surface of the middle of
the shaft of the radius and adjoining part of
the interosseus membrane.
 Insertion:
• Into the palmar surface of the base of the
distal phalanx of the thumb.
 Nerve Supply:
• From the anterior interosseus nerve (branch
of the median nerve).
 Action:
• Flexion of the thumb.

76
Flexor digitorum profundus
 Origin:
• From the upper ¾ of the anterior surface of the shaft of the ulna
and adjoining part of the interosseus membrane.
 Insertion:
• The muscle divides into 4 tendons which pierce the tendons of
the flexor digitorum superficialis and are inserted into the bases
of the distal phalanges of the medial 4 fingers.
 Nerve Supply:
• Its lateral half: from the anterior interosseus nerve (branch of the
median nerve).
• It medial half: from the ulnar nerve.
 Action:
1. Flexion of the distal interphalangeal joints of the medial 4
fingers.
2. Helps in flexion of the proximal interphalangeal joints and
metacarpophalangeal joints of the medial 4 fingers.
3. Helps of flexion of the hand at the wrist joint.

78 Pronator quadratus
 Origin:
• From the lower ¼ of the anterior surface of
the shaft of the ulna.
 Insertion:
• Into the lower ¼ of the anterior surface of
the shaft of the radius.
 Nerve Supply:
• From the anterior interosseus nerve (branch
of the median nerve).
 Action:
• Pronation of the forearm at the radio-ulnar
joints.

POSTERIOR (EXTENSOR)
COMPARTMENT
85

86
Muscles of the posterior
compartment of the forearm
A. Superficial Layer: (1) Brachioradialis, (2)
extensor carpi radialis longus, (3) extensor
carpi radialis brevis, (4) extensor digitorum,
(5) extensor digiti minimi, (6) extensor carpi
ulnaris and (7) anconeus.
B. Deep Layer: (1) Supinator, (2) abductor
pollicis longus, (3) extensor pollicis brevis,
(4) extensor pollicis longus and (5) extensor
indicis.

88 Brachioradialis
 Origin:
• from the upper 2/3 of the lateral supracondylar
ridge of the humerus.
 Insertion:
• Into the base of the styloid process of the
radius.
 Nerve Supply:
• From the radial nerve.
 Action:
1. Flexion of the forearm (specially in midprone
position).
2. Restoration of the forearm into the midprone
position.

90
Extensor carpi radialis longus
 Origin:
• from the lower 1/3 of the lateral
supracondylar ridge of the humerus.
 Insertion:
• Into the posterior surface of the base of
the 2nd metacarpal bone.
 Nerve Supply:
 Action:
1. Extension of the hand at wrist joint.
2. Abduction of the hand at wrist joint.

92
Extensor carpi radialis brevis
 Origin:
• from the lateral epicondyle of the
humerus (common extensor origin).
 Insertion:
• Into the posterior surface of the base of
the 3rd metacarpal bone.
 Nerve Supply:
• From the deep branch of radial nerve.
 Action:
2. Abduction of the hand at wrist joint.

94 Extensor digitorum
 Origin:
• from the lateral epicondyle of the humerus
(common extensor origin).
 Insertion:
• Into the extensor expansion of the medial 4
fingers.
 Nerve Supply:
 Action:
1. Extension of metacarpophalangeal and
interphalangeal joints of the medial 4 fingers.

96 Extensor digiti minimi
 Origin:
 Insertion:
• Into the extensor expansion of the little finger.
 Nerve Supply:
 Action:
1. Extension of metacarpophalangeal and
interphalangeal joints of the little finger.
2. Helps in extension of the hand at wrist joint.

98 Extensor carpi ulnaris
 Origin:
 Insertion:
• Into the posterior surface of the base of the 5th
metacarpal bone.
 Nerve Supply:
 Action:
2. Adduction of the hand at wrist joint.

100 Anconeus
 Origin:
• from the posterior aspect of the lateral
epicondyle of the humerus.
 Insertion:
• Into the lateral surface of the olecranon
process of the ulna.
 Nerve Supply:
 Action:
• It helps the triceps in extension of the elbow
joint.

102 Supinator  Origin:
• from (1) the lateral epicondyle of the humerus, (2) lateral collateral ligament of
the elbow joint, (3) annular ligament of the superior radio-ulnar joint, and (4)
supinator fossa and crest of the ulna.
 Insertion:
• Into the upper 1/3 of the lateral surface of the shaft of the radius.
 Nerve Supply:
• From the deep branch of the radial nerve.
 Action:
• It helps the biceps in supination of the forearm at the radio-ulnar joints.

104 Abductor pollicis longus
 Origin:
• from the middle of the posterior surface of
radius and ulna and intervening interosseus
membrane.
 Insertion:
• Into the posterior surface of the base of the 1st
metacarpal bone.
 Nerve Supply:
• From the deep branch of radial (posterior
interosseus) nerve.
 Action:
• Abduction and extension of the thumb at the
carpo-metacarpal joint.

106 Extensor pollicis brevis
 Origin:
• from the posterior surface of radius (below
abductor pollicis longus) and adjoining
interosseus membrane.
 Insertion:
• Into the posterior surface of the base of the
proximal phalanx of the thumb.
 Nerve Supply:
interosseus) nerve.
 Action:
• Extension of the metacarpophalangeal joint of
the thumb.

108 Extensor pollicis longus
 Origin:
• from the posterior surface of ulna (below
abductor pollicis longus) and adjoining
 Insertion:
• Into the posterior surface of the base of the
distal phalanx of the thumb.
 Nerve Supply:
interosseus) nerve.
 Action:
• Extension of the interphalangeal joint of the
thumb.

110 Extensor indicis
 Origin:
• from the posterior surface of ulna (below
extensor pollicis longus) and adjoining
 Insertion:
• Into the extensor expansion of the index
finger.
 Nerve Supply:
interosseus) nerve.
 Action:
• Extension of all joints of the index finger.
• It helps in extension of the wrist joint.

117 Muscle of the hand
Thenar muscles:
(1) Abductor pollicis brevis, (2) Flexor pollicis
brevis and (3) opponens pollicis.
Hypothenar muscles:
(1) Abductor digiti minimi, (2) Flexor digiti
minimi and (3) opponens digiti minimi.
Small muscles of the hand:
(1) Lumbricals, (2) interossei (palmar and dorsal),
and (3) adductor pollicis.

119 Abductor pollicis brevis
 Origin:
• from the scaphoid, trapezium and flexor
retinaculum.
 Insertion:
• Into the lateral aspect of the base of the
proximal phalanx of the thumb.
 Nerve Supply:
 Action:
• Abduction of the thumb at the carpo-metacarpal
joint.

121 Flexor pollicis brevis
 Origin:
• from the flexor retinaculum.
 Insertion:
• Into the lateral aspect of the base of
the proximal phalanx of the thumb.
 Nerve Supply:
 Action:
• Flexion of the thumb at the
metacarpophalangeal joint.

123 Opponens pollicis
 Origin:
 Insertion:
• Into the lateral border of the shaft of
the 1st metacarpal bone.
 Nerve Supply:
 Action:
• Opposition of the thumb against other
fingers.

125 Abductor digiti minimi
 Origin:
• from the pisiform and flexor retinaculum.
 Insertion:
• Into the medial aspect of the base of the
proximal phalanx of the little finger.
 Nerve Supply:
• From the deep branch of ulnar nerve.
 Action:
• Abduction of the little finger at the

127 Flexor digiti minimi
 Origin:
 Insertion:
• Into the medial aspect of the base of the
proximal phalanx of the little finger.
 Nerve Supply:
 Action:
• Flexion of the little finger at the

129 Opponens digiti minimi
 Origin:
 Insertion:
• Into the medial border of the shaft of
the 5th metacarpal bone.
 Nerve Supply:
 Action:
• Opposition of the little finger against
the thumb.

131 4 Lumbricals
 Origin:
• 1st and 2nd from the lateral side of the tendon of index
and middle fingers of the flexor digitorum profundus.
• 3rd and 4th from the adjacent sides of the tendon of
middle, ring and little fingers of the flexor digitorum
profundus.
 Insertion:
• Into the extensor expansions of the fingers.
 Nerve Supply:
• 1st and 2nd (lateral two) from the median nerve.
• 3rd and 4th (medial two) from the deep branch of ulnar
nerve.
 Action:
• Flexion of the metacarpophalangeal joints.
• Extension of the interphalangeal joints.

135 3 Palmar interossei  Origin:
• 1st from the medial side of the metacarpal bone of index
finger.
• 2nd and 3rd from the lateral side of the metacarpal bones of
the ring and little fingers.
 Insertion:
• 1st into the medial side of the base of the proximal phalanx
of the index finger.
• 2nd and 3rd into the lateral side of the base of the proximal
phalanges of the ring and little fingers.
• They also are inserted into the extensor expansions of the
index, ring and little fingers.
 Nerve Supply:
 Action:
1. Adduction of the index, ring and little fingers.
2. Flexion of their metacarpophalangeal joints.
3. Extension of their interphalangeal joints.

139 4 Dorsal interossei  Origin:
• From the adjacent sides of the metacarpal bones.
 Insertion:
• 1st and 2nd into the lateral sides of the bases of the
proximal phalanx of the index and middle fingers.
• 3rd and 4th into the medial sides of the bases of the
proximal phalanges of the middle and ring fingers.
• They also are inserted into the extensor expansions of the
index, ring and little fingers.
 Nerve Supply:
 Action:
1. Abduction of the index, middle and ring fingers.
2. Flexion of their metacarpophalangeal joints.
3. Extension of their interphalangeal joints.

143 Adductor pollicis
 Origin:
• Oblique head from the bases of the 2nd and 3rd metacarpal bones and the
adjoining carpal bones.
• Transverse head from the anterior surface of the shaft of the 3rd metacarpal
bone.
 Insertion:
• Into the medial side of the base of the proximal phalanx of the thumb.
 Nerve Supply:
 Action:
• Adduction of the thumb at the carpometacarpal joint.

146
Muscles of the Shoulder, Thorax and Abdominal Wall
Pectoral
muscles
Muscle Action Nerve supply
Pectoralis major Flexes, adducts & rotates arm Medial & lateral pectoral
nerves
Pectoralis minor Protract shoulder
Serratus anterior Stabilizes scapula, elevates ribs Long thoracic nerve
Shoulder
muscles
Deltoid Abducts, flexes, extends & rotates
arm
Axillary nerve
Back muscles
Trapezius Elevates & rotates scapula Spinal part of accessory
nerve
Latissimus dorsi Adducts & rotates arm Nerve to latissmus dorsi
Abdominal
muscles
Rectus abdominis
External oblique
Internal oblique
Transversus abdominis
Protect intra-abdominal viscera
Flex & rotate the trunk
Compress abdomen
Lower 5 intercostal &
subcostal nerves
Diaphragm
The diaphragm is a dome-shaped, musculotendinuous partition
separating the thoracic and abdominal cavities. It has peripheral
origin from the margins of the thoracic outlet and a central tendon.
It is the chief muscle of inspiration.
Phrenic nerve

147
Muscle Action Nerve supply
Musculo-cutaneous
nerve
Front of arm Coracobrachialis flexes & adducts the arm
Biceps brachii supinates & flexes the forearm
Brachialis flexes the forearm
Back of arm Ttriceps brachii extends forearm Radial nerve
Median & ulnar
nerves
Pronator teres pronate forearm
Pronator quadratus
Front of forearm
flexes & abducts wrist
flexes & adducts wrist
Flexor carpi radialis Flexor carpi ulnaris
Flexor digitorum superficialis & profundus flex wrist & fingers
Radial nerve
Back of forearm Supinator supinates forearm
extends & abducts wrist
extends & adducts wrist
Extensor carpi radialis
Extensor carpi ulnaris
Ext digitorum extends wrist & fingers
Extensor poilicis brevis extend thumb
Extensor poilicis longus
Abductor poilicis longus abducts thumb

Wish you Good Luck
. Thank you .
148

Upper limb muscles

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