1. Shoulder, Elbow, Wrist, and Hand
Chapters 16, 17, 18
Shoulder, Elbow, Wrist, and Hand

2. Shoulder Bones Scapula (anterior & posterior views)
Acromion Process: B1
Acromioclavicular Joint: B2
Coracoid Process: B3
Glenoid Fossa: B4
Spine: B5
Supraspinous Fossa: B6
Infraspinous Fossa: B7
Subscapular Fossa: B8
Medial Border: B9
Lateral Border: B10
Superior Border: B11
Inferior Angle: B13
Superior Angle: B14

3. Bones of the Shoulder Humerus (anterior view) Head: A1
Anatomical Neck: A5
Surgical Neck: A6
Coronoid Fossa: A10
Medial Epicondyle: A12
Trochlea: A14
Capitulum: A13
Lateral Epicondyle: A11
Radial Fossa: A9
Shaft: A7
Made up of three bones:
Humerus, Clavicle, and Scapula.
Bony parts to know:
Humerus:
Head of humerus, Greater Tubercle, Lesser Tubercle, Intertubercular groove
Scapula:
Acromion Process, Coracoid Process, Glenoid Fossa, Spine of scapula, Medial border, Lateral border, Superior border
Clavicle:
Acromial end, sternal end

4. Bones of the Elbow
3 bones: Humerus, Radius, Ulna (radius and ulna pictured)
Study Anterior View!
Head of the radius: A1
Neck of the radius: A2
Radial Tuberosity: A3
Ulnar Notch: A5
Styloid Process: A6
Trochlear Notch: B1
Coronoid Process: B2
Ulnar Tuberosity: B3
Radial Notch: B4
Short Styloid Process: B5
Olecranon Process: B6
Interosseous Membrane: C
3 bones – Humerus (Yellow Arrow), Ulna (Aqua Arrow), and Radius (Dk. Green Arrow)
Parts of the bones:
Humerus – Medial Epicondyle (Orange Arrow), Lateral Epicondyle (Blue Arrow), Coronoid Fossa (Black Arrow), Trochlea (Red Arrow), Capitulum (Dk. Blue Arrow), Olecranon Fossa (not pictured)
Ulna – Olecranon Process (not pictured), Trochlear Notch (Lgt. Green Arrow), Coronoid Process (Lgt. Purple Arrow), Radial Notch (Dk. Purple Arrow)
Radius – Head of Radius (Purple Arrow), Radial Tuberosity (Brown Arrow)

5. Bones of the Wrist and Hand Anterior Diagram
Carpals: C
8 carpal bones (proximal row/
distal row
Scaphoid: C1
Lunate: C2
Triquetal: C3
Pisiform: C4
Trapezium: C5
Trapezoid: C6
Capitate: C7
Hamate: C8
Metacarpals: D
5 metacarpals
Phalanges: E
14 phalanges
Proximal(E1), Middle (E2), Distal (E3)

6. Ranges of Motion Elbow Shoulder Wrist 1 2 3 4 5 6 1 2 3 4 5 6 7 8 9 1011 12 13

7. Muscles of the Shoulder
Rotator Cuff Muscles:
AKA “SITS” muscles
Subscapularis (not on diagram)
Origin: subscapular fossa of the scapula
Insertion: Lesser tubercle of the humerus
Action:
Infraspinatus: a-posterior
Origin: Infraspinous fossa of scapula
Insertion: Greater tubercle of the humerus
Teres Minor: b-posterior
Origin: upper 2/3 of dorsal surface of the lateral border of the scapula
Supraspinatus (not on diagram)
Origin: supraspinous fossa of scapula
Insertion: greater tubercle of the humerus
Subscapularis: Origin: subscapular fossa of the scapula.
Insertion: Lesser tubercle of the humerus.
Function: Medially rotates the arm; draws the humerus toward the glenoid fossa, strengthening the shoulder joint.
Infraspinatus: Origin: Infraspinous fossa of scapula
Insertion: Greater tubercle of the humerus
Function: Laterally rotates the arm; draws humerus towards the glenoid fossa, strengthening the shoulder joint.
Teres Minor: Origin: upper 2/3 of dorsal surface of the lateral border of the scapula
Function: Laterally rotate the arm and weakly adducts it; draws the humerus towards the glenoid fossa, strengthening the shoulder joint.
Supraspinatus: Origin: supraspinous fossa of scapula
Insertion: greater tubercle of the humerus
Function: Abducts the arm; draws the humerus towards the glenoid fossa, strengthening the shoulder joint.

8. Rotator Cuff

9. Pectoralis Muscles Pectoralis Major Pectoralis Minor: B Action:
Origin: Medial half
of the clavicle, sternum, upper six or
seven ribs
Insertion: Lateral lip of the
intertubercular groove of humerus
Action:
Pectoralis Minor: B
Origin: Origin: 3rd, 4th, and 5th ribs
Insertion: Coracoid process of the
scapula
Pectoralis Muscles
Pectoralis Major: Origin: Medial half of the clavicle, sternum, upper six or seven ribs.
Insertion: Lateral lip of the intertubercular groove of humerus.
Function: Flexes, adducts, and rotates the arm medially.
Pectoralis Minor: Origin: 3rd, 4th, and 5th ribs.
Insertion: Coracoid process of the scapula.
Function: Stabilizes the scapula by drawing it forward and downward.

10. Subclavius: A-anterior and posterior
Origin: 1st rib and its costal cartilage
Insertion: inferior surface of the clavicle
Action:
Subclavius: Origin: 1st rib and its costal cartilage
Insertion: inferior surface of the clavicle
Function: draws the shoulder forward and downward.

11. Trapezius D-Anterior and Posterior
Origin: Superior nuchal line and external occipital protuberance of occipital bone, ligamentum nuchae, spinous processes of C7 – T12 vertebrae
Insertion: Lateral 1/3 of clavicle, acromion and spine of the scapula
Action: Shoulder Extension, adduction, and internal rotation
Trapezius: Origin: Superior nuchal line and external occipital protuberance of occipital bone, ligamentum nuchae, spinous processes of C7 – T12 vertebrae
Insertion: Lateral 1/3 of clavicle, acromion and spine of the scapula
Function: Steadies, raises, retracts, and rotates the scapula; acting together, all parts raise the point of the shoulder in full abduction and flexion of the arm; acting together, the upper parts extend the head.

12. Latissimus Dorsi Not on diagram
Origin: spinous processes of the lower 6 thoracic vertebrae and thoracolumbar fascia, lumbar and sacral spinous processes, and the lower ribs
Insertion: Floor of the intertubercular groove of the humerus
Action:
Latissimus Dorsi: Origin: spinous processes of the lower 6 thoracic vertebrae and thoracolumbar fascia, lumbar and sacral spinous processes, and the lower ribs.
Insertion: Floor of the intertubercular groove of the humerus.
Function: Extends, adducts, and medially rotates the humerus at shoulder joint.

13. Scapular Rotators Levator Scapulae: E-anterior and posterior
Origin: Transverse processes of the first 3 – 4 cervical vertebrae
Insertion: Medial border of the scapula between the spine and the superior angle
Action:
Rhomboid Major: F-anterior and post.
Origin: Ligamentum nuchae and the spinous processes of T2 – T5 vertebrae
Insertion: Medial border of the scapula between the spine and the inferior angle
Scapular Rotators
Levator Scapulae: Origin: Transverse processes of the first 3 – 4 cervical vertebrae.
Insertion: Medial border of the scapula between the spine and the superior angle.
Function: Elevates and slightly retracts the scapula.
Rhomboid Major: Origin: Ligamentum nuchae and the spinous processes of T2 – T5 vertebrae.
Insertion: Medial border of the scapula between the spine and the inferior angle.
Function: Retracts and elevates the scapula; the lower part depresses the lateral angle, assisting in adduction of the arm.

14. Scapular Rotators cont.
Rhomboid Minor:
G-posterior
Origin: Ligamentum nuchae and spinous processes of C7 – T1 vertebrae
Insertion: Medial border of the scapula at the root of the spine
Action:
Teres Major: c-posterior
Origin: Dorsal surface of the lateral border of the scapula, near the inferior angle
Insertion: Medial lip of the intertubercular groove of the humerus
Scapular Rotators cont.
Rhomboid Minor: Origin: Ligamentum nuchae and spinous processes of C7 – T1 vertebrae.
Insertion: Medial border of the scapula at the root of the spine.
Function: Retracts and elevates the scapula.
Teres Major: Origin: Dorsal surface of the lateral border of the scapula, near the inferior angle.
Insertion: Medial lip of the intertubercular groove of the humerus.
Function: Adducts, extends, and medially rotates the arm.

15. Deltoid Muscles I-posterior
Origin: lateral 1/3 of the clavicle, lateral border of the acromion process, and spins of the scapula
Insertion: Deltoid tuberosity of the humerus
Action:
3 Parts: Anterior, Middle, Posterior
Deltoid: Origin: lateral 1/3 of the clavicle, lateral border of the acromion process, and spins of the scapula.
Insertion: Deltoid tuberosity of the humerus.
Function: Abducts the arm; some flexion and extension, some medial and lateral rotation.

16. Biceps Brachii a-anterior superficial view
Origin
Short Head: Apex of coracoid process of the scapula
Long Head: Supraglenoid tubercle of scapula
Insertion: tuberosity of the radius
Function:
Biceps Brachii: Origin: Short Head: Apex of coracoid process of the scapula (medial origin)
Origin: Long Head: Supraglenoid tubercle of scapula (lateral origin).
Insertion: tuberosity of the radius.
Function: flexes arm, flexes forearm, supinates hand.

17. Triceps Brachii posterior diagram
Origin
Long Head: Infraglenoid tubercle of scapula
Lateral Head: posterior surface of the humerus above the radial groove
Medial Head: posterior surface of humerus below the radial groove
Insertion: olecranon of the ulna
Function:
Triceps Brachii: Origin: Long Head: Infraglenoid tubercle of scapula
Origin: Lateral Head: posterior surface of the humerus above the radial groove
Origin: Medial Head: posterior surface of humerus below the radial groove.
Insertion: olecranon of the ulna.
Function: Extends forearm; the long head extends and adducts the arm.

18. Brachialis b-Anterior Superficial View
Origin: distal half of anterior surface of the humerus
Insertion: Tuberosity and coronoid process of the ulna
Action:
Brachialis: Origin: distal half of anterior surface of the humerus.
Insertion: Tuberosity and coronoid process of the ulna.
Function: Flexes the forearm.

19. Anconeus d-posterior superficial view
Origin: Lateral epicondyle of the humerus
Insertion: Olecranon of the ulna and synovial membrane of the elbow joint
Action:
Anconeus: Origin: Lateral epicondyle of the humerus.
Insertion: Olecranon of the ulna and synovial membrane of the elbow joint.
Function: Extends the forearm.

20. Superficial Wrist Flexor Muscles
Flexor Carpi Radialis: A-anterior
Origin: the medial epicondyle of the humerus
Insertion: base of the 2nd metacarpal bone
Action:
Palmaris Longis: B-Anterior
Origin: medial epicondyle of the humerus
Insertion: palmar aponeurosis
Flexor Carpi Ulnaris: C-both
Insertion: Pisiform bone and base of the 5th metacarpal bone
Flexor Digitorum Superficialis: D-anterior
Insertion: shafts of the middle phalanges of medial four fingers
Flexor Carpi Radialis: Origin: the medial epicondyle of the humerus.
Insertion: base of the 2nd metacarpal bone.
Function: flexes the hand and helps with radial deviation.
Palmaris Longis: Origin: the medial epicondyle of the humerus.
Insertion: palmar aponeurosis
Function: Flexes the hand.
Flexor Carpi Ulnaris: Origin: the medial epicondyle of the humerus.
Insertion: Pisiform bone and base of the 5th metacarpal bone.
Function: flexes hand and helps with ulnar deviation.
Flexor Digitorum Superficialis: Origin: the medial epicondyle of the humerus.
Insertion: shafts of the middle phalanges of medial four fingers.
Function: flexes the middle phalanx of each finger; by continued action, flexes the proximal phalanx and hand.

21. Deep Wrist Flexor Muscles
Flexor Pollicis Longus: F-anterior
Origin: Ventral surface of the radius and the interosseous membrane
Insertion: base of the distal phalanx of the thumb
Action:
Flexor Pollicis Longus: Origin: Ventral surface of the radius and the interosseous membrane.
Insertion: base of the distal phalanx of the thumb
Function: flexes the distal phalanx of the thumb; by continued action, flexes the proximal phalanx.

22. Superficial Wrist Extensor Muscles
Extensor Digiti Minimi: J-posterior
Origin: lateral epicondyle and supracondylar ridge of the humerus
Insertion: extensor expansion of the little finger
Action:
Extensor Carpi Radialis Longus: Origin: lateral epicondyle and supracondylar ridge of the humerus
Insertion: dorsal surfacce of the base of the 2nd metacarpal bone
Function: Extends and helps with radial deviation.
Extensor Carpi Radialis Brevis: Origin: lateral epicondyle and supracondylar ridge of the humerus
Insertion: Dorsal surface of base of 3rd metacarpal bone.
Extensor Digitorum: Origin: lateral epicondyle and supracondylar ridge of the humerus
Insertion: extensor expansions of the fingers
Function: extends the phalanges; by continued action, extends the hand.
Extensor Digiti Minimi: Origin: lateral epicondyle and supracondylar ridge of the humerus
Insertion: extensor expansion of the little finger
Function: extends the little finger
Extensor Carpi Ulnaris: Origin: lateral epicondyle and supracondylar ridge of the humerus
Insertion: Base of the 5th metacarpal bone
Function: extends and helps with ulnar deviation.

23. Deep Wrist Extensor Muscles
Abductor Pollicis Longus: L-both
Origin: Posterior surface of the middle of the radius and ulna, and the interosseous membrane
Insertion: base of the 1st metacarpal bone
Action:
Extensor Pollicis Brevis: M-posterior
Origin: Posterior surface of the middle of the radius, and the interosseous membrane
Insertion: base of the proximal phalanx of the thumb
Abductor Pollicis Longus: Origin: Posterior surface of the middle of the radius and ulna, and the interosseous membrane.
Insertion: base of the 1st metacarpal bone
Function: abducts the thumb; and by continued action, helps with radial deviation.
Extensor Pollicis Brevis: Origin: Posterior surface of the middle of the radius, and the interosseous membrane.
Insertion: base of the proximal phalanx of the thumb
Function: extends the proximal phalanx of the thumb; by continued action, helps with radial deviation.
Extensor Pollicis Longus: Origin: Posterior surface of the middle of the ulna, and the interosseous membrane.
Insertion: base of the distal phalanx of the thumb
Function: Extends the distal phalanx of the thumb; by continued action, abducts the hand.
Extensor Indicis: Origin: Posterior surface of the distal end of the ulna, and the interosseous membrane
Insertion: extensor expansion of the index finger
Function: extends the index finger

24. Brachioradialis P-both
Origin: lateral epicondyle and supracondylar ridge of the humerus
Insertion: lateral side of the base of the styloid process of the radius
Action:
Brachioradialis: Origin: lateral epicondyle and supracondylar ridge of the humerus
Insertion: lateral side of the base of the styloid process of the radius.
Function: flexes the forearm.

25. Pronator Teres S-anterior
Origin: two heads:
1 medial epicondyle of humerus
2 coronoid process of ulna
Insertion: Lateral surface of the radius
Action:
Pronator Quadratus: Origin: Distal ventral surface of the ulna
Insertion: anterior surface of the distal part of the radius.
Function: Pronates the hand
Pronator Teres: Origin: two heads: 1/ medial epicondyle of humerus, 2/ coronoid process of ulna.
Insertion: Lateral surface of the radius
Function: Pronate the hand.

26. Shoulder Injuries Acromioclavicular Sprain Rotator Cuff Strain
Shoulder Impingement
Bicipital Tendonitis
Shoulder Subluxation
Shoulder Dislocation
Labral Tear
Clavicular Fracture

27. Elbow Injuries Ulnar Collateral Ligament Sprain
Lateral Epicondylitis aka Tennis Elbow
Medial Epicondylitis aka Little League Elbow
Radial/Ulnar Fractures

28. Hand/Wrist Injuries Lunate Dislocation Gamekeeper’s Thumb
Mallett Finger
Jersey Finger
Boutonniere Deformity
Boxer’s Fracture
Bennet’s Fracture
Scaphoid Fracture