Vol 2. Movements of the Shoulder Forearm-2 Hand

Muscles Producing Movementa Nerve to Muscles Movement of Scapula Muscles Producing Movementa Nerve to Muscles Range of Movement (Angular Rotation; Linear Displacement) Elevation Trapezius, descending part Levator scapulae Rhomboids Spinal accessory (CN XI) Dorsal scapular 10-12 cm Depression Gravity Pectoralis major, inferior sternocostal head Latissimus dorsi Trapezius, ascending part Serratus anterior, inferior part Pectoralis minor Pectoral nerves Thoracodorsal Spinal accessory (CN XI) Long thoracic Medial pectoral   Protraction Serratus anterior Pectoralis major Pectoralis minor Long thoracic Pectoral nerves Medial pectoral 40-45°; 15 cm Retraction Trapezius, middle part Rhomboids Latissimus dorsi Spinal accessory (CN XI) Dorsal scapular Thoracodorsal Upward rotationa Trapezius, descending part Trapezius, ascending part Serratus anterior, inferior part Spinal accessory (CN XI) Long thoracic 60°; inferior angle: 10-12 cm, superior angle: 5-6 cm Downward rotationb Gravity Levator scapulae Rhomboids Latissimus dorsi Pectoralis minor Pectoralis major, inferior sternocostal head Dorsal scapular Thoracodorsal Medial pectoral Pectoral nerves

Principal muscles acting on the shoulder joint Abductors Supraspinatus Deltoid Adductors Pectoralis major Lattisimus dorsi Extensors Teres major Deltoid (posterior fibres) Flexors Coracobrachialis Deltoid (anterior fibres) Medial rotators Subscapularis  Lateral rotators Infraspinatus Teres minor

Muscle Origin Insertion Nerve Function Deltoid Lateral third of clavicle; acromion and spine of scapula Deltoid tuberosity of humerus Axillary nerve Clavicular (anterior) part: flexes and medially rotates arm Acromial (middle) part: abducts arm Spinal (posterior) part: extends and laterally rotates arm Supraspinatus Supraspinous fossa of scapula Superior facet of greater tubercle of humerus Suprascapular nerve Initiates and assists deltoid in abduction of arm and acts with rotator cuff muscles Infraspinatus Infraspinous fossa of scapula Middle facet of greater tubercle of humerus Laterally rotates arm; and acts with rotator cuff muscles Teres minor Middle part of lateral border of scapula Inferior facet of greater tubercle of humerus Teres major Posterior surface of inferior angle of scapula Medial lip of intertubercular sulcus of humerus Inferior subscapular nerve Adducts and medially rotates arm Subscapularis Subscapular fossa (most of anterior surface of scapula) Lesser tubercle of humerus Sup. & Inf. subscapular nerves Medially rotates arm; as part of rotator cuff, helps hold head of humerus in glenoid cavity

Muscles of the superficial layer flexor carpi radialis flexor carpi ulnaris palmaris longus pronator teres two heads Ulnar head Humeral head Medial epicondyle

Muscles of the superficial layer flexor carpi radialis Medial epicondyle of humerus Base of metacarpals II & III 2. flexor carpi ulnaris Humeral head: Medial epicondyle of humerus Ulnar head: Olecranon & Posterior border of ulna •Pisiform & hamate •5th metacarpal 3. palmaris longus Medial epicondyle of humerus Flexor retinaculum & palmar aponeurosis 4. pronator teres Humeral head: Medial epicondyle & adjacent supraepicondylar ridge Ulnar head: Coronoid process Lateral surface of radius

Shafts of middle phalanges of 3. ..the muscles of the intermediate and deep layers? Muscles of the intermediate layer flexor digitorum superficialis Humeroulnar head • Medial epicondyle of humerus • Adjacent margin of coronoid process Radial head Superior half of anterior border Shafts of middle phalanges of medial four digits

Muscles of the deep layer 3. ..the muscles of the intermediate and deep layers? flexor digitorum profundus flexor pollicis longus pronator quadratus Proximal ¾ of medial & anterior surfaces of ulna Interosseous membrane Anterior surface of radius Adjacent interosseous membrane Distal ¼ of anterior surface of ulna Distal ¼ of anterior surface of radius Bases of distal phalanges of 4th & 5th digits Bases of distal phalanges of 2nd & 3rd digits Base of distal phalanx of thumb

Fxns of the anterior compartment muscles Flexion of forearm @ the elbow joint Pronator teres Flexion of hand @ the wrist joint Flexor carpi radialis et ulnaris- Palmaris longus Abduction (radial deviation) of hand @ the wrist joint Flexor carpi radialis Adduction (ulnar deviation) of hand @ the wrist joint Flexor carpi ulnaris Pronation of forearm Pronator teres – Pronator quadratus

intrinsic muscles of the hand Palmaris brevis Thenar muscles Abductor pollicis brevis Abductor digiti minimi Hypothenar muscles Opponens pollicis Adductor pollicis Flexor digiti minimi Flexor pollicis brevis Lumbrical Interossei

functions the intrinsic muscles of the hand Palmar interossei adduct the thumb, index, ring, and little fingers with respect to a long axis through the middle finger Dorsal interossei major abductors of the index, middle, and ring fingers, at the metacarpophalangeal joints

Lumbricals functions the intrinsic muscles of the hand flexing metacarpophalangeal joints extending interphalangeal joints medial two deep branch of the ulnar nerve lateral two median nerve

How are the intrinsic muscles innervated? All of the intrinsic muscles of the hand by deep branch of the ulnar nerve Except three thenar & two lateral lumbrical muscles by median nerve

Superficial palmar arch ....arteries of the hand Superficial palmar arch Deep palmar arch

...sensory innervation of the hand Ulnar nerve medial side of the palm, medial half of the dorsum of the hand, the 5th finger, and the medial half of the 4th finger, anterior surfaces of the medial one and a half digits, Median nerve thumb,index,middle fingers,lateral side of the ring [distal parts on the dorsum of the hand] Radial nerve dorsolateral side

THANK YOU! SEE YOU @ VOL.3 Thigh Popliteal fossa