dr. Ch. Tri Nuryana, M.

Kes
MUSCLE ORIGIN INSERTION INNERVATION BLOOD ACTION
SUPPLY
Pectoralis Clavicle, Intertubercular Medial and Thoracoacrom Adduction of the arm
major upper half of groove of lateral ial artery- Medial rotator of
sternum humerus pectoral pectoral humerus
nerves branch
(C5C8)
Pectoralis 3rd to 5th ribs Superior Medial Thoracoacrom Stabilizes scapula by
minor surface of pectoral ial artery- drawing it inferiorly
coracoid nerve (C8,T1) pectoral and anteriorly against
process branch thoracic wall

Subclavius 1st rib Inferior surface Nerve to Thoracoacrom Anchors and depresses
of middle third subclavius ial artery- clavicle
of clavicle (C5, C6) clavicular
branch

Serratus 1st8th ribs Anterior Long thoracic Lateral Protracts scapula,

• INJURY n. Thoracalis longus
• WINGED SCAPULAE
• UPPER LIMB CAN’T ABDUCT > HORIZONTAL
POSITION
• WEAKEST: JUNCTION 1/3LAT & MED
• M. STERNOCLEIDMASTOIDEUS MED FRAGMENT
• END OF FRAGMENT IS PROMINENT (PALPABLE)
• M. TRAPEZIUS UNABLE TO HOLD LAT FRAGMENT
• THE SHOULDER DROP
• M.PECTORALIS MAJOR PULL LAT FRAGMNT TO MED
• OVERRIDING THE BONE FRAGMENT
• SHORTEN THE CLAVICLE
• RESULT OF SEVERE TRAUMA
• SCAPULAE IS COVERED ON BOTH SIDES BY
MUSCLES
Muscle Origin Insertion Innervation Blood Supply Action
Trapezius Vertebrae Lateral third of Spinal accessory Transverse Rotate scapula for full
(C7T12) clavicle, Medial nerve cervical artery abduction
surface of Upper fibers elevate
acromion, spine of shoulder
scapula Central fibers retract
shoulder
Lower fibers draw scapula
downward
Latissimus Vertebrae Intertubercle Thoracodorsal Thoracodorsal Extends, adducts, medially
dorsi (T3T8) groove of humerus nerve (C6C8) artery rotates the humerus

Levator Vertebrae Superior medial 3rd and 4th Dorsal scapular Elevates the superior angle
scapulae (C1C4) border of scapula cervical nerves of artery of the scapula
cervical plexus, Rotates scapula so that the
dorsal scapular glenoid cavity is tilted
nerve (C5) inferiorly
Rhomboid Minor: C7 and Medial border of Dorsal scapular Dorsal scapular Retract scapula, rotates it to
minor and T1 vertebrae scapula nerve (C4,C5) artery depress glenoid gavity
major Major: T2T5 Fix scapula to thoracic wall
vertebrae
Muscle Origin Insertion Innervation Blood Supply Action

Deltoid Lateral third of Deltoid tuberosity of Axillary nerve (C5, Posterior circumflex Abduction of the arm, movement
clavicle, superior humerus (lateral) C6) humeral artery initiated with supraspinatus
surface of acromion,, Clavicular portion rotates arm
spine of scapula medially
Spinous portion rotates arm
laterally
Supraspinatus Supraspinous fossa Greater tubercle of Suprascapular nerve Suprascapular artery Draws humerus towards glenoid
of scapula humerus (C5, C6) fossa
Initiates abduction of shoulder
Lateral rotator of humerus
Infraspinatus Infraspinous fossa of Greater tubercle of Suprascapular nerve Suprascapular artery Braces head of humerus in the
scapula humerus (C5, C6) glenoid fossa
Lateral rotator of humerus
Teres minor Lateral border of Greater tubercle of Axillary nerve (C5, Circumflex scapular Rotates arm laterally, weakly
scapula humerus C6) artery adducts arm at shoulder
Draws humerus towards glenoid
fossa
Teres major Dorsal surface of Intertubercular Lower subscapular Circumflex scapular Extends arm from flexed position
inferior angle of groove of humerus nerve (C6, C7) artery Adducts and medially rotates arm
scapula at shoulder
Subscapularis Subscapular fossa Lesser tubercle of Upper and lower Subscapular artery Helps stabilize shoulder joint
Lateral border of humerus subscapular nerves Prevents anterior displacement of
scapula (C5, C6) humerus
Medially rotates and adducts
humerus
• SURGICAL NECK (MOST) ~ AXILLARY NERVE
• RADIAL GROOVE ~ RADIAL NERVE
• DISTAL END ~ MEDIAN NERVE
• MEDIAL EPICONDYLE: ULNAR NERVE
• AVULSION FRACTURE OF TUBERCULUM MAJUS
• TRANSVERSE/SPIRAL FRACTURE OF THE SHAFT
• INTERCONDYLAR FRACTURE
Muscle Origin Insertion Innervation Blood Supply Action
Biceps Short head: Radial Musculocutaneo Brachial artery Powerful
brachii coracoid tuberosity us nerve (C5, supinator of
process of C6) forearm
scapula Flexor of
Long head: supinated
Supraglenoid forearm
tubercle of
scapula
Coracobrachi Coracoid Medial Musculocutaneo Brachial artery Flexes and
alis process of surface of us nerve (C6, adducts arm
scapula humerus C7) at the shoulder

Brachialis Distal anterior Coronoid Musculocutaneo Brachial artery Powerful flexor

humerus process and us nerve (C5, of the forearm
tuberosity C6) at the elbow
of the ulna
Muscle Origin Insertion Innervation Blood Supply Action
Triceps Long head: Olecranon of Radial nerve Deep brachial Extends forearm at the
bracii infraglenoid the ulna , (C6C8) artery elbow
tubercle of fascia of Long head of triceps
scapula forearm can also extend
Lateral head: humerus at the shoulder
posterior joint
surface of
humerus
Medial head:
posterior
surface of
humerus
Anconeus Lateral Lateral surface Radial nerve Deep brachial Extends forearm at
epicondyle of of olecranon (C6C8) artery elbow
humerus of ulna
• COLLES FRACTURE
• ULNAR STYLOID PROCESS AVULSION
• SCAPHOID FRACTURE
• HAMATE FRACTURE
Muscle Origin Insertion Innervatio Blood Action
n Supply
Abductor Flexor Lateral side of base of Recurrent Superficial Abducts thumb at
pollicis brevis retinaculum, proximal phalanx of thumb branch of palmar branch of carpometacarpal and
tubercle of median nerve radial artery metacarpophalangeal joints
scaphoid and (C8, T1)
trapezium bones

Flexor pollicis Superficial head: Lateral side of first Recurrent Superficial Flexes proximal phalanx of
brevis flexor metacarpal bone branch of palmar branch of thumb
retinaculum, median nerve radial artery
trapezium (C8, T1)
Deep head: floor
of carpal canal

Opponens Flexor Lateral side of first Recurrent Superficial Pulls and rotates first
pollicis retinaculum, metacarpal bone branch of palmar branch of metacarpal in a medial fashion
trapezium median nerve radial artery across palm, opposing thumb
(C8, T1) against fingers
Adductor Bases of 2nd and Converge on sesamoid bone, Deep branch Deep palmar Adducts proximal phalanx of
pollicis 3rd metacarpals, attach to base of proximal of ulnar arterial arch thumb toward middle digit
capitate bone phalanx of thumb nerve (C8,
T1)
Muscle Origin Insertion Innervation Blood Supply Action
Abductor Pisiform Base of Deep branch Ulnar artery Abducts 5th digit
digiti minimi bone proximal of ulnar nerve
phalanx of 5th (C8, T1)
digit
Flexor digiti Hook of Base of Deep branch Ulnar artery Flexes proximal
minimi brevis hamate proximal of ulnar nerve phalanx of 5th digit at
bone, phalanx of (C8, T1) metacarpophalangeal
flexor little finger joint
retinaculu
m
Opponens Hook of Palmar surface Deep branch Ulnar artery Abducts, flexes,
digiti minimi hamate of body of 5th of ulnar nerve laterally rotates 5th
bone, metacarpal (C8, T1) metacarpal, enhances
flexor cupping of hand, grip,
retinaculu opposes little finger to
m thumb
Muscle Origin Insertion Innervatio Blood Action
n Supply
Lumbricals 1,2 Lateral tendons Lateral sides of Median Superficial Flex metacarpophalangeal joint
of flexor extensor expansions nerve (C8, palmar arterial Extend interphalangeal joint
digitorum of digits 2-5 T1) arch Prevent extensor digitorum from
profundis hyperextending wrist

Lumbricals 3,4 Medial tendons Lateral sides of Deep branch Superficial Flex metacarpophalangeal joint
of flexor extensor expansions of ulnar palmar arterial Extend interphalangeal joint
digitorum of digits 2-5 nerve (C8, arch Prevent extensor digitorum from
profundis T1) hyperextending wrist

Palmar Palmar surfaces Extensor expansions Deep branch Palmar Adduct fingers at the
interosseous of metacarpal of digits and bases of ulnar metacarpal metacarpophalangeal joint (towards
muscles (3 bones of digits 2, of proximal nerve (C8, arterial arch middle finger)
total) 4, 5 phalanges of digits T1)
2, 4, 5
Dorsal Arise by 2 heads Base of the Deep palmar Dorsal and Abducts fingers away from middle
interosseous from adjacent proximal phalanx branch of palmar finger
muscles (4 sides of the and aponeurosis ulnar nerve metacarpal Flex fingers at metacarpophalangeal
total) metacarpal that forms extensor (C8, T1) arterial arch joints
bones expansion of digits Extend 2 distal phalanges at
24 interphalangeal joint
• FEMORAL HEAD NOT ~ ACETABULUM
• TRENDELENBURG SIGN +
(hip appears to drop on one side during walking)
• SCIATIC NERVE INJURY
• COMMON: NECK
• EXOROTATION OF LOWER LIMB
• DISRUPT BLOOD SUPPLY TO FEMUR HEAD
• MEDIAL CIRCUMFLEX FEMORAL ARTERY
• LIGAMENT ACTION
• MCL (TCL): PREVENT EXCESSIVE LATERAL TWISTING
• LCL (FCL) : PREVENT EXCESSIVE MEDIAL TWISTING
• ACL: PREVENT HYPEREXTENSION
• PCL: PREVENT HYPERFLEXION
• COMMON: FIBULAR NECK FRACTURE
• FOOTDROP
• ANKLE SPRAIN: LATERAL LIGAMENT
• POTT FRACTURE DISLOCATION: MEDIAL LIGAMENT