upper limb muscles

1. UPPER LIMB
MUSCLES-I
NIMRA FARAZ
DPT
ABASYN UNIVERSITY PESHAWAR

2. MUSCLES CONNECTING UPPER LIMB TO
THORACIC WALL
1. Pectoralis major
2. Pectoralis minor
3. Subclavius
4. Serratus Anterior

3. In this lecture
 Muscles connecting upper limb to thoracic wall
 Muscles connecting upper limb to vertebral column
 Muscles connecting scapula to humerus

4.  Pectoralis major, Pectoralis minor and
Subclavius muscle are also known as
muscles of the pectoral region.
 The pectoral region lies on front of the
chest. It consists of structures
connecting upper limb to anterolateral
chest wall.

5. PECTORALIS MAJOR
 ORIGIN:
 Anterior surface of medial half of clavicle
 Anterior surface of manubrium and sternum
upto 6th costal cartilage
 2nd to 6th costal cartilage
 INSERTION:
 Lateral lip of the bicipital groove
 NERVE SUPPLY:
 Medial and lateral pectoral nerves from
brachial plexus
 NERVE ROOTS:
 C5, C6, C7, C8 and T1

6. ACTION:
 Acting as a whole the muscle causes Adduction and medial rotation of shoulder
 Clavicular part causes flexion of arm

7. PECTORALIS MINOR
 ORIGIN:
 3,4,5 ribs
 INSERTION:
 coracoid process of scapula
 NERVE SUPPLY:
 Medial pectoral nerve
 NERVE ROOT:
 C6,C7,C8
 ACTION:
 Draws scapula forward (with serratus anterior)
 Depresses point of shoulder
 Helps in forced inspiration
 If scapula fixed, it raises the ribs of origin

8. PATHOLOGY
 Both the axillary artery and vein, as well as some
nerves of the brachial plexus run between the
pectoralis minor and the coracoid process
(coracopectoral space).
 In cases of hypertrophy or stiffening, a compression
of the neurovascular bundle can often occur.
 This is referred to as pectoralis minor syndrome
(PMS). Common complaints are tingling, numbness
up to pain in the affected arm (especially in the ring
and small finger) and a stiff shoulder.

9. SUBCLAVIUS
 ORIGIN:
 1st rib at costochondral junction
 INSERTION:
 Subclavian groove in middle one-
third of clavicle
 NERVE SUPPLY:
 Nerve to subclavius from upper
trunk of brachial plexus
 NERVE ROOT:
 C5, 6
 ACTION:
 Steadies and depresses the clavicle
during movement of shoulder

10. PATHOLOGY
 The vessels and nerves running behind the
subclavius muscle can sometimes get
entrapped in the room between the clavicle
and the first rib (costoclavicular space). This is
referred to as the costoclavicular syndrome.
 Typical symptoms are irritations of the
brachial plexus and circulatory disorders of
the arm.

11. SERRATUS ANTERIOR
 ORIGIN:
 Upper 8 ribs
 INSERTION:
 Medial border and inferior angle of scapula
 NERVE SUPPLY:
 Long thoracic nerve
 NERVE ROOT:
 C5,C6,C7
 ACTION:
 Scapular abduction and upward rotation
 Along with the pectoralis minor muscle it pulls
the scapula forward to protract the upper limb
in pushing and punching movements.

13. CLINICAL FEATURES
 Paralysis of serratus anterior produces ‘winging of scapula’ in which the
inferior angle and the medial border of scapula are unduly prominent. The
patient is unable to do any pushing action, nor he can raise his arms above
head. Any attempt to do so makes the inferior angle of scapula more
prominent.

14. MUSCLES CONNECTING UPPER LIMB
TO THE VERETBRAL COLUMN
1. Trapezius
2. Latissimus dorsi
3. Levator scapulae
4. Rhomboid minor
5. Rhomboid major

16. TRAPEZIUS
 ORIGIN:
 Medial one-third of superior nuchal line
 External occipital protuberance
 Ligamentum nuchae
 C7 spine
 T1-T12 spines
 INSERTION:
 UPPER FIBERS into posterior border of
lateral one-third of clavicle
 MIDDLE FIBERS into acromion of scapula.
 LOWER FIBERS into upper lip of spine of
scapula.
 NERVE SUPPLY:
 Spinal part of accessory nerve (motor)

17. ACTIONS:
 UPPER FIBERS act with levator scapulae and elevate the scapula (shrugging)
 MIDDLE FIBERS act with rhomboids and retract the scapula
 LOWER FIBERS lower fibers pull medial border of scapula downward

18. LATISSMUS DORSI
 ORIGIN:
 Posterior one-third of outer lip of iliac crest
 Lumbar fascia
 Spines of T7-T12
 Lower 4 ribs
 Inferior angle of scapula
 INSERTION:
 The tendon is twisted and inserted into floor
of bicipital groove of humerus
 NERVE SUPPLY:
 Thoracodorsal nerve, or middle subscapular
nerve or the long subscapular nerve

19. ACTION:
 Adduction, extension and medial rotation of shoulder.
 Folding the arm behind the back and scratching opposite scapula
 Hold inferior angle of scapula in place

20. LEVATOR SCAPULAE
 ORIGIN:
 Transverse processes of C1-C4
 INSERTION:
 Superiorly medial border of scapula.
 NERVE SUPPLY:
 Dorsal scapular nerve
 C3, C4
 ACTION:
 Elevation of scapula
 Steadies the scapula during movements of arm

22. RHOMBOID MAJOR
 ORIGIN:
 Spines of T2 T3 T4 T5
 INSERTION:
 Middle of the Medial border of scapula.
 NERVE SUPPLY:
 Dorsal scapular nerve
 ACTION:
 Raises medial border of scapula
upward and medially
 Retracts scapula

23. RHOMBOID MINOR
 ORIGIN:
 Spines of C7 and T1
 INSERTION:
 Medial border of scapula
 NERVE SUPPLY:
 Dorsal scapular nerve
 ACTION:
 Raises medial border of scapula upward
and medially
 Retracts scapula

24. MUSCLES CONNECTING SCAPULA TO
HUMERUS
1. Deltoid
2. Supraspinatus
3. Infraspinatus
4. Teres major
5. Teres minor
6. Subscapularis

25. DELTOID
 ORIGIN:
 Anterior fibers into Lateral one-third of clavicle
 Middle fibers into acromion of scapula
 Posterior fibers into Lower lip of spine of
scapula
 INSERTION:
 Deltoid tuberosity of humerus
 NERVE SUPPLY:
 Axillary nerve

26.  ACTION:
 Anterior fibers are flexors and medial rotators of
arm
 Middle fibers are powerful abductors of arm at
shoulder joint
 Posterior fibers are extensors and lateral
rotators of arm

27. SUPRASPINATUS
 ORIGIN:
 Supraspinous fossa of scapula
 INSERTION:
 Greater tuberosity of humerus
 NERVE SUPPLY:
 Suprascapular nerve
 NERVE ROOTS:
 C4 C5 C6

28. ACTION:
 Initiates abduction of arm and
 Steadies humeral head so that it
doesn’t slip out of glenoid cavity

29. INFRASPINATUS
 ORIGIN:
 Infraspinous fossa of scapula
 INSERTION:
 Greater tuberosity of humerus
 NERVE SUPPLY:
 Suprascapular nerve
 NERVE ROOT:
 C6 C7
 ACTION:
 Lateral rotator of arm
 Stabilizes humeral head

30. TERES MAJOR
 ORIGIN:
 Lower third of lateral border of
scapula
 INSERTION:
 Medial lip of bicipital groove of
humerus
 NERVE SUPPLY:
 Lower subscapular nerve
 NERVE ROOT:
 C6 C7
 ACTION:
 Medial rotator
 Adductor of arm
 Stabilizes shoulder joint

31. TERES MINOR
 ORIGIN:
 Upper two-third of lateral border of
scapula
 INSERTION:
 Greater tuberosity of humerus
 NERVE SUPPLY:
 Axillary nerve
 NERVE ROOT:
 C4 C5 C6
 ACTION:
 Lateral rotator of arm
 Stabilizes shoulder joint

32. SUBSCAPULARIS
 ORIGIN:
 Subscapular fossa
 INSERTION:
 Lesser tuberosity of humerus
 NERVE SUPPLY:
 Subscapular nerves
 NERVE ROOTS:
 C5 C6
 ACTION:
 Medially rotate arm
 Stabilizes shoulder joint

33. ROTATOR CUFF MUSCLES
 The rotator cuff consists of the following muscles: supraspinatus muscle, infraspinatus muscle, teres
minor muscle and subscapularis muscle.
 These muscles all originate from the scapula and insert in the humerus.
 The main function of the rotator cuff is to stabilize and center the humeral head in the joint socket,
the glenoid cavity.
 Certainly the rotator cuff – as the name suggests – plays a major role in the internal and external
rotation of the upper arm in the shoulder joint.