levator scapulae
origin: transverse processes of C1-C4
insertion: medial border of scapula superior to spine
action: elevates and adducts scapula
Rhomboids
Origin: Spinous processes of C7-T5
Insertion: Medial border of the scapula
Action: retraction, elevation, downward rotation
serratus anterior
-Origin: fleshy slips from the outer surface of upper 8 or 9 ribs -Insertion: costal aspect of medial margin of the scapula -Actions: protracts and stabilizes scapula, assists in upward rotation.
pectoralis major
O- (Cl portion – medial 1/3 of clavicle) – (St portion – sternum and 1st 6 ribs) I- lateral lip of bicipital groove A- Adduction, internal rotation, horizontal adduction (Cl -1st 60 of flex) (st – 1st 60 of ext)
pectoralis minor
O – anterior surface, ribs 3-5 I – coracoid process A – depression, downward rotation, scapular tilt
elbow carrying angle
males: 5-8 degrees, females 10-15 degrees
Brachialis
O – Distal ½ of anterior humerus I – coronoid process and ulnar tuberosity of ulna A – Elbow Flexion
Brachioradialis
O- lateral supracondylar ridge of humerus I – Styloid process of radius A – Elbow Flexion
biceps brachii
O – Long head – supraglenoid tubercle, Short head – coracoid process I – radial tuberosity of radius A – Elbow flexion – assists in shoulder flexion, helps in supination (bicep curl)
triceps brachii
O – Long head – infraglenoid tubercle, Lateral head – inferior to greater tubercle on posterior humerus, Medial head – posterior ½ of humerus I- Olecranon process of ulna A – Elbow Extension
Anconeus
Origin: Lateral Epicondyle
Insertion: Lateral surface of the olecranon process and posterior surface of ulna
Action: Extension of Elbow, keeps annular ligament from being pinched, does not allow radius and ulna to rotate in ext.
Innervation: Radial Nerve
supinator
Origin: Lateral epicondyle of humerus & trochlear notch of ulna
Insertion: anterior surface of proximal radius
Action: Supinates forearm
pronator teres
origin: medial epicondyle of humerus & coronoid process of ulna
insertion: lateral aspect of radius
action: pronates forearm and assists in elbow flexion
flexor carpi ulnaris
Origin: Medial epicondyle of the humerus
Insertion: 5th metacarpal (pisiform)
Action: Flexes the hand, ulnar deviation
palmaris longus
origin: medial epicondyle of humerus insertion: palmar fascia action: flexes wrist
flexor carpi radialis
Origin: Medial epicondyle of humerus Insertion: Bases of second and third metacarpal bones Action: Flexion and abduction at wrist
extensor carpi radialis longus
Origin: lateral supracondylar ridge of humerus
Insertion: base of metacarpal II
Action: extends and abducts hand
extensor carpi radialis brevis
Origin: Lateral epicondyle of humerus
Insertion: Base of third metacarpal bone
Action: Extension and abduction at wrist
extensor carpi ulnaris
Origin: Lateral epicondyle of the humerus
Insertion: 5th metacarpal
Action: Extends the hand
flexor digitorum superficialis
origin: medial epicondyle of the humerus
insertion: digits 2-5
action: flexes digits 2-5
flexor digitorum profundus
Origin upper 3/4 of the anterior and medial surfaces of the body of the ulna,
Insertion base of the distal phalanges of the fingers
Actions flex hand and both interphalangeal joints
flexor pollicis longus
Origin: Anterior surface of radius, and interosseous membrane
Insertion: Distal phalanx of thumb
Action: Flexes thumb
abductor pollicis longus
Origin: Posterior surface of middle of radius, ulna, and interosseous membrane
Insertion: Base of 1st metacarpal bone
Action: Abduction and extension of thumb at CMC and radial deviation of wrist
extensor pollicis longus
Origin Middle third of posterior surface of ulna, interosseous membrane Insertion thumb, distal phalanx Actions extension of the thumb (metacarpophalangeal and interphalangeal)
extensor pollicis brevis
Origin: Posterior surface of middle of radius and interosseous membrane
Insertion: Base of 1st proximal phalanx
Action: Extension of thumb & radially deviate wrist
extensor digitorum
origin: lateral epicondyle of humerus
insertion: digits 2-5
action: extends digits 2-5
flexor pollicis brevis
Origin trapezium, flexor retinaculum
Insertion thumb, proximal phalanx
Actions Flexes the thumb at the first metacarpophalangeal joint
abductor pollicis brevis
Origin: Scaphoid, trapezium, and Flexor Retinaculum
Insertion: Base of proximal phalanx of thumb
Action: Abduction of thumb
Opponens Pollicis
Origin: Flexor retinaculum and trapezium
Insertion: Lateral side of 1st metacarpal
Action: Moves thumb across palm to meet little finger (opposition) at CMC
adductor pollicis
Origin capitate, base of 2nd MC, palmar surface of 3rd MC
Insertion base of proximal phalanx
Actions adducts the thumb at the carpometacarpal joint
Dorsal Interossei
attaches to sides of MC
action: abducts fingers
Palmar Interossei
attaches to sides of MC
action: adducts fingers (not middle finger)
lumricales
origin: flexor tendon
intertion: extensor tendon
Action: flex the MCP while extending the PIP and DIP of 2-5
Flexor Digiti Minimi
-Origin: hook of the hamate and flexor retinaculum
-Insertion: proximal phalanx of fifth digit
-Function: flexion of MCP joint and opposition of the fifth digit
abductor digiti minimi
"Origin: Pisiform and tendon of flexor carpi ulnaris"
"Insertion: Medial side of proximal phalanx of 5th finger"
"Action: Abducts fifth finger"
Opponens Digiti Minimi
origin: hook of hamate, flexor retinaculum
insertion: 5th MC
Action: opposes 5th CMC
Colles fracture
fracture where radius will shift anteriorly, arm looks like they are waving
Smith Fracture
radius will shift posteriorly
carpal tunnel syndrome
compression of the median nerve due to inflammation as it passes between the ligament and the bones and tendons of the wrist
pain with flexion, numbness in thumb 2nd & 3rd finger
DeQuarvian's Syndrome
inflammation in synovial sheath surrounding tendon test by making fist with thumbs in, hold in functional position then flex fists, pain will be along lat. forearm
Gamekeeper's thumb
typically caused by catching incorrectly
hyperextension of thumb, tear of UCL
Trigger finger
causes fingers to stay flexed (typically 3rd & 4th)
inflammation catches tendon which keeps them flexed
Dupuytren's contracture
all flexors in digitorum flexed and caught in this position
Mallet Finger
end of finger bent into flexion due to torn extensor tendon
can try to brace in extension to try to heal/scar in normal position
Jersey Finger
inability to flex finger due to flexor tendon tear
Neck Flexion AROM
80-90 chin to chest
Neck Extension AROM
70 level of chin and jaw to head
Lateral Neck Extension
20-45 trap can be connected, try not to let pt. allow trapezius to rise to get more ROM
Neck Rotation AROM
70-90 nose to shoulder
Trunk Flexion AROM
looking for arch in back
Trunk Extension AROM
extension of back without bringing hips forward
Lateral Trunk Bending AROM
fingertips to mid knee joint considered normal
Trunk Rotation AROM
back shoulder to front shoulder
Sternocleidomastoid
origin: sternum and clavicle
insertion: mastoid process
action: bilaterally-flexes neck and hyperextends head unilaterally-laterally bends the neck and rotates head to opposite side
Splenius Capitus
origin: vertebrae C7-T6, ligamentum nuchae insertion: mastoid process, occipital bone action: bilaterally-extend head and neck, unilaterally-rotate and laterally flex to same side
Splenius Cervicis
origin: spinous process of T3-T6
insertion: transverse process of C1-C3
action: bilaterally-extend neck, unilaterally-rotate and laterally flex to same side
rectus abdominis
origin: pubic bone
insertion: costal cartilage of ribs and xiphoid process
action: compresses abdomen and trunk flexion
external obliques
Origin: Lower 8 ribs
Insertion: Iliac breast and linea alba
action: bilaterally-trunk flexion and compression of abdomen, unilaterally-lateral bending and rotation to opposite side
internal obliques
Origin: iliac crest, inguinal ligament and lumbar fascia
Insertion: 10th to 12th ribs and rectus sheath
Action: bilaterally-trunk flexion and compression of abdomen, unilaterally-lateral bending and rotation to same side
transverse abdominis
Origin: inguinal ligament, iliac crest, cartilages of last five or six ribs, and lumbar fascia
Insertion: linea alba and pubic crest
Action: compression of abdomen
erector spinae
origin: spinous processes, transverse processes, posterior ribs
insertion: spinous processes, transverse processes, post. ribs
action: bilaterally-extend neck and trunk, unilaterally- laterally bend neck and trunk
transversospinalis group
origin: transverse provesses
insertion: spinous processes of vertebrae above
action: bilaterally-extend neck and trunk, unilaterally-rotate neck and trunk to opposite side
quadrates lumborum
origin: iliac crest
insertion: lumbar transverse processes and 12th rib
action: extends and laterally flexes the lumbar region of spine; can also raise the hip
rotator cuff muscles
SITS Supraspinatus Infraspinatus Teres Minor Subscapularis
scapulohumeral rhythm
The first 30 degrees is purely GH joint motion. After than, for every 2 degrees of shoulder flexion or abduction that occurs, the scapula must upwardly rotate 1 degree; 2:1 ratio
Full abduction of the glenohumeral joint
glide and roll inferiorly of humeral head (lats, Teres major and minor) and externally rotate (teres minor and infraspinatus)