MSK Upper limb (clavicle teres major)

Origin of pec major

Clavicular head: medial ⅓ of anterior clavicle

Sternocostal region: anterior region of sternum; costal cartilage of ribs 1-6

Insertion of pec major

Lateral lip of Intertubercular groove of humerus

Innervation of pec major

Lateral Pectoral Nerve (C5-C7);

Medial Pectoral Nerve (C8-T1)

Blood supply of pec major

Pectoral branch of thoracoacromial artery (A)

Actions of pec major

Clavicular head: flexes, medially rotate humerus

Sternocostal head: adduction of humerus

origin of pec minor

lateral to costochondral junction of ribs 3, 4, 5

insertion of pec minor

coracoid process of scapula

Innervation of pec minor

medial pectoral nerve (C8)

Blood supply of pec minor

Pectoral branch of thoracoacromial artery (A)

Actions of pec minor

Scapula stabiliser

Depresses scapula

Pulls scapula into thoracic wall

Origin of serratus anterior

costochondral junction of upper 8 ribs

Insertion of serratus anterior

Anterior surface of medial border of scapula

Innervation of serratus anterior

Long thoracic nerve

Blood supply of serratus anterior

Superior thoracic artery, Thoracoacromial artery, Lateral thoracic artery

Action of serratus anterior

Extending upper limb in reaching Important for fixing medial border of scapula against thoracic wall Scapula rotation

Subclavius origin

Anterior surface of costochondral junction of rib 1

Subclavius insertion

Subclavian groove on inferior surface of clavicle

Innervation of subclavius

subclavian nerve

Blood supply of subclavius

Clavicular branch of thoracoacromial artery

Action of subclavius

Stabilisation of clavicle when arm is reaching

Trapezius origin

External occipital protuberance, superior nuchal line, spine processes C7-T12

Trapezius insertion

1. descending — clavicle + acromion of scapula

2. transverse — spine of scapula

3. ascending — base of spine of scapula

Innervation of trapezius

accessory nerve of cranial nerve

Blood supply of trapezius

Transverse cervical artery (main); occipital artery, dorsal scapula artery

Action of trapezius

Stabiliser and rotator of scapula

Full abduction of arm (lateral rotation of scapula)

Origin of latissimus dorsi

Spinous processes of T7-L5, thoracolumbar fascia, posterior iliac crest, inferior angle of scapula

Insertion of latissimus doors

Floor of intertubercular groove of humerus

Innervation of latissimus dorsi

Thoracodorsal nerve (C6, 7, 8)

Blood supply of latissimus dorsi

Thoracodorsal branch of subscapular artery

Action of latissimus dorsi

Broad origin on spine, stabilises the trunk when upper limb is fixed

Forms posterior wall of the axilla

Origin of rhomboid major

Spinous processes of T2-T5

Insertion of rhomboid major

Medial border of scapula, from root of spine to inferior angle

Innervation of rhomboid major

Dorsal scapular nerve (C5)

Blood flow of rhomboid major

dorsal scapular artery

Action of rhomboid major

Scapular retraction, medial rotation of scapular

Origin of rhomboid minor

Nuchal ligament and spinous processes of C7-T1

Insertion of rhomboid minor

Medial border of scapula at the root of the scapular spine

Innervation of rhomboid minor

Dorsal scapular nerve (C5)

Blood supply of rhomboid minor

Dorsal scapular artery

Action of rhomboid minor

Acts w rhomboid major as a functional unit

Stabilise scapula against thoracic wall during pulling/rowing movements of the arm

Origin of Levator scapulae

Transverse processes of C1-C4

Insertion of Levator scapulae

Medial border of scapula, between superior angle and root of the spine

Innervation of Levator scapulae

Dorsal scapular nerve (C5)

Blood supply of Levator scapulae

Dorsal scapular artery and ascending cervical artery

Action of Levator scapulae

Scapular elevation and retraction with rhomboids, medial rotation of scapula

Holds scapula steady against chest wall, prevents shoulder from dropping when carrying heavy loads

Origin of deltoid

Posterior: Inferior edge of the crest of the spine of scapula

Middle: Lateral margin of the acromion

Anterior: Anterior border of lateral ⅓ of clavicle

Insertion of deltoid

Deltoid tuberosity of humerus

Innervation of deltoid

Axillary nerve (C5, C6)

Blood supply of deltoid

Deltoid branch of thoracoacromial artery (A); anterior (A)and posterior circumflex humerus artery (P)

Action of deltoid

Shoulder abduction, shoulder flexion, shoulder extension

Origin of supraspinatus

Supraspinous fossa of scapula

Insertion of supraspinatus

Superior facet of greater tubercle of humerus

Innervation of supraspinatus

Suprascapular nerve (C5,6)

Blood supply of supraspinatus

Suprascapular artery, dorsal scapular artery

Action of supraspinatus

Abduction of the arm (0-15 deg), working with deltoid the rest of the range

Origin of infraspinatus

Infraspinous fossa of scapula

Insertion of infraspinatus

Middle facet of greater tubercle of humerus

Innervation of infraspinatus

Suprascapular nerve (C5, C6)

Blood supply of infraspinatus

Suprascapular artery, circumflex scapular artery

Action of infraspinatus

Laterally rotates the arm

Origin of teres minor

Upper ⅔ of lateral border of scapula, dorsal surface

Insertion of teres minor

Lower facet of greater tubercle of humerus

Innervation of teres minor

Axillary nerve (C5, C6)

Blood supply of teres minor

Circumflex scapular artery, posterior circumflex humerus artery

Action of teres minor

Lateral rotation and weak adduction of glenohumeral joint

Origin of subscapularis

Subscapular fossa

Insertion of subscapularis

Lesser tubercle of humerus

Innervation of subscapularis

Upper and lower subscapular nerve

Blood supply of subscapularis

Circumflex scapular artery, subscapular artery

Action of subscapularis

Medially rotates the arm

Adducts the arm

Stabilises humeral head anteriorly in glenoid cavity

Origin of teres major

dorsal surface of inferior angle of Scapula

Insertion of teres major

medial lip of intertubercular groove of humerus

Innervation of teres major

Lower subscapular nerve (C5, C6)

Blood supply of teres major

Circumflex scapular artery, subscapular artery

Action of teres major

Medially rotates the arm Assists extension of flexed / abducted arm