DAA Exam 2 FULL!!!

Trapezium Origin

superior nuchal line, EOP, nuchal lig., SPs C7-T12

Trapezium Insertion

acromion and spine of scapula, lateral 1/3 clavicle

Trapezium action

elevation, depression, retraction (adduction) of scapula; hyperextend; rotating the scapula during abduction of humerus

Trapezium nerve innervation

CN XI (spinal accessory nerve), ventral rami of C3-C4

Latissimus Dorsi origin

Sps of T7-T12 posterior layer of thoracolumbar fascia (and thus L1-L5); iliac crest, ribs 10-12

Latissimus Dorsi insertion

interturbercular groove (sulcus) of humerus

Latissimus Dorsi action

extends, adducts, and medially (internally) rotates arm at shoulder

Latissimus Dorsi nerve innervation

thoracodorsal nerve (C6-C8) *also known as middle subscapular nerve*

Rhomboid minor origin

nuchal ligament, SP's of C7 and T1

Rhomboid minor insertion

medial border of scapula

Rhomboid major origin

SP's of T2-T5

Rhomboid major insertion

medial border of the scapula (inferior to the spine)

Rhomboid action

retract (adduct) scapula (capable of slight elevation as well); rotates scapula to depress the glenoid fossa

Rhomboids nerve innervation

dorsal scapular nerve

Pectoralis minor origin

external surface of upper margins of ribs 3-5

Pectoralis minor insertion

coracoid process of scapula

Pectoralis minor action

protract and depresses scapula

Pectoralis minor nerve innervation

medial pectoral nerve

Serratus anterior origin

lateral surface of ribs 1-9

Serratus anterior insertion

anterior (costal) surface of vertebral (medial) border of scapula

Serratus anterior action

protracts (abducts) and holds scapula against thoracic wall; (some texts may list slight depression of scapula)

*important scapular stabilizing muscle "boxers muscle"

Serratus anterior nerve innervation

long thoracic

Subclavius origin

upper border of the 1st rib and costal cartilage

Subclavius insertion

inferior surface of middle 1/3 of the clavicle

Subclavius action

anchors and depresses the clavicle

Subclavius nerve innervation

subclavian (nerve to subclavius C5-C6)

Levator Scapulae origin

TVPs of C1-C2, posterior tubercles of TVPs of C3-C4

Levator Scapulae insertion

medial border of the scapula (superior to spine)

Levator Scapulae action

elevation of the scapula (and pulls it slightly medial); inferiorly rotates glenoid cavity (fossa); some may say laterally flexes the neck as well

Levator Scapulae nerve innervation

dorsal scapular nerve (C5); ventral (anterior) rami of C3 and C4

Deltoid origin

lateral third of clavicle, acromion, spine of scapula

Deltoid insertion

deltoid tuberosity of humerus

Deltoid action

abduction of arm (beyond 15-20)

flexion, extension, and medial and laterla rotation of the arm (everything but adduction arm)

Deltoid nerve innervation

axillary nerve

Supraspinatus origin

supraspinous fossa of scapula

Supraspinatus insertion

greater tubercle of humerus

Supraspinatus action

abduction of the arm first 15-20 degrees (rotator cuff muscles)

Supraspinatus nerve innervation

suprascapular nerve

Infraspinatus origin

infraspinous fossa of scapula

Infraspinatus insertion

greater tubercle of humerus

Infraspinatus action

lateral rotation of arm (rotator cuff muscle)

Infraspinatus nerve innervation

suprascapular nerve

Teres minor origin

lateral border of posterior surface of the scapula (upper 2/3)

Teres minor insertion

greater tubercle of humerus

Teres minor action

lateral rotation of arm (rotator cuff muscle)

Teres minor nerve innervation

axillary nerve)

Teres major origin

lower portion of lateral border of scapula (lateral portion of inferior angle)

Teres major insertion

medial lip of intertubercular groove (sulcus) of humerus

Teres major action

adduct and medially rotate the arm; (extension of arm may be listed in som ereferences)

Teres major nerve innervation

lower subscapular nerve

Subscapularis origin

subscapular fossa

Subscapularis insertion

lesser tubercle of humerus

Subscapularis action

medial rotation and adduction of arm

Subscapularis nerve innervation

upper subscapular (C5-C6), and lower subscapular (C5-C6)

Pectoralis major clavicular origin

sternal half of the clavicle

Pectoralis major sternal origin

manubrium and body of sternum, carilage of true ribs

Pectoralis major abdominal/costal portion origin

aponeurosis of external abdominal oblique

Pectoralis major insertion

lateral lip of intertubercular groove of humerus

Pectoralis major action

flexes, adducts, and mediall rotates arm (some may state lower fibers can assist extension of arm after fully flexed)

Pectoralis major nerve innervation

medial (C8, T1) and lateral (C5-C7) pectoral nerves

Coracobrachialis origin

coracoid process of scapula

Coracobrachialis insertion

middle third of anteromedial surface of the shaft of humerus

Coracobrachialis action

flexes and adducts the arm

Coracobrachialis nerve innervation

musculocutaneous (C5-C7) - pierces the belly of muscle

triangle of ausculation

thinnest region between skin and thoracic wall

latissimus dorsi

vertebral border of scap

trapezius

rhomboid major as floor

Inspiration

diaphragm and external intercostals

more superficial muscles that elevate ribs for inspiration

Expiration

internal intercostals

deeper muscles that depress the ribs during forced expiration

Diaphragm

partition between thoracic and abdominal cavities

most important muscle in inspiration

innervated by phrenic nerves

Diaphragm origin

xiphoid process, costal cartilage 7-12; L1-L3 vertebrae

Diaphragm insertion

converges into a central tendon

Diaphragm action

draws central tendon inferior and anterior during inspiration to help expand the thoracic cavity

Diaphragm nerve innervation

phrenic nerves

External intercostals

elevate ribs, increasing width of thoracic cavity for inspiration; support intercostal spaces

Internal intercostal

depress ribs during forced expiration, decreasing width of thoracic cavity; support intercostal spaces (during both inspiration and expiration)

Innermost intercostals

depress ribs during forced expiration, decreasing width of thoracic cavity; support intercostal spaces (both inspiration and expiration)

Breathing in (inspiration)

diaphragm contracts and pulls downward

intercostals muscles pull ribs upward

increasing size of thoracic cavity

lungs fill with air

Breathing out (expiration)

diaphragm relaxes returning to normal position

intercostal muscles relax allowing ribs to return to normal position

air is forced our due to elastic recoil of lungs

Scalenes

elevate first two ribs during inspiration

Levatores costarum

typically seen attached to TvP from C7-T11 and subajacent ribs; assist with elevating ribs during inspiration

Subcostal

span multiple ribs (most numerous in lower ribs; attach to internal surfaces and superior borders; assist with depressing ribs during expiration)

Extrinsic back muscles - superficial

involved with movement of pectoral girdle and humerus at the shoulder joint

Intermediate extrinsic back muscle

serratus posterior superior

serratus posterior inferior

Intrinsic back mucles

splenius (spinotransversales) - superficial intristic group

errector spinae (sacrospinalis)

- intermediate intristic group

transversospinalis

- deep intrinsic group

interspinal

intertransversarii

Splenius

"bandage"

fibers run superior and lateral

Splenius capitis origin

nuchal ligament, SP's of C7 to T4

Splenius capitis insertion

lateral aspect of superior nuchal line and mastoid process of temporal bone

Splenius capitis action

bilaterally extends head; unilaterally laterally flexes head, can slightly rotate head

Serratus posterior superior

inserts onto the superior aspects of ribs 2-5

elevates the ribs that it inserts onto

Serratus posterior inferior

inserts onto the inferior aspects of ribs 9-12

depresses the ribs that it inserts

Errector spinae

lateral - iliocostalis

intermediate column - longissimus

medial column - spinalis

Errector spinae group origin

sacrum, iliac crest, sacrospinous ligament, supraspinous ligament, spinous process of some (or all) lumbar vertebrae

Errector spinae insertion

ribs, thoracic and cervical vertebrae, and skull

Errector spinae action

prime movers of back extension and lateral bending; can extend and laterall flex the head as well

Longissimus capitis origin

TVPs of C4-T4

Longissimus capitis insertion

mastoid process of temporal bone

Longissimus cervicis origin

TVPs of T1-T5

Longissimus Cervicis insertion

TVPs of C2-C6

Longissimus thoracis origin

spinous processes of L1-L5, posterior surface of sacrum, posterior sacroiliac ligament

Longissimus thoracics insertion

TVP's of all thoracic vertebrae and ribs 5-12

Iliocostalis cervis origin

angles of ribs 3-6