Types of Muscle of Upper Limb MuscleKey Terms and Overview Upper Limb MuscleBlood Supply of Upper Limb MuscleNerves of Upper Limb MuscleExtensors Muscles of Arm/Upper Limb Muscle comprises many muscles that are organized into anatomical compartments. These muscles act on the various joints of the hand, arm, and shoulder, maintaining tone, providing stability and allowing precise fluid movement.Axioappendicular groups of muscles arise from the axial skeleton to act upon the pectoral girdle. Scapulohumeral muscles originate from the scapula and insert into the proximal humerus. Included in this category are the rotator cuff muscles which provide stability to the glenohumeral joint. In the arm, the muscles of the anterior compartment are involved in flexion of the forearm, and the posterior comprises of the forearm extensors. Similarly, the anterior compartment of the forearm contains the flexors of the hand and the posterior has extensors. The hand is divided into the thenar, the hypothenar, the adductor compartment, as well as the short muscles of the hand.[rx][rx][rx][rx][rx]The upper extremity (UE) is comprised of its associated muscles, nerves, and vessels, organized into anatomical compartments.[rx] The muscles cross joints to provide tone, maintain dynamic joint stability, and perform dynamic functions of the entire extremity. In addition, the arteries and veins provide nourishment and remove waste, and the nerves provide the motor and sensory innervations.[rx]Types of Muscle of Upper Limb MusclePectoral Anterior Axioappendicular Muscles (Thoracoappendicular Muscles)Pectoral muscles lie in the chest and exert force through the shoulder to move the upper arm. Three pectoral muscles interact with the shoulder.Pectoralis majorThe pectoralis major is a large, fan-shaped muscle covering the chest. It is comprised of clavicular and sternocostal regions.Function – flexion, adduction, medial rotation of the humerus.Origin – clavicular head: medial clavicle anteriorly, sternocostal head: anterior sternum and costal cartilages of ribs 1 to 6 as well as an external oblique aponeurosisInsertion: the lateral edge of the intertrabecular groove of the humerusInnervation: medial pectoral nerve (C8, T1) lateral pectoral nerve (C5, C6, C7) of brachial plexusAttachments: The clavicular region originates from the clavicle and the sternocostal region originates from the sternum and the fascia of the oblique muscles of the abdomen. Both attach to the humerus.Actions: Adducts and rotates the upper arm.Pectoralis minorThe pectoralis minor muscle is smaller and lies beneath the pectoralis major.Function: Depression of the shoulder, protraction of the scapulaOrigin: Third, fourth, fifth ribs close to their respective costal cartilagesInsertion: Coracoid processInnervation: Medial pectoral nerve (C8, T1)Attachments: The pectoralis minor originates from the third to fifth ribs and attaches to the scapula.Actions: Supports and depresses the scapula.SubclaviusFunction: Depression and stabilization of the clavicleOrigin: First rib mediallyInsertion: Middle of the clavicle, inferiorlyInnervation: Nerve to subclavius (C5, C6)Serratus anterior The serratus anterior is located in the lateral wall of the chest.Function: Protraction of scapula, rotation of the scapulaOrigin: Lateral first to the eighth ribInsertion: anterior scapula, mediallyInnervation: long thoracic nerve (C5, C6, C7)Attachments: The muscle is formed of several strips originating from the second to eight ribs, each of which attaches to the scapula.Actions: Supports the scapula allowing for elevation of the upper arm.Posterior Axioappendicular MusclesSuperficial layer Latissimus dorsi The latissimus dorsi originates from the lower back and covers a wide area.Function: Adduction, medial rotation, an extension of humerusOrigin: Spinous processes of seventh to 12th thoracic vertebrae, iliac crest, thoracolumbar fascia, and inferior third and fourth ribInsertion: Intertubercular groove of humerusInnervation: Thoracodorsal nerve (C5,C6,C7)Attachments: The latissimus dorsi originates from the lower spine and ribs and the upper pelvis and fascia of the deep trunk muscles. The muscle converges into a tendon attaching to the humerus.Actions: Extends, adducts, and medially rotates the upper arm.Trapezius The trapezius is the most superficial muscle of the back and forms a broad flat triangle.Function: Elevation, depression, and retraction of the scapula, rotation of glenoid cavityOrigin: Superior nuchal line, nuchal ligament, occipital protuberance, spinous processes of C7- T12Insertion: Spine of scapula, acromion, and lateral clavicleInnervation: CN XIActions: The superior region supports the arm and elevates and rotates the scapula, the intermediate region retracts the scapula, and the inferior region rotates and depresses the scapula.Attachments: The trapezius originates from the skull and spine of the upper back and neck. It attaches to the clavicle and scapula.Deep LayerLevator scapulaeFunction: Adduction, medial rotation, an extension of humerusOrigin: Transverse processes of C1 through C4 vertebraeInsertion: Scapula at its medial borderInnervation: Thoracodorsal nerve (C5, C6, C7)Rhomboid majorFunction: Retraction of scapula and depression of glenoid cavityOrigin: Spinous processes of T2 through T5 vertebraeInsertion: Inferior aspect of medial scapulaInnervation: Dorsal scapular nerve (C4, C5)Rhomboid minorFunction: Retraction of scapula and depression of glenoid cavityOrigin: Nuchal ligament as well as spines of C7 and T1 vertebraeInsertion: Superior aspect of medial scapulaInnervation: Dorsal scapular nerve (C4, C5)Three deep muscles lie below the superficial muscles of the shoulderLevator Scapulae – A small, strap-like muscle that joins the neck to the scapula.Attachments: Originates from the side of the spine in the neck and attaches to the scapula.Actions: Elevates the scapula.Rhomboid Major – Sits inferiorly to the levator scapulae.Attachments: Originates from the spine in the upper back and attaches to the scapula in an inferior position to the levator scapulae attachment.Actions: Retracts and rotates the scapula.Rhomboid Minor – Sits between the levator scapulae and rhomboid major, with which it is paired in action and function. It retracts and rotates the scapula.Scapulohumeral (Intrinsic Shoulder Muscles)Location of the deltoid musclesHighlighted in orange, the deltoids cover the rounding of the shoulder joint. Intrinsic muscles originate from the scapula or clavicle and attach to the humerus. There are six intrinsic muscles, four of which form the rotator cuff.Deltoid Muscle The deltoid muscle is a triangular muscle that covers the shoulder. The action of the muscle is complex, with the components acting in opposing and separate ways during the course of a contraction.Attachments: The deltoid muscle originates from the scapula and clavicle and attaches to the lateral surface of the humerus.Actions: The anterior region assists the pectoralis major during transverse flexion of the shoulder and acts weakly in strict transverse flexion. The lateral region assists in shoulder flexion when the shoulder is rotating, although it also assists the transverse abduction of the shoulder. The posterior region is the hyperextension of the shoulder, contributing to the transverse extension.Function: Anterior part: flexion and medial rotation of the arm, middle part: the abduction of arm, posterior part: extension and lateral rotation of the armOrigin: Lateral clavicle, acromion and scapular spineInsertion: Deltoid tuberosityInnervation: Axillary nerve (C5, C6)Teres majorThe teres major is a thick flattened muscle connecting the lower scapula with the humerus.Function: Adduction and medial rotation of the armOrigin: Posterior surface of scapula at its inferior angleInsertion: Intertubercular groove on its medial aspectInnervation: Lower scapular nerve (C5, C6)Attachments: Originates from the posterior of the scapula and attaches to the humerus.Actions: Adducts the shoulder and assists in rotation of the arm.Supraspinatus Function: Initiation of arm abductionOrigin: Posterior scapula, superior to the scapular spineInsertion: Superior aspect of the greater tubercleInnervation: Suprascapular nerve (C5, C6)Part of rotator cuff musclesInfraspinatusFunction: Lateral rotation of armOrigin: Posterior scapula, inferior to the scapular spineInsertion: Greater tubercle of the humerus, between the supraspinatus and teres minor insertionInnervation: Suprascapular nerve (C5, C6)Part of rotator cuff musclesTeres minor Function: Lateral rotation of armOrigin: Posterior surface of scapula at its inferior angleInsertion: Inferior aspect of the greater tubercleInnervation: Axillary nerve (C5, C6)Part of rotator cuff musclesSubscapularisFunction: Adduction and medial rotation of the armOrigin: Anterior aspect of the scapulaInsertion: Lesser tubercle of the humerusInnervation: Subscapular nerves (C5, C6, C7)Part of rotator cuff musclesRotator cuff muscles: supraspinatus, infraspinatus, teres minor, subscapularisMuscles of Anterior Compartment of Arm (Flexors of Arm)Biceps brachii –The biceps brachii is a two-headed muscle. Although the majority of the muscle mass is located anteriorly to the humerus, it has no attachment to the bone itself.Function: Major flexion of forearm, supination of forearm, resists dislocation of shoulderOrigin: Short head originates from the coracoid process. The long head is from the supraglenoid tubercle of scapulaInsertion: Radial tuberosity and forearm fascia (as bicipital aponeurosis)Innervation: Musculocutaneous nerve (C5, C6)Attachments: Both heads originate from the scapula and attach via the bicipital aponeurosis to the fascia of the forearm.Action: Supination of the forearm. It also flexes the arm at the elbow and at the shoulder.Brachialis – The brachialis muscle lies within the distal region of the biceps brachii.Attachments: Originates from the humerus and attaches to the ulna.Action: Flexing of the arm at the elbow.Function: Flexion of forearmOrigin: Distal anterior humerusInsertion: Coronoid process and ulnar tuberosityInnervation: musculocutaneous nerve (C5, C6, C7 small contribution)Coracobrachialis – The coracobrachialis lies within the two heads of the biceps brachii.Attachments: Originates from the scapula and attaches to the humerus.Action: Flexing of the arm at the shoulder, and weak adductionFunction: Flexion and adduction of armOrigin: Coracoid processInsertion: Middle of the humerus, on its medial aspectInnervation: Musculocutaneous nerve (C5, C6, C7)Muscles of Posterior Compartment of Arm (Extensors of Arm)Triceps brachiiFunction: Major extensor of the forearm, resists dislocation of the shoulderOrigin: Lateral head: above the radial groove, medial head: below the radial groove, long head: infraglenoid tubercle of the scapulaInsertion: Olecranon process of ulna and forearm fasciaInnervation: Radial nerve (C6,C7,C8)Anconeus- The anconeus is located in the superficial region of the forearm posterior compartment and is blended with the triceps brachii.Function: Extension of the forearm, stabilization of elbow jointOrigin: Lateral epicondyle of humerusInsertion: Olecranon process and posterior ulnaInnervation: Radial nerve (C7, C8, T1)Attachments: Originates from the humerus and attaches to the ulna.Actions: Moves the ulna during pronation and extends the forearm at the elbow.Muscles of Anterior Compartment of Forearm (Flexors of Forearm)Superficial layerPronator Teres – A rectangular muscle located in the superficial region of the anterior compartment.Attachments: The pronator teres has two origins, one on the proximal end of the humerus and one of the distal end of the ulna. It attaches to the mid-region of the radius.Function: Pronation of radio-ulnar joint and Pronates the forearm.Origin: Coronoid process and medial epicondyle of humerusInsertion: Lateral surface of the radiusInnervation: Median nerve (C6, C7)Pronator Quadratus – A square-shaped muscle located adjacent to the wrist in the deep region of the anterior compartment.Attachments: Originates from the ulna and attaches to the radius.Action: Pronates the forearm.PosteriorSuperficial LayerThe superficial layer of the posterior forearm contains seven muscles. The posterior compartment of the forearm is split into superficial and deep regions.Anconeus – The anconeus is located in the superficial region of the forearm posterior compartment and is blended with the triceps brachii.Attachments: Originates from the humerus and attaches to the ulna.Action: Moves the ulna during pronation and extends the forearm at the elbow.Brachioradialis – The brachioradialis is located in the superficial region of the forearm posterior compartment,The brachioradialis is located in the superficial region of the forearm posterior compartmentAttachments: Originates from the humerus and attaches to the distal end of the radius.Action: Flexes the forearm at the elbow.Attachments: Originates from the humerus and attaches to the distal end of the radius.Actions: Flexes the forearm at the elbow.Supinator – The supinator is located in the deep region of the forearm posterior compartment.Attachments: The supinator has two heads: one originating from the humerus, the other from the ulna. Together they attach to the radius.Action: Supinates the forearm.Flexor carpi radialisFunction: Flexion and adduction at the wristOrigin: Medial epicondyle of humerusInsertion: Base of the second metacarpalInnervation: Median nerve (C6, C7)Palmaris longusFunction: Flexion at the wrist, tensing of the palmar aponeurosisOrigin: Medial epicondyle of humerusInsertion: Flexor retinaculumInnervation: Median nerve (C7, C8)Flexor carpi ulnarisFunction: Flexion and adduction at the wristOrigin: Medial epicondyle of humerus and olecranonInsertion: Pisiform, hook of hamate and fifth metacarpalInnervation: Median nerve (C7, C8)Extensor Carpi Radialis Longus and Brevis – A pair of muscles located on the side of the forearm, allowing them to control the extension and abduction of the wrist.Attachments: Both originate from the humerus and attach to the base of the hand.Actions: Extend and abduct the wrist.Extensor Digitorum – The extensor digitorum is the main extensor of the fingers.Attachments: Originates from the humerus, splitting into four tendons at the wrist which travel through the carpal tunnel and attach to the digits.Actions: Extends fingers.Extensor Digiti Minimi – Originates from the extensor digitorum. In some people, these muscles cannot be individually defined.Attachments: Originates from the humerus and attaches to the little finger.Actions: Extends the little finger, and contributes to extension at the wrist.Extensor Carpi Ulnaris – Located on the other side of the forearm to the extensor carpi radialis longus and brevis, it performs a similar role.Attachments: Originates from the humerus and attaches to the base of the hand.Actions: Extension and adduction of the wrist.Intermediate LayerFlexor digitorum superficialis Function: Flexion of the proximal interphalangeal joint of the second, third, fourth, and fifth finger. Also has a weaker flexion action on the metacarpophalangeal joints of the same fingersOrigin: Medial epicondyle, coronoid process, and anterior radiusInsertion: Second, third, fourth, and fifth middle phalangesInnervation: Median nerve (C7, C8, T1)Deep LayerFlexor digitorum profundusFunction: Flexion of the distal interphalangeal joint of the second, third, fourth, and fifth fingerOrigin: Medial and the anterior surface of the proximal ulna and interosseous membraneInsertion: Second, third, fourth, and fifth distal phalangesInnervation: Ulnar nerve (C8, T1) for the medial part, anterior interosseous nerve (C8,T1) for the lateralFlexor pollicis longusFunction: Flexion of the interphalangeal joint of the thumbOrigin: Anterior aspect of radius as well as interosseous membraneInsertion: Base of distal phalanx of thumbInnervation: Anterior interosseous nerve (C7, C8)Pronator quadratusFunction: Pronator of the forearmOrigin: Anterior aspect of the distal ulnaInsertion: Anterior aspect of the distal radiusInnervation: Anterior interosseous nerve (C7, C8)BrachioradialisFunction: Weak flexor of the forearmOrigin: Proximal supracondylar ridge on the humerusInsertion: Lateral surface of distal end of radiusInnervation: Radial nerve (C5, C6, C7)Muscles of Posterior Compartment of ForearmSuperficialExtensor carpi radialis longusFunction: Extension and abduction of the wristOrigin: Proximal supracondylar ridge on humerusInsertion: Dorsal base of second metacarpalInnervation: Radial nerve (C6, C7)Extensor carpi radialis brevis Function: Extension and abduction of the wristOrigin: Lateral epicondyle of humerusInsertion: Dorsal base of the third metacarpalInnervation: Deep branch of the radial nerve (C7, C8)Extensor digitorumFunction: Extension of the proximal interphalangeal joint of the second, third, fourth, and fifth finger. Also has a weaker extension action on the metacarpophalangeal joints of the same fingersOrigin: Lateral epicondyle of humerusInsertion: Extensor expansions on the dorsal aspect of second, third, fourth, and fifth middle and distal phalangesInnervation: Posterior interosseous nerve (C7, C8)Extensor digit minimiFunction: Extension of the little finger at the metacarpophalangeal joint and interphalangeal jointOrigin: Lateral epicondyle of humerusInsertion: Extensor expansion on the dorsal aspect of the fifth phalanxInnervation: Posterior interosseous nerve (C7, C8)Extensor carpi ulnarisFunction: Extension and adduction of the wristOrigin: Lateral epicondyle of the humerus and posterior ulnaInsertion: Fifth metacarpal baseInnervation: Posterior interosseous nerve (C7, C8)Muscles of the ForearmAs with the upper arm, the forearm is split into the anterior and posterior compartment. Each contains many more muscles than described below due to the requirement for more complex movements in the wrist and hand.Superficial LayerThree muscles are located in the superficial layer of the anterior compartment of the forearm.Flexor Carpi Ulnaris – A long muscle originating near the elbow and passing through into the wrist.Attachments: Originates from the humerus and ulna and attaches to one of the carpal bones in the wrist.Actions: Flexion and adduction at the wrist.Palmaris Longus – A long muscle originating near the elbow and passing through into the wrist.Attachments: Originates from the humerus and attaches to the base of the hand.Actions: Flexion at the wrist.Flexor Carpi Radialis – A long muscle originating near the elbow and passing through into the wrist.Attachments: Originates from the humerus and attaches to the base of the digits.Actions: Flexion and abduction at the wrist.Pronator Teres – A rectangular muscle.Attachments: The pronator teres has two origins, one on the proximal end of the humerus and one of the distal end of the ulna. It attaches to the mid region of the radius.Actions: Pronates the forearm.Deep LayerThere are four muscles in the deep layer of the posterior compartment of the forearm.Supinator – The supinator is located in the deep region of the forearm posterior compartment.Attachments: The supinator has two heads: one originates from the humerus, the other from the ulna. Together they attach to the radius.Actions: Supinates the forearm.Abductor Pollicis Longus – The abductor pollicis longus is situated immediately distal to the supinator muscle.Attachments: Originates from the radius and ulna attaching to the base of the thumb.Actions: Abducts the thumb.Extensor Pollicis Brevis – The extensor pollicis Brevis is located below the abductor pollicis longus.Attachments: Originates from radius and attaches to the base of the thumb.Actions: Extends the thumb.Extensor Indices Proprius – This muscle allows the index finger to be independent of the other fingers during extension.Attachments: Originates from the ulna and attaches to the index finger.Actions: Extends the index finger.Intermediate LayerThere is just one muscle in the intermediate layer of the anterior compartment of the forearm.Flexor Digitorum Superficialis – Lying below the superficial region, the flexor digitorum superficialis is a key muscle controlling wrist and finger flex.Attachments: Originates from the humerus and the radius, splitting into four tendons at the wrist which travel through the carpal tunnel and attach to the fingers.Actions: Flexes fingers and wrist.Deep LayerThere are three muscles in the deep layer of the anterior compartment of the forearm.Flexor Digitorum Profundus – A long muscle originating near the elbow and passing through into the wrist, lying adjacent to the flexor pollicis longus.Attachments: Originates from the ulna, splitting into four tendons at the wrist which travel through the carpal tunnel and attach distally to the fingers.Actions: Flexes the wrist and the most distal regions of the fingers.Flexor Pollicis Longus – A long muscle originating near the elbow and passing through into the wrist, lying adjacent to the flexor digitorum profundus.Attachments: Originates from the radius and attaches to the base of the thumb.Actions: Flexes the thumb.Pronator quadratus – A square-shaped muscle located adjacent to the wrist.Attachments: Originates from the ulna and attaches to the radius.Actions: Pronates the forearm.Deep LayerExtensor indicesFunction: Extension of the index fingerOrigin: Dorsal surface of the distal ulna and interosseous membraneInsertion: Extensor expansion of the second fingerInnervation: Posterior interosseous nerve (C7, C8)Supinator Function: Supination of the forearmOrigin: Lateral epicondyle and supinator crest of the ulnaInsertion: Lateral surface of radiusInnervation: Deep branch of the radial nerve (C7, C8)Abductor policies longus Function: Abduction of the thumb by acting on the carpometacarpal joint and the metacarpophalangeal jointOrigin: Dorsal aspects of the proximal radius, ulna, and interosseous membraneInsertion: Base of the first metacarpalInnervation: Posterior interosseous nerve (C7, C8)Extensor policies longus Function: Extension of the thumb by acting on the carpometacarpal joint, the metacarpophalangeal joint, and the interphalangeal joint.Origin: Dorsal aspects of the middle ulna and interosseous membraneInsertion: Distal phalanx of 1st fingerInnervation: Posterior interosseous nerve (C7, C8)Extensor policies BrevisFunction: Extension of the thumb by acting on the carpometacarpal joint and the metacarpophalangeal jointOrigin: Dorsal aspects of middle radius and interosseous membraneInsertion: Distal phalanx of 1st fingerinnervation: Posterior interosseous nerve (C7, C8)Intrinsic Muscles of HandThenar musclesThe thenar muscles are three short muscles located at the base of the thumb and responsible for its fine movement.Opponents policies The opponent’s pollicis is the largest and deepest-lying of the thenar muscles.Function: Opposition of the thumbOrigin: Flexor retinaculum and tubercle of trapeziumInsertion: Lateral aspect of the first metacarpalInnervation: Recurrent branch of the median nerve (C8, T1)Attachments: Originates from the wrist and attaches to the thumb.Actions: Rotates the thumb towards the palm, producing opposition and improving grip.Abductor policies BrevisLocated anteriorly to the opponens pollicis and proximal to the flexor pollicis brevis.Function: Abduction of the thumb at the metacarpophalangeal joint, Abducts the thumb.Origin: Flexor retinaculum and tubercle of the scaphoidInsertion: Lateral aspect of proximal phalanx of the first fingerInnervation: Recurrent branch of the median nerve (C8, T1)Attachments: Originates from the wrist and attaches to the thumb.Flexor policies Brevis The smallest and most distal of the thenar muscles.Function: Flexion of the thumb at the metacarpophalangeal jointOrigin: Flexor retinaculum and tubercle of trapeziumInsertion: Lateral aspect of proximal phalanx of the first fingerActions: Flexes the thumb.Innervation: Recurrent branch of the median nerve (C8, T1)Attachments: Originates from the wrist and attaches to the thumbAdductor CompartmentAdductor policiesFunction: Adduction of the thumbOrigin: Second, third metacarpal, and capitateInsertion: Proximal phalanx and extensor expansion of 1st fingerInnervation: Deep branch of ulnar nerve (C8, T1)Hypothenar MusclesHypothenar MusclesThe hypothenar muscles are located at the base of the little finger. Their naming, function, and organization are similar to those of the thenar muscles.Abductor digiti minimiThe most superficial of the hypothenar muscles.Function: Abduction of the little finger at the metacarpophalangeal jointOrigin: PisiformInsertion: Medial aspect of proximal phalanx of the fifth fingerInnervation: Deep branch of the ulnar nerve (C8, T1)Attachments: Originates from the wrist and attaches to the little finger.Actions: Abducts the little finger.Flexor digiti Minimi BrevisLocated laterally to the digiti minimi.Function: Flexion of the little finger at the metacarpophalangeal jointOrigin: Flexor retinaculum and hook of hamateInsertion: Medial aspect of proximal phalanx of the fifth fingerInnervation: Deep branch of the ulnar nerve (C8, T1)Attachments: Originates from the wrist and attaches to the little finger.Actions: Flexes little finger.Opponents digit minimiThe opponent’s digit minimi is the deepest-lying of the hypothenar muscles.Function: Opposition of the little fingerOrigin: Flexor retinaculum and hook of hamateInsertion: Medial aspect of the fifth metacarpalInnervation: Deep branch of the ulnar nerve (C8, T1)Attachments: Originates from the wrist and attaches to the little finger.Actions: Rotates little finger towards the palm, producing opposition and improving grip. Short MusclesLubricants These are four lumbricals in the hand, each associated with an individual finger.Attachments: Originates from a tendon of attached to the flexor digitorum profundus of the forearm, each attaching to an individual fingerActions: Flexes and extends the fingers.Function: Flexion of the metacarpophalangeal joints with the extension of the interphalangeal jointsOrigin: Arise from tendons of flexor digitorum profundus. First 2 are unipennate, and the third and fourth are bipennateInsertion: Extensor expansions of the second, third, fourth, and fifth fingerInnervation: Median nerve (C8, T1) for the lateral 2 lumbricals, deep branch of the ulnar nerve (C8, T1) for the medial 2 lumbricalsInterosseiThe interossei muscles are located between the fingers; they can be split into two groups.Dorsal interossei Located superficially on the dorsal side of the hand, there are four dorsal interossei muscles.Function: Abduction of the second, third, and fourth finger away from the axial lineOrigin: Adjacent metacarpalsInsertion: Extensor expansions and proximal phalanges of the second, third, and fourth fingersInnervation: Deep branch of the ulnar nerve (C8, T1)Attachments: Originates from the base of the finger, each attaching after the first finger joint.Actions: Abducts the fingers.Palmar interosseiLocated on the anterior side of the hand, there are three palmar interossei, with the index finger controlled by the extensor indices properties.Function: Adduction of the second, third, and fourth finger towards the axial lineOrigin: Palmar surfaces of second, fourth, and fifth metacarpalsInsertion: Extensor expansions and proximal phalanges of the second, fourth, and fifth fingersInnervation: Deep branch of the ulnar nerve (C8, T1)Attachments: Originates from the base of the finger, each attaching after the first finger joint.Actions: Adducts the fingers.Palmaris Brevis – The palmaris brevis is a small superficial muscle found in the palm.Attachments: Originates from the fascia of the palm and attaches to the dermis.Actions: Wrinkles the skin and deepens the curvature of the palm improving grip.Key Terms and Overview Upper Limb MusclePronator Teres – A muscle of the anterior compartment of the forearm that controls pronation.Supinator – A muscle of the posterior compartment of the forearm that controls supination.Pronator Quadraturs – A muscle of the anterior compartment of the forearm that controls pronation.Brachioradialis – A muscle of the posterior compartment of the forearm that flexes the forearm.Biceps Brachii – A muscle of the anterior compartment of the upper arm that flexes the forearm.Triceps Brachii – A muscle of the posterior compartment of the upper arm that extends the forearm.The extension (forearm away from the upper arm) – Produced by the triceps brachii and anconeus of the forearm.Flexion (forearm towards the upper arm) – Produced by the brachialis, biceps brachii, and brachioradialis of the forearm.Pronation (rotation of the forearm so the palm faces downwards) – Produced by the pronator quadratus and pronator teres of the forearm.Supination(rotation of the forearm so the palm faces upwards) – Produced by the supinator of the forearm and biceps brachii.Palmaris Longus – A long muscle originating near the elbow and passing through into the wrist, attaching to the base of the hand.Flexor Digitorum Superficialis – A key muscle controlling wrist and finger flex.Flexor Carpi Ulnaris – A long muscle originating near the elbow and passing through into the wrist, attaching to one of the carpal bones in the wrist.Flexor Carpi Radialis – A long muscle originating near the elbow and passing through into the wrist, attaching to the base of the digits (fingers).Flexor Digitorum Profundus – A long muscle originating near the elbow and passing through into the wrist, flexing the wrist and the most distant regions of the fingers.Pronator Teres – A rectangular muscle that pronates the forearm.Flexor Pollicis Longus – A long, deep muscle responsible for flexing the thumb.Pronator quadratus – A square-shaped muscle located adjacent to the wristsKey TermsPectoralis major – A large, fan-shaped muscle of the chest.Rotator cuff – A set of four smaller muscles in the shoulder responsible for rotating the humerus (upper arm bone).Trapezius – A large vertebrate skeletal muscle divided into an ascending, descending, and transverse portion, attaching the neck and central spine to the outer extremity of the scapula. It functions in scapular elevation, adduction, and depression.Deltoid – The deltoid muscle, a triangular muscle on the human shoulder.The extension (upper limb backward behind back) – Produced by the posterior deltoid, latissimus dorsi, and teres major.Flexion (upper limb forwards past chest – Produced by the biceps brachii (both heads), pectoralis major, anterior deltoid, and coracobrachialis.Abduction (upper limb away from the trunk, spreading arms wide) – Produced by the supraspinatus and deltoid. Past 90 degrees, the scapula needs to be rotated by the trapezius and serratus anterior to achieve abduction.Adduction (upper limb towards the trunk, bringing arms down to side) – Produced by contraction of the pectoralis major, latissimus dorsi, and teres major.Medial Rotation (rotation of arm inwards to cover abdomen) – Produced by contraction of the subscapularis, pectoralis major, latissimus dorsi, teres major, and anterior deltoid.Lateral Rotation (rotation of arm outwards away from the abdomen) – Produced by contraction of the infraspinatus and teres minor.The shoulder exhibits a wide range of movement, which makes it susceptible to dislocation and injury.The trapezius muscles rotate the scapulae upward.The rhomboid major and the rhomboid minor press the scapula against the thoracic wall, retracting the scapula towards the spine.The deltoid is a complex muscle that forms the rounded edge of the shoulder and participates in many articulations of the shoulder joint.The rotator cuff are the muscles that stabilize the movement of the shoulder.The pectoralis minor and pectoralis major are large muscles of the chest that participate in many movements, including flexion of the humerus.Blood Supply of Upper Limb MuscleBlood supply of the supraspinatusThe suprascapular artery delivers blood to the supraspinatus muscle.Blood supply of the deltoidThe posterior circumflex humeral artery and the deltoid branch of the thoracoacromial artery are the vascular sources for the deltoid.Blood supply of the trapeziusThe transverse cervical artery provides vascular supply to the trapezius.Blood supply of the serratus anteriorThe circumflex scapular artery is the blood supply to the serratus anterior.Nerves of Upper Limb MuscleThe collateral nerves of the brachial plexus are listed as follows:The dorsal scapular nerve.The long thoracic nerve.The suprascapular nerve.The lateral pectoral nerve.The medial pectoral nerve.The upper subscapular nerve.The lower subscapular nerve.The thoracodorsal nerve.The medial brachial cutaneous nerve.The medial antebrachial cutaneous nerve.Innervation of the supraspinatusThe neural supply of the supraspinatus is by the suprascapular nerve (C5, C6) from the upper trunk of the brachial plexus.Innervation of the deltoidThe neural supply of the deltoid is via the axillary nerve (C5, C6) from the posterior cord of the brachial plexus.Innervation of the trapeziusThe neural supply of the trapezius is the spinal accessory nerve (C1-C5). C3 and C4 are responsible for the proprioception of the trapezius.Innervation of the serratus anteriorThe neural supply of the serratus anterior is the long thoracic nerve (C5-C7) which originates from the roots of the brachial plexus. 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