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Tables 7

1

2

3

4

467

UPPER LIMB • Tables

Superficial layer of muscles in the anterior compartment of the forearm

(spinal segments indicated in bold are the major segments innervating the muscle)

Muscle

Origin

Insertion

Innervation

Function

 

 

 

 

 

Flexor carpi

1 Humeral head—medial

ulnaris

epicondyle of humerus;

 

ulnar head—olecranon and

 

posterior border of ulna

Pisiform bone, and then

Ulnar nerve [C7, C8, T1] Flexes and adducts the wrist joint

via pisohamate and

 

pisometacarpal ligaments

 

into the hamate and base

 

of metacarpal V

 

Palmaris

2

Medial epicondyle of

Palmar aponeurosis of

Median nerve [C7, C8]

Flexes wrist joint; because the

longus

 

humerus

hand

 

palmar aponeurosis anchors skin

 

 

 

 

 

of the hand, contraction of the

 

 

 

 

 

muscle resists shearing forces

 

 

 

 

 

when gripping

Flexor carpi

3

Medial epicondyle of

Base of metacarpals II

Median nerve [C6, C7]

Flexes and abducts the wrist

radialis

 

humerus

and III

 

 

Pronator

4

Humeral head—medial

Roughening on lateral

Median nerve [C6, C7]

Pronation

teres

 

epicondyle and adjacent

surface, midshaft, of

 

 

 

 

supracondylar ridge; ulnar

radius

 

 

 

 

head—medial side of

 

 

 

 

 

coronoid process

 

 

 

Intermediate layer of muscles in the anterior compartment of the forearm

Flexor

5

Humero-ulnar head—

digitorum

 

medial epicondyle of

superficialis

 

humerus and adjacent

 

 

margin of coronoid process;

 

 

radial head—oblique line of

 

 

radius

 

 

 

Four tendons, which

Median nerve [C8, T1]

Flexes proximal interphalangeal

attach to the palmar

 

joints of the index, middle, ring,

surfaces of the middle

 

and little fingers; can also flex

phalanges of the index,

 

metacarpophalangeal joints of the

middle, ring, and little

 

same fingers and the wrist joint

fingers

 

 

 

 

 

Deep layer of muscles in the anterior compartment of the forearm

Flexor

6 Anterior and medial

digitorum

surfaces of ulna and

profundus

anterior medial half of

 

interosseous membrane

Four tendons, which attach to the palmar surfaces of the distal phalanges of the index, middle, ring, and little fingers

Lateral half by

median nerve (anterior interosseous nerve); medial half by ulnar nerve [C8, T1]

Flexes distal interphalangeal joints of the index, middle, ring, and little fingers; can also flex metacarpophalangeal joints of the same fingers and the wrist joint

Flexor

7 Anterior surface of

pollicis

radius and radial half of

longus

interosseous membrane

Palmar surface of base

Median nerve (anterior

Flexes interphalangeal joint of

of distal phalanx of

interosseous nerve)

the thumb; can also flex

thumb

[C7, C8]

metacarpophalangeal joint of the

 

 

thumb

Pronator

8 Linear ridge on distal

Distal anterior surface

Median nerve (anterior

Pronation

quadratus

anterior surface of ulna

of radius

interosseous nerve)

 

 

 

 

[C7, C8]

 

468

Tables 7

1

2

3

4

5 6

7

8

469

Tables 7

Deep layer of muscles in the posterior compartment of the forearm

(spinal segments indicated in bold are the major segments innervating the muscle)

Muscle

Origin

Insertion

Innervation

Function

 

 

 

 

 

Supinator 1 Superficial part—lateral epicondyle of humerus, radial collateral and anular ligaments; deep part— supinator crest of the ulna

Lateral surface of

Posterior interosseous

Supination

radius superior to the

nerve [C6, C7]

 

anterior oblique line

 

 

Abductor

2 Posterior surfaces of ulna

Lateral side of base of

Posterior interosseous

Abducts carpometacarpal joint

pollicis

and radius (distal to the attachments

metacarpal I

nerve [C7, C8]

of thumb; accessory extensor

longus

of supinator and anconeus) and

 

 

of the thumb

 

intervening interosseous membrane

 

 

 

Extensor

3 Posterior surface of radius (distal to

pollicis

abductor pollicis longus) and the

brevis

adjacent interosseous membrane

Dorsal surface of base

Posterior interosseous

Extends metacarpophalangeal

of proximal phalanx of

nerve [C7, C8]

joint of the thumb; can also

the thumb

 

extend the carpometacarpal

 

 

joint of the thumb

Extensor

4 Posterior surface of ulna (distal to

pollicis

the abductor pollicis longus) and the

longus

adjacent interosseous membrane

Dorsal surface of base

Posterior interosseous

Extends interphalangeal joint

of distal phalanx of

nerve [C7, C8]

of the thumb; can also extend

thumb

 

carpometacarpal and

 

 

metacarpophalangeal joints of

 

 

the thumb

Extensor

5 Posterior surface of ulna (distal to

Extensor hood of index

Posterior interosseous

Extends index finger

indicis

extensor pollicis longus) and

finger

nerve [C7, C8]

 

 

adjacent interosseous membrane

 

 

 

1

4

 

2

3

5

471

UPPER LIMB • Tables

Intrinsic muscles of the hand

(spinal segments indicated in bold are the major segments innervating the muscle)

Muscle

 

Origin

Insertion

Innervation

Function

Palmaris brevis

1

Palmar aponeurosis and

Dermis of skin on the

Superficial branch of

Improves grip

 

 

flexor retinaculum

medial margin of the hand

the ulnar nerve [C8,

 

 

 

 

 

T1]

 

Dorsal interossei

2

Adjacent sides of

Extensor hood and base

Deep branch of ulnar

Abduction of index,

(four muscles)

 

metacarpals

of proximal phalanges of

nerve [C8, T1]

middle, and ring

 

 

 

index, middle, and ring

 

fingers at the

 

 

 

fingers

 

metacarpophalangeal

 

 

 

 

 

joints

Palmar interossei

3

Sides of metacarpals

Extensor hoods of the

Deep branch of ulnar

Adduction of the

(four muscles)

 

 

thumb, index, ring, and

nerve [C8, T1]

thumb, index, ring,

 

 

 

little fingers and the

 

and little fingers at the

 

 

 

proximal phalanx of

 

metacarpophalangeal

 

 

 

thumb

 

joints

Adductor pollicis

4

Transverse head—

Base of proximal phalanx

Deep branch of ulnar

Adducts thumb

 

 

metacarpal III; oblique

and extensor hood of

nerve [C8, T1]

 

 

 

head—capitate and

thumb

 

 

 

 

bases of metacarpals II

 

 

 

 

 

and III

 

 

 

Lumbricals

5 Tendons of flexor

Extensor hoods of index,

(four muscles)

digitorum profundus

ring, middle, and little

 

 

fingers

Medial two by the

Flex metacarpophalan-

deep branch of the

geal joints while

ulnar nerve; lateral

extending interphalan-

two by digital

geal joints

branches of the

 

median nerve

 

Thenar muscles

Opponens pollicis

6 Tubercle of trapezium and

 

flexor retinaculum

Lateral margin and

Recurrent branch of

Medially rotates thumb

adjacent palmar surface

median nerve [C8, T1]

 

of metacarpal I

 

 

Abductor pollicis brevis

7

Tubercles of scaphoid and

Proximal phalanx and

Recurrent branch of

Abducts thumb at

 

 

trapezium and adjacent

extensor hood of thumb

median nerve [C8, T1]

metacarpophalangeal

 

 

flexor retinaculum

 

 

joint

Flexor pollicis brevis

8

Tubercle of the trapezium

Proximal phalanx of the

Recurrent branch of

Flexes thumb at

 

 

and flexor retinaculum

thumb

median nerve [C8, T1]

metacarpophalangeal

 

 

 

 

 

joint

 

 

 

 

 

 

Hypothenar muscles

 

 

 

 

 

Opponens digiti minimi

9

Hook of hamate and flexor

Medial aspect of

Deep branch of ulnar

Laterally rotates

 

 

retinaculum

metacarpal V

nerve [C8, T1]

metacarpal V

Abductor digiti minimi

10

Pisiform, the pisohamate

Proximal phalanx of little

Deep branch of ulnar

Abducts little finger at

 

 

ligament, and tendon of

finger

nerve [C8, T1]

metacarpophalangeal

 

 

flexor carpi ulnaris

 

 

joint

Flexor digiti minimi brevis

11

Hook of the hamate and

Proximal phalanx of little

Deep branch of ulnar

Flexes little finger at

 

 

flexor retinaculum

finger

nerve [C8, T1]

metacarpophalangeal

 

 

 

 

 

joint

 

 

 

 

 

 

472

Tables 7

1

2

3

4

5

6

7

 

9

11

8

10

473

HEADANDNECK• Tables

Muscles of the face

Muscle

 

Origin

Insertion

Innervation

Function

Orbital group

 

 

 

 

 

Orbicularis oculi

1

Medial palpebral ligament

Lateral palpebral raphe

Facial nerve [VII]

Closes the eyelids

—Palpebral part

 

 

 

 

gently

—Orbital part

2

Nasal part of frontal bone;

Fibers form an uninter-

Facial nerve [VII]

Closes the eyelids

 

 

frontal process of maxilla;

rupted ellipse around

 

forcefully

 

 

medial palpebral ligament

orbit

 

 

Corrugator supercilii

3

Medial end of the supercili-

Skin of the medial half of

Facial nerve [VII]

Draws the eyebrows

 

 

ary arch

eyebrow

 

medially and

 

 

 

 

 

downward

 

 

 

 

 

 

 

 

 

 

 

 

Nasal group

 

 

 

 

 

Nasalis

4

Maxilla just lateral to nose

Aponeurosis across

Facial nerve [VII]

Compresses nasal

—Transverse part

 

 

dorsum of nose with

 

aperture

 

 

 

muscle fibers from the

 

 

 

 

 

other side

 

 

—Alar part

5

Maxilla over lateral incisor

Alar cartilage of nose

Facial nerve [VII]

Draws cartilage

 

 

 

 

 

downward and

 

 

 

 

 

laterally opening

 

 

 

 

 

nostril

Procerus

6

Nasal bone and upper part

Skin of lower forehead

Facial nerve [VII]

Draws down medial

 

 

of lateral nasal cartilage

between eyebrows

 

angle of eyebrows

 

 

 

 

 

producing transverse

 

 

 

 

 

wrinkles over bridge of

 

 

 

 

 

nose

Depressor septi

7

Maxilla above medial

Mobile part of the nasal

Facial nerve [VII]

Pulls nose inferiorly

 

 

incisor

septum

 

 

 

 

 

 

 

 

1

3

6

 

 

2

4

 

 

5

7

590

Tables 8

Muscles of the face

Muscle

 

Origin

Oral group

1 Oblique line of mandible

Depressor anguli oris

 

 

below canine, premolar,

 

 

and first molar teeth

Insertion

Innervation

Function

Skin at the corner of

Facial nerve [VII]

Draws corner of mouth

mouth and blending with

 

down and laterally

orbicularis oris

 

 

Depressor labii

2 Anterior part of oblique line

inferioris

of mandible

Lower lip at midline;

Facial nerve [VII]

Draws lower lip

blends with muscle from

 

downward and laterally

opposite side

 

 

Mentalis

3

Mandible inferior to incisor

Skin of chin

Facial nerve [VII]

Raises and protrudes

 

 

teeth

 

 

lower lip as it wrinkles

 

 

 

 

 

skin on chin

Risorius

4

Fascia over masseter

Skin at the corner of the

Facial nerve [VII]

Retracts corner of

 

 

muscle

mouth

 

mouth

Zygomaticus major

5

Posterior part of lateral

Skin at the corner of the

Facial nerve [VII]

Draws the corner of

 

 

surface of zygomatic bone

mouth

 

the mouth upward and

 

 

 

 

 

laterally

Zygomaticus minor

6

Anterior part of lateral

Upper lip just medial to

Facial nerve [VII]

Draws the upper lip

 

 

surface of zygomatic bone

corner of mouth

 

upward

Levator labii superioris

7

Infra-orbital margin of

Skin of upper lateral half

Facial nerve [VII]

Raises upper lip; helps

 

 

maxilla

of upper lip

 

form nasolabial furrow

Levator labii

8

Frontal process of maxilla

Alar cartilage of nose

Facial nerve [VII]

Raises upper lip and

superioris alaeque nasi

 

 

and upper lip

 

opens nostril

Levator anguli oris

9

Maxilla below infra-orbital

Skin at the corner of

Facial nerve [VII]

Raises corner of

 

 

foramen

mouth

 

mouth; helps form

 

 

 

 

 

nasolabial furrow

Orbicularis oris

10

From muscles in area;

Forms ellipse around

Facial nerve [VII]

Closes lips; protrudes

 

 

maxilla and mandible in

mouth

 

lips

 

 

midline

 

 

 

Buccinator

11

Posterior parts of maxilla

Blends with orbicularis

Facial nerve [VII]

Presses the cheek

 

 

and mandible;

oris and into lips

 

against teeth;

 

 

pterygomandibular raphe

 

 

compresses distended

 

 

 

 

 

cheeks

8

 

 

 

6

 

7

 

5

 

9

11

4

 

2

 

10

 

 

 

1

 

 

 

3

 

 

591

HEADANDNECK• Tables

Muscles of the face

Muscle

 

Origin

Insertion

Innervation

Function

Other muscles or groups

 

 

 

 

 

Anterior auricular

1

Anterior part of temporal

Into helix of ear

Facial nerve [VII]

Draws ear upward

 

 

fascia

 

 

and forward

Superior auricular

2

Epicranial aponeurosis

Upper part of auricle

Facial nerve [VII]

Elevates ear

 

 

on side of head

 

 

 

Posterior auricular

3

Mastoid process of

Convexity of concha of

Facial nerve [VII]

Draws ear upward

 

 

temporal bone

ear

 

and backward

Occipitofrontalis

4

Skin of eyebrows

Into galea aponeurotica

Facial nerve [VII]

Wrinkles forehead;

—Frontal belly

 

 

 

 

raises eyebrows

—Occipital belly

5

Lateral part of superior

Into galea aponeurotica

Facial nerve [VII]

Draws scalp

 

 

nuchal line of occipital

 

 

backward

 

 

bone and mastoid

 

 

 

 

 

process of temporal

 

 

 

 

 

bone

 

 

 

 

 

 

 

 

 

Extrinsic (extra-ocular) muscles

Muscle

 

Origin

Insertion

Innervation

Function

Levator palpebrae

1

Lesser wing of sphenoid

Anterior surface of tarsal

Oculomotor nerve

Elevation of upper eyelid

superioris

 

anterior to optic canal

plate; a few fibers to skin

[III]—superior branch

 

 

 

 

and superior conjunctival

 

 

 

 

 

fornix

 

 

Superior rectus

2

Superior part of common

Anterior half of eyeball

Oculomotor nerve

Elevation, adduction,

 

 

tendinous ring

superiorly

[III]—superior branch

medial rotation of eyeball

Inferior rectus

3

Inferior part of common

Anterior half of eyeball

Oculomotor nerve

Depression, adduction,

 

 

tendinous ring

inferiorly

[III]—inferior branch

lateral rotation of eyeball

Medial rectus

4

Medial part of common

Anterior half of eyeball

Oculomotor nerve

Adduction of eyeball

 

 

tendinous ring

medially

[III]—inferior branch

 

Lateral rectus

5

Lateral part of common

Anterior half of eyeball

Abducent nerve [VI]

Abduction of eyeball

 

 

tendinous ring

laterally

 

 

Superior oblique

6

Body of sphenoid,

Outer posterior quadrant of

Trochlear nerve [IV]

Depression, abduction,

 

 

superior and medial to

eyeball (superior surface)

 

medial rotation of eyeball

 

 

optic canal

 

 

 

Inferior oblique

7

Medial floor of orbit

Outer posterior quadrant of

Oculomotor nerve

Elevation, abduction,

 

 

posterior to rim; maxilla

eyeball (inferior surface)

[III]—inferior branch

lateral rotation of eyeball

 

 

lateral to nasolacrimal

 

 

 

 

 

groove

 

 

 

 

 

 

 

 

 

592

Tables 8

4

2

1

5

3

1

2

 

7

 

3

 

5

6

4

 

593

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