Evon Chai | ME216

Muscle Origin Insertion Action Neurovascular Remarks

PECTORAL MUSCLES
Clavicular head (F)
-Antero-medial clavicle
Lateral lip of A: Thoracoacromial Ant axillary fold
Sternocostal head (E) Adduction
Pectoralis major Intertubercular (b/o axillary A) Deltopectoral
-Sternum, CC 1-6, Medial rotation
groove N: Pectoral (m,l) triangle
aponeurosis ext oblique

Protracts scapula,
Pectoralis minor 3-5 ribs Coracoid process N: Pectoral (m,l)
depress shoulder

N: Subclavian C5, C6
Subclavius 1st rib and 1st CC junc. Subclavian groove Steadies clavicle
(b/o upper trunk)
1st to 8th ribs + Ant IC Protracts scapula Boxer’s muscle
Inner medial N: long thoracic C5,
Serratus anterior Membrane from MCL Lateral rotation Winging of scapula
border scapula C6, C7
Ext oblique (5th to 8th) Forward, upward Pushing, punching
SCAPULAR MUSCLES
Sup nuchal line, ext
occipital protuberance, Lat 3rd clavicle, Elevates (sup) N: spinal root of
Trapezius (S) nuchal ligament, acromion, Retract (mid) accessory nerve
C7-T12 spinous process spine of scapula Depress (inf) (CN XI)

N: thoracodorsal
T7-T12 spinous process Adduction Climbing m/s
Intertubercular C6, C7, C8
Latissimus dorsi (S) Thoracolumbar fascia, Extension Swimmer’s muscle
groove (post branch)
Iliac crest, inf 3-4 ribs Medial rotation (= teres major)
Nuchal ligament, Retracts scapula
Rhomboid minor Medial border of
C7-T1 spinous process Depress glenoid N: Dorsal scapular
scapula to inferior
Fix scapula to wall C5 root
Rhomboid major T2-T5 spinous process angle
Elevates scapula
Superomedial N: Dorsal scapular
Levator scapulae C1-C4 post tubercles Depress glenoid
scapula C5 root

Med rotation, Flexion, A: Thoracoacromial,

Lateral 3rd clavicle
Deltoid tuberosity Adduction (Ant) humeral circumflex
Deltoid Lateral acromion
on lat. Humerus Abduction* (Lat) N: Axillary (post cord)
Lower lip spine of scapula
Lat rotation, E (Post) C5, C6
Supraspinatus Supraspinous fossa Greater tubercle Abduction 0-15o N: Suprascapular
Rotator cuff SITS
Infraspinatus Infraspinous fossa Greater tubercle Lateral rotation N: Suprascapular
Teres minor Lateral scapula Greater tubercle Lateral rotation N: Axillary
Stability of shoulder
Subscapularis (Ant) Subscapular fossa Lesser tubercle Medial rotation N: Subscapular
ARM
Long head
- supraglenoid tubercle of Radial tuberosity
Flexion (supinated)
Biceps brachii scapula (bicipital gr.) Bicipital N: musculocutaneous
Supination
Short head aponeurosis
- coracoid process
Middle 3rd medial Flexion (shoulder)
Coracobrachialis Coracoid process N: musculocutaneous = Pectoralis major
humerus Adduction (shoulder)
Coronoid process N: musculocutaneous, Workhorse of
Brachialis Distal half ant humerus Flexion (all position)
Ulnar tuberosity Radial elbow flexors
Distal radius Supinator jerk
Brachioradialis Lateral supracondylar line Flexion (mid-prone) N: Radial
(styloid) (radial N)
Long head
- Infraglenoid tubercle
Lateral head Olecranon Assisted by
Triceps brachii Extension N: Radial
- sup. Radial groove process of ulna anconeus
Medial head
- inf Radial groove
Olecranon
Anconeus
Lateral epicondyle (post) process of ulna Extension N: Radial
 Evon Chai | ME216

FOREARM
FLEXORS & PRONATORS
Pronator teres syn
Pronator teres (S) Medial epicondyle Radial shaft Pronation Median N enters
btw 2 head
Flexor carpi Flexion N: Median
Medial epicondyle 2nd/3rd MC
radialis (S) Abduction
Apex of palmar
Palmaris longus (S) Medial epicondyle Flexion
aponeurosis
Flexor carpi Medial epicondyle Pisiform and base Flexion
N: Ulnar
ulnaris (S) Subcut. Ulnar border of 5th MC Adduction
Medial epicondyle,
Flexor digitorum 2-5 middle
Coronoid process ulna; Flexion (WJ, MP, PIP) N: Median Carpal tunnel
superficialis (I) x2 phalenges > splits
Ant border radius
N: Ulnar (medial 2)
Flexor digitorum 2-5 distal Flexion (WJ, MP, PIP, Ant Interosseous
Ulnar upper 3/4th Carpal tunnel
profundus (D) phalenges DIP) (lat 2) b/o Median N

Flexor pollicis Thumb (base of

Radius (ant) Flexion (WJ, CM, MP) N: Ant Interosseous Carpal tunnel
longus (D) distal phalanx)
Pronator quadratus
Ulnar lower 1/4th Radius lower 1/4th Pronation N: Ant Interosseous
(D)
EXTENSORS & SUPINATORS
Extensor carpi
Lateral supracondylar line 2nd MC base N: Radial To 2nd MC
radialis longus (S) Extension
Extensor carpi 2nd and 3rd MC Abduction
Lateral epicondyle To 3rd MC
radialis brevis (S) base
Dorsal digital
Extensor
Extensor digitorum expansion:
Lateral epicondyle expansion of 2-4
(S) Extension (WJ, MP, Lumbricals, Dorsal
fingers
PIP, DIP) & palmar interossei
Extensor digiti Extensor
Lateral epicondyle
minimi (S) expansion of 5th
Extensor carpi Extension
Lateral epicondyle 5th MC base To 5th MC
ulnaris (S) Adduction N: Post. Interosseous
Lateral epicondyle Radius (ant, lat, b/o radial N
Supinator (D) Supination
Supinator crest on ulna post)
Abductor pollicis
Ulnar + radius 1st MC base Abduction
longus (D)
Extensor pollicis Thumb (base of
Radius (post) Extension (CM, MP)
brevis (D) prox. phalanx)
Extensor pollicis Thumb (base of Extension (CM, MP,
Ulnar (post, middle)
longus (D) distal phalanx) IP)
Extensor Extension (WJ, PIP,
Extensor indicis (D) Ulnar (post, middle)
expansion of 2nd DIP)
HAND
Flexor pollicis brevis Thumb (base of
Flexion (MCP, CMC)
(S) prox. phalanx)
Abductor pollicis Thumb (base of Thenar
Flexor retinaculum Abduction (CMC) N: Median
brevis (S) prox. phalanx)
Opponens pollicis
Entire 1st MC Opposes CMC
(D)
Thumb (base of
Adductor pollicis Oblique head: 2nd, 3rd MC
prox. phalanx) Adduction (CMC)
(D) Transverse head: 3rd MC
Flexor digiti minimi Little finger (base
Flexion (MCP)
(S) of prox. phalanx)
Abductor digiti Little finger (base Hypothenar
Flexor retinaculum Abduction (MCP) N: Ulnar
minimi (S) of prox. phalanx)
Opponens digiti Little finger
Lateral rotation
minimi (D) (medial)
Adj sides of MC in
Dorsal interossei Abduction All metacarpals
interspace
Extensor
Palmar interossei 2nd, 4th, 5th MC Adduction 2,4,5 metacarpals
expansion
Flexor digitorum Extension (IP) N: Median 1st 2nd On lateral sides of
Lumbricals
profundus Flexion (MCP) Ulnar 3rd, 4th extensor exp.
 Evon Chai | ME216

Muscle Origin Insertion Action Neurovascular Remarks

Iliotibial tract,
Ilium, back of sacrum and Extension
Gluteus maximus G. trochanter, N: Inf gluteal Sitting up
coccyx Lateral rotation
gluteal tuberosity
Gluteus medius Greater Abduction
Ext surface of ilium
Gluteus minimus trochanter Medial rotation N: Sup gluteal
Tensor fascia lata Iliac crest Iliotibial tract Flexion Maintain knee Ext
Piriformis Anterolateral sacrum N: Piriformis S1, S2
Superior gemellus Ischial spine Greater
Lateral rotation N: Obturator internus
Medial obturator trochanter of
Obturator internus Extension L5, S1, S2
membrane femur
Inferior gemellus
N: Quadratus femoris
Ischial tuberosity Intertrochanteric
Quadratus femoris Lateral rotation L4, L5, S1
crest

POSTERIOR THIGH
Ischial tuberosity
Biceps femoris Fibula
Short head: femur Extension (Hip) N: Tibial b/o sciatic N
Hamstring
Semimembranosus Tibia Flexion (Knee) (short head BF by CPN)
Ischial tuberosity
Semitenditosus Tibia

ANTERIOR THIGH
Sartorius ASIS
Ant & lateral shaft of
Vastus medialis
femur
Intertrochanteric line
Vastus intermedius
Lateral lip of linea aspera
Greater trochanter
Vastus lateralis
Lateral lip of linea aspera
AIIS, ilium sup to
Rectus femoris
acetabulum
Iliacus Iliac fossa
Psoas Vertebral bodies (T12-L5)
Flexion, Abduction,
Sup medial tibia lateral rotation (Hip)
Flexion (knee)
Common
tendinous A: Femoral
Extension (knee)
(quadriceps N: Femoral
Quadriceps
tendon) to patella
RF – Flexion (hip)
→ patellar lig →
tibial tuberosity
Lesser trochanter Flexion (hip)
N: Lumbar plexus L1-3 Sitting up

MEDIAL THIGH
Pectineal line at Flex (hip), Adduction, N: Femoral N
Pectineus Sup ramus pubis
femur Medial rotation &Obturator N
Adductor brevis Pubic (body, inf rami) Ant div L2-L4
Linea aspera Adduction
Adductor longus Pubic (body, crest) Ant div L2-L3
A: Profunda femoris,
Adductor – linea
Adductor – ischiopubic Obturator vessels Post div L2-4
aspera, medial
rami N: Obturator
supracondylar Adduction
Adductor magnus Adductor hiatus
ridge Medial rotation
Hamstring – ischial Hamstring –
N: Tibial b/o sciatic N
tuberosity Adductor tubercle
Adduction (thigh)
Gracilis Pubic (body, inf rami) Sup medial tibia L2-L3
Flexion (knee)
N: Obturator
Trochanteric
Obturator externus Obturator membrane (ex) Lateral rotation L3-L4
fossa

POSTERIOR LEG
Medial and lateral
Gastrocnemius (S)
condyle of femur
Soleal line (post tibia &
Soleus (S)
fibula)
Plantaris (S) Lat epicondyle of femur
Popliteus (D) Lat epicondyle of femur
Post tibia, fibula,
Tibialis posterior (D)
interosseous membrane
Flexor digitorum Post tibia – Below soleal
longus (D) line
Flexor hallucis
Post fibula
longus (D)
Achilles tendon > Flexion (plantar,
post calcaneum knee)
Triceps surae
Post calcaneum Flexion (plantar)
Med calcanean Flexion (plantar,
Freshman’s nerve
tuberosity knee)
N: Tibial b/o sciatic N
Lat rotation of femur
Above soleal line A: Post tibial, Unlocking muscle
Med rotation of leg
peroneal
Navicular Flexion (plantar)
tuberosity Inversion TOM, DICK, HARRY
2-5th distal Supports medial
phalanges Flexion (plantar, arch (Tibialis post)
Distal phalanx of digits) TARSAL TUNNEL
great toe
 Evon Chai | ME216

ANTERIOR & LATERAL LEG

Dorsiflexion Supports medial
Tibialis anterior Lateral tibia Medial cuneiform
Inversion arch
Extensor hallucis Distal phalanx of Dorsiflexion N: Deep peroneal b/o
Fibula (medial half)
longus great toe Extension of digits common peroneal N
Extensor digitorum Distal 2-5th Dorsiflexion A: Ant tibial →
Tibia (lateral condyle) In front of EHL
longus phalanges Extension of digits Dorsalis pedis
5th metatarsal Dorsiflexion
Peroneus tertius Fibula (distal medial) Part of EDL
base Eversion
Medial cuneiform N: Superficial Supports lateral &
Peroneus longus Fibula (lateral)
and 1st metatarsal Eversion peroneal b/o transverse arch
5th metatarsal Plantar flexion common peroneal N
Peroneus brevis Fibula (lateral distal 2/3)
base A: Peroneal

DORSUM & SOLE OF FOOT

Extensor hallucis Proximal phalanx
brevis of great toe N: Deep peroneal b/o
Sup lateral calcaneus Extension of MTP
Extensor digitorum Proximal 2-4th common peroneal N
brevis phalanges
Flexor digitorum Middle 2-5th
Calcaneus Flexion of MTP
brevis phalanges > splits N: Medial plantar b/o
Calcaneus (medial Proximal phalanx Flexion of 1st MTP tibial N
Abductor hallucis FIRST LAYER
tuberosity) of great toe (med) Abduction
Abductor digiti Calcaneus (lateral & Proximal phalanx Abduction of MTP of
minimi medial tuberosity) of small toe (lat) little toe N: Lat plantar b/o
Calcaneus (lateral & Lateral flexor Flexion of 2-5th tibial N
Quadratus plantae
medial tuberosity) digitorum longus phalanges
N: Medial plantar (1st SECOND LAYER
Extensor hoods of Flexion of MTP
Lumbricals Flexor digitorum longus lumbrical), lateral
2-4th digits Extension IP
plantar (lat 3)
Flexor hallucis Tendon of tibialis post; Proximal phalanx N: Medial plantar b/o
Flexion of 1st MTP
brevis Cuboid bone of great toe tibial N
Flexor digiti minimi Prox phalanx of
5th metatarsal base Flexion of little toe THIRD LAYER
brevis little toe
Deep transverse MT lig; Proximal phalanx N: Lat plantar b/o
Adductor hallucis Adduction of 1st MTP
2-4th metatarsal of great toe tibial N
Plantar interossei Proximal 3-5th
Medial 3, 4, 5 MT Adduction
x3 phalanges
FORTH LAYER
Prox 2-5th N: Lat plantar (lat 2),
Dorsal interossei x4 2-5th MT Abduction
phalanges Deep PN (med 2)

Hip Shoulder
Flexion Iliopsoas, Pectineus, RF, Sartorius, TFL Flexion P major (C), Deltoid (A), coracobrachialis
Extension Gluteus max, hamstrings, piriformis, gem, obt in Extension P major (S), Deltoid (P), Latissimus
Abduction Gluteus med, Gluteus min, Sartorius, TFL Abduction Supraspinatus, Deltoid (L), trapezius, serratus ant
Adduction Add magnus, longus, brevis, Gracilis, pectineus Adduction P major, Latissimus, Deltoid (A), coracobrachialis
Medial rotation Gluteus med, Gluteus min, TFL, Add magnus Medial rotation P major, Latissimus, Deltoid (A), subscapularis
Lateral rotation Piriformis, gemelli, obturator in/ex, QF, Glut max, Lateral rotation Teres minor, Infraspinatus, deltoid (P)
Psoas major, sartorius
Knee Scapular
Flexion Hamstrings, Sartorius, gracilis, gastroc, plantaris Retract (Med) Trapezius, rhomboid
Extension Quadriceps, TFL Protract (Lat) P minor, serratus ant
Medial rotation Semitendinosus, semimembranosus, popliteus Elevates Trapezius (S), levator scapulae, serratus ant
Lateral rotation Biceps femoris Depress Trapezius (I)
Foot Forearm
Dorsiflexion Tibialis ant, EDL (+peroneus tertius), EHL Supination Biceps brachii (flexed), supinator
Plantar flexion Tibialis post, FDL, FHL, gastroc, soleus, plantaris Pronation Pronator teres, pronator quadratus
Inversion Tibialis ant, tibialis post Flexion Biceps brachii, brachialis, brachioradialis (mid)
Eversion Peroneus longus, brevis, tertius Extension Triceps brachii, anconeus
Wrist
Flexion FCR, PL, FCU, FDS, FDP
Extension ECRL, ECRB, ECU, ED, EI, EDM
Toes Fingers
Flexion FDL, FDB, FHL, FHB, FDMB, lumbricals (MT), QP (IP) Flexion FDS, FDP, FPL, FPB, FDMB, lumbricals (MCP)
Extension EDL, EDB, EHL, EHB, lumbricals (IP) Extension ED, EPL, EPB, EI, EDM, lumbricals (IP)
Abduction Dorsal interossei, AH, ADM Abduction Dorsal interossei, APL, APB, ADM
Adduction Plantar interossei (3,4,5), Adductor hallucis Adduction Palmar interossei (2,4,5), Adductor Pollicis
 Evon Chai | ME216

Shoulder joint (Glenohumeral) – synovial, ball & socket → multiaxial

Proximal: Glenoid fossa of scapula
Distal: Head of humerus
1. Capsular ligament (glenohumeral ligament)
2. Coracohumeral ligament
3. Transverse humeral ligament – biceps tendon
4. Glenoid labrum
Bursae: Subscapularis, subacromial, infraspinatus

Elbow joint – synovial, hinge → uniaxial

Proximal: Capitulum and trochlea of humerus
Distal: Head of radius and trochlear notch of ulna
1. Annular ligament → superior radio-ulnar joint
2. Radial collateral ligament
3. Ulnar collateral ligament – strongest
Bursae: Subcutaneous olecranon, subcutaneous medial & lateral epidoncyle

Radio-ulnar joint → pronation & supination

Sup: pivot joint (radial head in osseo-fibrous ring)
Mid: fibrous joint – fibrous syndesmosis (Interosseous membrane) → stretched in mid-prone (radial dislocation)
Inf: pivot joint (ulnar head & ulnar notch of radius) → articular cartilage

Wrist Joint (Radiocarpal joint) → synovial, condyloid → biaxial

Proximal: Radius
Distal: Carpal bones (scaphoid, lunate, triquetrum)

Hip joint – synovial, ball & socket → multiaxial

Proximal: Acetabular notch + transverse acetabular ligament
Distal: Head of femur (covered with hyaline cartilage except at fovea)
1. Capsular ligament
2. Transverse acetabular ligament
3. Ligamentum teres/ligament of head of femur/round ligament of femur – prevents over lateral rotation and adduction
4. Ilio-femoral ligament – prevents hyperextension
5. Pubo-femoral ligament – prevents over abduction
6. Ischio-femoral ligament – prevents hyperextension
Bursae: Iliacus, psoas

Knee joint – synovial, condyloid (modified hinge) → biaxial

Compound joint: tibia, femur, patella
Proximal: articular surface of femur condyles
Distal: articular surface of tibia (except where popliteus tendon crosses)
Other: Patella & patella ligament
1. Ligamentum patellae → knee jerk reflex
2. Tibial collateral ligament (medial) → medial meniscus
3. Fibula collateral ligament (lateral) – splits biceps femoris tendon into 2
4. Oblique popliteal ligament (expansion of semimembranosus)
5. Arcuate popliteal ligament
6. Ant cruciate ligament – prevents hyperextension, ant dislocation
7. Post cruciate ligament – prevents hyperflexion, post dislocation
8. Medial meniscus → MCL *injury
9. Lateral meniscus (separated from LCL by popliteal tendon)
Bursae: Suprapatellar, popliteus, medial head of gastrocnemius, semimembranosus

Tibio-fibular joint
Sup: synovial joint
Inf: fibrous joint – syndesmosis

Ankle joint (Talocrural joint) – synovial, modified hinge (dorsiflexion & plantar flexion)
Compound joint: tibia, fibula, talus
Proximal: Malleolar mortise (inner surface medial & lateral malleolus, inf tibia)
Distal: Trochlea of talus
1. Ant talofibular ligament (lateral) *injury
2. Calcaneofibular ligament (lateral)
3. Post talofibular ligament (lateral)
4. Deltoid ligament (medial) – 4 ligaments (ant/post tibiotalar ligament, tibionavicular ligament, tibiocalcaneal ligament)
5. Achilles tendon
Anatomical subtalar joint (Post talocalcaneal joint) – plane joint (Inversion & eversion)
Talocalcaneonavicular joint – Talonavicular (rotation) + Ant Talocalcaneal (inversion & eversion)
Clinical subtalar joint – Anatomical subtalar joint + Ant Talocalcaneal (inversion & eversion)
 Evon Chai | ME216

Transverse tarsal joint – Talonavicular + calcaneocuboid (rotation)

CUTANEOUS NERVES

UPPER LIMB

Nerve Branch of Supply

Medial cutaneous N of arm T1
Medial cutaneous N of forearm C8, T1
Sup lateral cutaneous N of arm Axillary N
Inf lateral cutaneous N of arm Radial N
Anterior
Lateral cutaneous N of forearm Musculocut. N
Palmar cutaneous of median Lateral palm
Median N
Terminal sensory of median Lateral 3 ½ digits (palm) + dorsum of distal 3 ½
Palmar cutaneous of ulnar Medial palm
Terminal sensory of ulnar Ulnar N Medial 1 ½ digits (palm)
Dorsal cutaneous of ulnar Medial 1 ½ digits (dorsum) + medial dorsum
Post cutaneous N of arm
Posterior
Post cutaneous N of forearm Radial N
Superficial branch Lateral dorsum + dorsum of prox 3 ½ digits

LOWER LIMB

Nerve Branch of Supply

Lateral cutaneous N of thigh L2, L3 Lateral thigh
Femoral cutaneous N Femoral N Anteromedial thigh
(Medial & intermediate) (L2, L3, L4)
Obturator N L2, L3, L4 Medial thigh (minimal) Subsartorial
Anterior
Saphenous N Femoral N Ant + med + post leg
Lateral sural cutaneous N CPN Upper ant + lat + post leg
Superficial peroneal N CPN Lower anterolateral leg + dorsum
Deep peroneal N CPN Adjacent big and second toe
Posterior cutaneous N of thigh S1, S2, S3 Posterior thigh
Sural N Tibial N + CPN Posterolateral leg + lateral foot
Tibial N Sciatic N Sole of foot (calcaneum) Posterior
Medial plantar Tibial N Medial 3 ½ digits + medial sole
Lateral plantar Tibial N Lateral 1 ½ digits + lateral sole

NERVE PALSY
1. Upper trunk injury C5, C6 (Erb’s paralysis)
Adducted, medially rotated, elbow extension, pronation (Waiter’s/Porter’s tip)
Suprascapular, axillary, musculocutaneous N

2. Lower trunk injury C8, T1 (Klumpke’s paralysis)

Claw hand
Radial, ulnar, median N

3. Long thoracic nerve C5, C6, C7

Winging of scapula (serratus anterior)

4. Median nerve C5, C6, C7, C8, T1

Sign of benediction (1st and 2nd lumbricals)
Pinch sign, pen test – FPL (Ant interosseous N)
Carpal tunnel syndrome (Phalen’s, Tinel’s, Pen test)
Sensory: lateral 3 ½ palm & fingers

5. Ulnar nerve C8, T1

Claw hand (3rd & 4th lumbricals)
Sensory: medial 1 ½ palm, dorsum & fingers

6. Radial nerve C5, C6, C7, C8, T1

Posterior interosseous N injury → extensors affected
Wrist drop (Sat night palsy, honeymoon palsy, crutch palsy)
Sensory: Post arm, post forearm, lateral 3 ½ dorsum & prox fingers

7. Common peroneal nerve

Motor: Loss of eversion, dorsiflexion → Talipes equinovarus
Sensory: Lower leg and dorsum
 Evon Chai | ME216

Gait: Steppage gait (foot drop)

8. Tibial nerve
Motor: Loss of plantar flexion, eversion dominates → Talipes calcaneo-valgus
Sensory: Sole of foot, sural nerve
Gait: Shuffling gait
*Rarely injured due to its deep position, except at Tarsal tunnel

9. Femoral nerve
Motor: Loss of hip extension, impaired hip flexion
Sensory: Anteromedial thigh, anteromedial leg (saphenous N)
Gait: Can stand/walk on ground, difficulty walking up/down stairs

10. Obturator nerve

Motor: Loss of adduction
Sensory: Minimal on medial thigh

11. Sciatic nerve

Motor: Tibial nerve/Common peroneal nerve injury
Sensory: Below knee except in area supplied by saphenous & obturator N