Origin, Insertion, Innervation, Blood Supply, Action Of Block 1

Front 1

?

Back 1

-Origin:
-Insertion:
-Innervation:
-Blood supply:
-Action:

Front 2

splenius capitis

Back 2

-Origin: nuchal ligament, supraspinous ligament, spinous processes of C7-T4
-Insertion: mastoid process and occipital bone
-Innervation: dorsal rami
-Blood supply: dorsal branch of posterior intercostal arteries
-Action:

Front 3

splenius cervicis

Back 3

-Origin: spinous processes of T3-T6
-Insertion: transverse processes of C1-C3
-Innervation: dorsal rami
-Blood supply: dorsal branch of posterior intercostal a.
-Action:

Front 4

Transversospinal muscle group

Back 4

-semispinalis, multifidus, rotatares
-Origin: transverse processes
-Insertion: spinous processes, except semispinalis, which inserts onto the nuchal line of skull
-Innervation: dorsal rami
-Blood supply: dorsal branch of posterior intercostal a.
-Action: contralateral rotation

Front 5

Multifidus

Back 5

-Origin: sacrum, ilium, transverse processes of C4-C7
-Insertion: spinous processes of above vertebra, spanning 2-4 spinal segments
-Innervation: dorsal rami
-Blood supply: dorsal branch of posterior intercostal a.
-Action:

Front 6

trapezius

Back 6

-Origin: external occipital protuberance, superior nuchal line, nuchal ligament, spinous processes of C7-T12
-Insertion: spine of scapula, acromion, lateral 1/3 of clavicle
-Innervation:
motor: CN 11 (spinal accessory nerve)
sensory: proprioception via C3-C4 spinal nerves
-Blood supply: superficial branch of transverse cervical a.
-Action: elevates and depresses scapula, adducts/retracts scapula, rotates scapula upward & outward

Front 7

latissimus dorsi

Back 7

-Origin: spinous processes of T7-T12, thoracolumbar fascia, iliac crest, ribs 9-12
-Insertion: floor of bicipital/intertubercular groove
-Innervation: thoracodorsal/middle subscapular nerve (C6 mainly,7,8); branches from posterior cord of the brachial plexus
-Blood supply: thoracodorsal a. (a branch of subscapular a.)
-Action: extends, adducts and medially rotates

Front 8

Levator scapulae

Back 8

-Origin: transverse processes of C1-C4
-Insertion: medial boarder of scapula, superior to scapular spine
-Innervation: C3-C4 anterior rami and dorsal scapular nerve
-Blood supply: deep branch of transverse cervical a.
-Action: elevates scapula, tilts glenoid fossa inferiorly by rotating scapula, extends neck, laterally flexes neck

Front 9

rhomboid minor
-origin
-insertion
... rest rhomboid major

Back 9

-Origin: spinous processes of C7-T1
-Insertion: root of spine of scapula

Front 10

rhomboid major

Back 10

-Origin: T2-T5
-Insertion: medial border of scapula
-Innervation: dorsal scapular nerve
-Blood supply: deep branch of transverse cervical a./dorsal scapular a.
-Action: retracts and elevates scapula, (w/help from other muscles rotates lateral aspect inferiorly)

Front 11

serratus posterior superior

Back 11

-Origin: lower part of ligamentum nuchae, spinous processes of C7-T3
-Insertion: ribs 2-5
-Innervation: intercostal nerves T2-T5
-Blood Supply:
-Action: elevates ribs (during forced inspiration)

Front 12

serratus posterior inferior

Back 12

-Origin: spinous processes of T11-L3
-Insertion: ribs 9-12
-Innervation: intercostal nerves T9-T12
-Blood Supply:
-Action: stabalizes lower ribs against diaphragm contraction

Front 13

Deltoid

Back 13

Proximal attachment:
Lateral 1/3 of clavicle, acromion, spine of scapula

Distal attachment:
Deltoid tuberosity of humerus

Innervation
Axillary nerve

Blood Supply:
Deltoid branch of thoracoacromial artery
Posterior humeral circumflex artery

Action:
Abducts, flexes, extends, internal and external rotation

Front 14

Supraspinatus Muscle

Back 14

Proximal attachment:
Supraspinous fossa

Distal attachment:
Greater tubercle of humerus

Innervation:
Suprascapular nerve


Blood supply:
Suprascapular artery


Main action:
Initiates abduction of upper limb (*critical for first 15 degrees)
Holds head of humerus in the glenoid cavity during arm elevation (flexion, abduction)

Front 15

Infraspinatus Muscle

Back 15

Proximal attachment:
Infraspinous fossa of scapula

Distal attachment:
Middle facet on greater tubercle of humerus

Innervation:
Suprascapular nerve (C5 and C6)


Blood supply:
Suprascapular artery & scapular circumflex artery

Main Actions:
Laterally rotates humerus
Holds head of humerus in glenoid fossa during arm movements

Front 16

Teres Minor Muscle

Back 16

Proximal attachment:
Superior part of lateral border of scapula

Distal attachment:
Inferior facet on greater tubercle of humerus

Innervation:
Axillary nerve

Main Actions:
Laterally rotates the humerus

Blood Supply:
Scapular circumflex

Front 17

Subscapularis Muscle

Back 17

Proximal attachment:
Subscapular fossa

Distal attachment:
Lesser tubercle of humerus

Innervation:
Upper and lower subscapular nerves (C5, C6 and C7)

Main Actions:
Medially rotates the humerus

Blood Supply:
Subscapular artery

Front 18

Teres Major Muscle

Back 18

Proximal attachment:
Posterior surface of inferior angle of scapula

Distal attachment:
Medial lip of intertubercular groove of humerus

Innervation:
Lower subscapular nerve

Blood supply:
Circumflex scapular a.

Main Actions:
Medially rotates the humerus (opposite to teres minor)
Adducts and extends the humerus

Front 19

Serratus Anterior M:
-NN
-Main actions

Back 19

-Innervation
Long thoracic nerve (C5, C6 and C7)
Innervated by anterior rami

-Main actions
Protracts the scapula
Holds scapula against body wall
Assists in rotating scapula during abduction of upper limb

Front 20

Pectoralis Minor Muscle:

Back 20

Proximal attachment is 3rd-5th ribs near their costal cartilages.
Distal attachment is to the coracoid process of the scapula.
Innervated by the medial pectoral nerve (anterior rami C8 and T1)
Main action is to stabilize the scapula during upper limb movements.

Front 21

Subclavius Muscle:

Back 21

Arises from the 1st rib near its costal cartilage.
Attaches to the inferior surface of the middle 3rd of the clavicle.
Innervated by the nerve to the subclavius (mainly C5, and C6)
Nerve comes off superior trunk of the brachial plexus
Main action – to anchor and stabilize the clavicle

Front 22

Brachialis

Back 22

Lies deep to the biceps brachii
Origin – Distal half of anterior surface of humerus
Insertion – Coronoid process & ulnar tuberosity
Innervated by the musculocutaneous n., C5 & C6 (and small lateral component-radial n., C7)


Main Actions
Most powerful forearm flexor, all elbow positions.
Isometric contraction allows controlled forearm extension

Front 23

Gluteus Maximus

Back 23

Proximal attachment
Ilium posterior to the posterior gluteal line, sacrum, coccyx, and sacrotuberous ligament.

Distal attachment
gluteal tuberosity of the femur and the iliotibial tract

Innervated by the inferior gluteal nerve (L5,mainly S1, mainly S2)

Extends thigh (and assists with lateral rotation

Front 24

Tensor Fascia Lata

Back 24

Proximal attachment: anterior superior iliac spine (ASIS) and anterior part of iliac crest

Distal attachment: iliotibial tract to the lateral condyle of the tibia

Innervated by the superior gluteal nerve (mainly L4,mainly L5,S1)

Abducts and medially rotates the thigh (active along with gluteus medius to stabilize the pelvis during unilateral stance). Helps flex the thigh

Front 25

Gluteus Medius

Back 25

Proximal attachment: External surface of the ilium between the anterior and posterior gluteal lines

Distal attachment lateral surface of the greater trochanter of femur

Innervated by the superior gluteal nerve

Abducts thigh, keep pelvis level during unilateral stance phase of gate
Anterior fibers medially rotate thigh

Front 26

Gluteus Minimus

Back 26

Proximal attachment: Ilium between anterior and inferior gluteal lines

Distal attachment: Anterior surface of the greater trochanter of the femur

Innervated by the superior gluteal nerve

Abducts and medially rotates the thigh, helps keep pelvis level during unilateral stance phase of gate

Front 27

Positive Trendelenburg Gait/Sign:

Hip abductors keep the pelvis level during unilateral stance phase of gait. If one of the ___ muscles is weak (perhaps due to ___ nerve injury) then the pelvis will drop on the ___ side.. This is called a Trendelenburg gait pattern or a gluteus medius gait if observed while the patient is walking.

If the pelvis drops when you ask a patient to raise one foot off the floor during an examination then it is called a positive Trendelenburg sign

Back 27

-gluteus medius
-superior gluteal
-contralateral

Front 28

Piriformis

Back 28

Proximal attachment: anterior surface of the sacrum and sacrotuberous ligament

Distal attachment: superior border of greater trochanter of the femur

Innervated by branches of anterior rami of mainly S1,S2

Laterally rotates thigh, abducts the thigh from the flexed position

Front 29

Quadratus Femoris

Back 29

Proximal attachment: lateral border of ischial tuberosity

Distal attachment: Quadrate tubercle on intertrochanteric crest of femur

Innervated by nerve to quadratus femoris (L5,S1)

Laterally rotates thigh and stabilizes femoral head in the acetabulum

Front 30

Obturator internus

Back 30

Proximal attachment: obturator internus originates from the obturator membrane, margin of the obturator foramen

Distal attachment: medial aspect of the greater trochanter

Innervated by the nerve to obturator internus

Laterally rotates thigh

Front 31

Obturator externus

Back 31

Proximal attachment: external surface of obturator membrane and adjacent bone

Distal attachment: trochanteric fossa

Innervated by the obturator nerve

It is an external rotator of the femur

Front 32

Hamstrings
-attachments

Back 32

Proximal attachment is the ischial tuberosity

Distal attachments
Biceps femoris
lateral side of the head of the fibula

Semitendinosus
medial surface of superior part of tibia

Semimembranosus
Posterior part of medial condyle of tibia (Oblique popliteal ligament)

Front 33

Sartorius

Back 33

Proximal attachment: Anterior superior iliac spine (ASIS)

Distal attachment: superior part of medial surface of tibia

Innervated by the femoral nerve

Flexes, abducts, laterally rotates the thigh at the hip joint, and flexes the leg at the knee joint

Front 34

Adductor Magnus (adductor part)

Back 34

Proximal attachment: Adductor part - ischiopubic ramus

Distal attachment: posterior surface proximal femur, linea aspera medial supracondylar line

Innervated by the obturator nerve

Adducts thigh, aids medial rotation

Front 35

Adductor Magnus (hamstring part)

Back 35

Hamstring part :
Proximal attachment: ischial tuberosity

Distal attachment: adductor tubercle of femur and supracondylar line

Innervated by the tibial division of sciatic n.

Front 36

Adductor Longus and Brevis

Back 36

Proximal attachment: pubis

Distal attachment: linea aspera

Innervated by obturator nerve

Adducts thigh

Front 37

Pectineus

Back 37

Proximal attachment: pectineal line of pubis

Distal attachment: femur inferior to lesser trochanter to the linea aspera

Innervated by femoral nerve (even though its in the medial compartment)

Adducts and flexes thigh

Front 38

Gracilis

Back 38

Proximal attachment: Pubis (body and inferior ramus)

Distal attachment: superior part of medial surface of tibia

Innervated by obturator nerve

Adducts thigh
Flexes leg and helps rotate leg medially at the knee joint

Front 39

Obturator externus

Back 39

Proximal attachment: external surface of obturator membrane and adjacent bone

Distal attachment: trochanteric fossa

Innervated by the obturator nerve

It is an external rotator of the femur