Extremities Review Chart 1.3

8/13/2019 Extremities Review Chart 1.3

1/7

Muscles Action Nerve Blood Injury

AnteriorThigh

Sartorius

Thigh flexion @ hip

Lateral rotationThigh Abduction

(Resisted hip flexion: L1, L2)

Femoral

Lateral

femoral

circumflex

&

Saphenous

Iliopsoas(psoas major & iliacus)

Thigh flexion @ hip

Femoral n. &

Ventral

primary rami

of L3-L4

Iliolumbar

Quadriceps femoris =

Rectus femoris

Vastus medialis, lateralis,

intermedialis

Leg extension @ knee

Lateral rotationFemoral

Lateral

circumflex

femoral &

Deep

femoral

Avascular necrosis: Femur

head fracture cuts off

lateral & medial circumflex

arteries

Damage to femoral nerve:

paralysis of quadriceps

impaired hip flexion & leg

extension

M

edialThigh

Adductor longus Thigh Adduction Obturator

Obturator

& Deep

femoral

Damage to obturator nerve:Weakness of adduction;

lateral swinging during

walking (due to unopposed

abductors)

Pectineus

Thigh Adduction

Thigh flexion & medial

rotation @ knee

Femoral &

Obturator

Medial

femoral

circumflex

GracilisThigh Adduction

Flexes & medially rotatesObturator Obturator

Adductor brevis Thigh Adduction Obturator

Obturator

& deep

femoral

Adductor magnus Thigh AdductionObturator &

Tibial

Obturator,Deep

femoral,

& Medial

femoral

circumflex

Can occlude femoral artery

Obturator externus Lateral Rotation Obturator Obturator

PosteriorThigh

Hamstrings=

Medial:Semitendinosus &

Semimembranous

Lateral:Biceps femoris

Thigh extension @ hip

Leg flexion@ knee(Resisted knee flexion: L5-S2)

Sciatic

Tibial division

*Biceps Femoral

dual innervationshort head:

Common

Peroneal

(fibula)

Deep

femoral

Hamstring pull: extend leg

@ knee while flexing thigh

@ hip

Bursitis: from constantly

extending thigh @ hipusing gluteus maximus &

hamstring muscles


2/7

Gluteal

Gluteal medius/minimusThigh Abduction

Medial rotation

Superior

gluteal

Superior

gluteal(internal iliac

branch)

Damage to Superior

Gluteal nervePositive

Trendelenburg Test: hip

sagging on unsupported

side where foot is lifted

Gluteal maximusThigh extension @ hip

Lateral/external rotationInferior gluteal

Inferior

gluteal(internal iliac

branch)

Damageunable to

extend thighBursitis: painful

inflammation

Tensor fascia lataThigh flexion @ hip

Medial rotationThigh Abduction

Superior

gluteal

Superior

gluteal

PiriformisLateral rotationThigh Abduction

Ventral rami of

S1-S2

Piriformis Syndrome: sciaticcompression by piriformis; fat

wallet syndrome

Obturator internusLateral rotation

Abduction

N. to the

obturator

internus

Obturator

Superior/inferior gemelli Lateral rotation

Superior:Superiorgluteal

Inferior:N. toquadratusfemoris

Inferiorgluteal

Quadratus femoris Lateral rotationN. to quadratus

femoris

Inferior

gluteal

P

opliteal

Area/Knee

PopliteusUnlocks knee jointby pulling

tibia medially or femur laterallyTibial

Popliteal(continuationof superficial

femoral)

Occlusion due to PVD: leg

cold, pain while walking

Popliteal Artery Aneurysm

large pulsing mass

Popliteal (Bakers) Cyst:

fluid-filled, non-pulsing

mass

Poster

iorLeg

Gastrocnemius

Plantar-flexion

(Elevates heel)

(Toe walking: S1, S2)

Posterior tibialPosterior

tibial

Injury to S1 or S2:

decreased calcaneal tendon

reflex & sensation; weak

plantar-flexion

Soleus Plantar-flexion TibialPosterior

tibial

Achilles Tendon Rupture:due to forced foot dorsiflexion &

extension of leg @ knee

Plantaris Weak Plantar-flexion Tibial Popliteal

Flexor Digitorum longusPlantar-flexion of 4 smaller

toesTibial Tibial

Flexor Hallicus longus Plantar-flexion big toe Tibial

Tibial &

Fibular

(peroneal)

Tibialis posteriorPlantar-flexion

Foot inversion (towards midline)Tibial

Tibial &

Fibular

(peroneal)


3/7

LateralLeg

Peroneus (Fibularis)

longus/brevisEvert foot (pivot foot laterally)

Can help in plantarflexionSuperficial

peroneal

Fibular

(peroneal)

Damage to common

peroneal nerve: foot drop;

loss of sensation on dorsum

of foot & lateral leg;

paralysis of dorsiflexor &

everter foot muscles

Damage to superficialperoneal nerve: loss of foot

eversion but no foot drop

Anteriorleg/dorsumoffoot

Tibialis anterior

Dorsiflexion (extend foot)

(Heel walking: L4, L5)

Can help invert foot

Deep peroneal Anterior

tibial(branch of

popliteal)

Shin splints: excessive

stress on tibialis anterior

muscle and/or over

dorsifleixion

Stress fractures: from

overuse of bone/muscle

pulling on tibia

Foot Drop: damage to deep

peroneal nerveinability

to dorsiflex; loss of

sensation in 1

st

web spaceAnterior compartment

syndrome: may result in

weak pulse in dorsalis

pedis artery

Extensor Digitorum longus Elevates toesDeep fibular

(peroneal)

Anterior

tibial

Extensor Hallicus longus Extends big toeDeep fibular

(peroneal)

Anterior

tibial

Foot

Plantar Surface

Medial &

Lateral plantar

n. (Tibial divisionof Sciatic)

Posterior

tibial

Lateral &

Medial

plantar

arteries

S1 compressionback of

thigh & leg to little toe:

Weakness in plantarflexion

of foot, big toe; difficulty

walking on toes

Dorsal Surface

Superficial

peroneal nerve

1stweb space is

from Deep

peroneal nerve

Anterior

tibial

Dorsalis

pedis

artery(continuation

of anterior

tibial a.)

L5 compressionlateral

leg & dorsal foot:

Weakness in dorsiflexion

of foot and big toe;

difficulty walking on heels


4/7

Muscles Action Nerve Blood Injury

Pec

toral Pectoralis Major

Adducts& medially rotates

humerus

Anteriorly & inferiorly draws

scapula

Dual: Medial &

Lateral pectoralThoracoacromial

Pectoralis Minor

Protraction & downward

rotation of scapula Medial pectoral Lateral thoracic

Subclavius Stabilizes the clavicle N. to subclavius

Clavicular br. of

thoracoacromial

trunk

Posterior

Axilla

Teres majorAdducts

Extends & Medially rotates

humerus

Lower

subscapularCircumflex scapula

Latissimus dorsiAdducts

Extends & Medially rotates

humerus

Thoracodorsal

C6, 7, 8Thoracodorsal

(subscapular a. branch)

Med

ial

Axilla

Serratus anteriorProtracts scapula

Assists in superior rotation

Long Thoracic

C5, 6, 7 Lateral thoracic

Winged Scapula:

damage to long

thoracic nerveparalyzes serratus

anterior

Shoulder

Trapezius

Elevates scapula

Retracts scapula

Depresses scapula

Spinal Accessory

(CN XI)Transverse cervical

Deltoid

Anterior: Flexesarm

Middle: Abductsarm up to

~100o

Posterior: Extendsarm

Axillary

Posterior humeral

circumflex (3rdsegment of axillary a.

branch)

Inferior shoulder

dislocation:

damage to axillary

nerve paralyzes

teres minor &

deltoid; difficulty

abductingRhomboids Retracts scapula

Dorsal scapular

C5Dorsal scapular

Teres major

Medially rotates &

Adductsarm

Extends humerus @ shoulder

Lower

subscapular

Scapular

anastomoses

Triceps (long head) Extends arm & forearm Radial Profunda brachii

RotatorCu

ffmuscles

(SITS)

SupraspinatusAbductsarm (initiator for

first 15o)Suprascapular Suprascapular

Rotator cuff

injuries: lateral

rotation puts stress

on supraspinatus,

infraspinatus, &

teres minus

supraspinatus tear

Infraspinatus Laterally rotates arm Suprascapular Suprascapular

Teres minor Laterally rotates Adductsarm AxillaryScapular

anastomoses

SubscapularisMedially rotates

Adductsarm

Upper & lower

subscapularSubscapular artery


5/7

AnteriorArm-

FLEXION

CoracobrachialisFlexes

AdductsarmMusculocutaneous

C5, 6Brachial

Damage to

Musculocutaneous

nerve: unable to

flex forearm and

loss of cutaneous

innervation on

lateral forearm

Biceps brachii (short

& long heads)

Supinates

Flexes forearmMusculocutaneous Brachial

Biceps tendon

rupture: due to

forceful flexion at

elbow joint against

resistance

Brachialis Flexes forearm MusculocutaneousBrachial &

Radial recurrent

PosteriorArm

-EXTE

NSION

Triceps brachii

(lateral, medial, long

heads)

Extends forearm Radial C6, 7, 8Profundi (deep)

brachii

Fractured humerus

may transect radial

nerve, paralyzing

forearm extensor;

will definitely

result in Wrist

Drop and

numbness on back

of forearm & hand

AnteriorForearm

FLEXION&PRONATION

(PFPF)

Pronator teresLaterally rotates arm into

pronationMedian

Ulnar &

Anterior ulnar

recurrent

Flexor carpi radialis

longus

Flex hand @ wrist & Radial

(lateral) deviation

(abduction)

Median Ulnar

Palmaris longus Flex hand Median Ulnar

Flexor carpi ulnaris

Flexion & ulnar (medial)

deviation

Adductshand

Ulnar Ulnar

Cubital Tunnel

Syndrome:compression of ulnarnumbness,

tingling along 5thdigit, medial side of

4th digit, hand

Flexor digitorum

superficialisFlex digits at PIP Median Ulnar

Hand of Benediction:median nerve

injuryFDS, FDP,FPL paralyzed

Flexor pollicis longus Flex thumb at IPAnterior

interosseous

Anterior

interosseous

Flexor digitorum

profundusFlexes distal phalanxes

Index & Middle:

Interosseous

nerve

Ring & Pinky:

Ulnar nerve

Anterior

interosseous

Ulnar

Pronator quadratus Pronates forearmAnterior

interosseous

Anterior

interosseous


6/7

P

osteriorForearm

EXTE

NSION&

SUPINATION

Abductor pollicis

longusAbductsthumb

Radial nerve deep

branch = PIN

Posterior

interosseous

Extensor pollicis

brevisExtends thumb

Posterior

interosseous

Posterior

interosseous

Extensor pollicis

longusExtends thumb

Posterior

interosseous

Posterior

interosseous

Extensor carpiradialis longus

Extends & abducts hand Radial Radial

Extensor carpi

radialis brevisExtends & abducts hand Deep radial Radial

Extensor digitorum Extends fingers Deep radial

Interosseous

recurrent &

posterior

Extensor indicis Extends index fingerPosterior

interosseous

Posterior

interosseous

Extensor digiti

minimiExtends little finger Deep radial

Interosseous

recurrent

Extensor carpi

ulnarisExtends & adducts hand Deep radial Ulnar

Supinator Supinates forearm Deep radial Recurrentinterosseous

Thenareminence

Abductor pollicis

brevisAbductsthumb

Median recurrent

branch

Superficial palmar

branch

Carpal TunnelSyndrome: median ncompressweakopposing, flexing,

abducting thumb &flexing index & ring

at MP joints

Flexor pollicis brevis Flexes thumb at MPMedian recurrent

branch

Superficial palmar

branch

Opponens pollicis Opposes the thumb Median recurrentbranch

Superficial palmararch

Hypothenar

eminence

Abductor digiti

minimiAbductspinky Ulnar Ulnar a.

Claw hand: ulnarnerve injuryweakflexing wrist, little,

and ring fingers,hyperextended MPjoints; hypothenar

eminence atrophy

Flexor digiti minimi Flexes pinky Ulnar Ulnar a.

Opponens digiti

minimiFlex & laterally rotate pinky Ulnar Ulnar a.

Hand-other

4 lumbricals Flex digits at MP Index & Middle: MedianRing & Pinky: Ulnar Superficial & deeppalmar arches

Claw hand: ulnar

nerve damage; FDPto 4th& 5thdigits &lumbricals paralyzed

3 palmar interossei Adductindex, middle, ring {PAD} Ulnar deep branch Palmar metacarpal

4 dorsal interossei Abductindex, middle, ring {DAB} Ulnar deep branchDorsal & palmar

metacarpal

Adductor pollicis Adductsthumb Ulnar deep branch Deep palmar arch

Palmaris brevisFolds the skin of the hypothenar

eminence transverselySuperficial branch

of Ulnar


7/7

Documents

Extremities Review Chart 1.3