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Upper Limb Muscles

Muscles of the upper limb

Right lateral view

Upper Limb Muscles

 1 Trapezius

 2 Deltoid

 3 Pectoralis major

 4 Biceps brachii

 5 Triceps brachii

 6 Serratus anterior

 7 Teres major

 8 Infraspinatus

 9 Teres minor

10 Latissimus dorsi

 11 Posterior antebrachial muscles

12 Anterior antebrachial muscles

13 Hypothenar muscles

14 Intermetacarpal muscle

Other Muscles and Structures

15 Muscles of mastication

16 Muscles of facial expression

17 Sternocleidomastoid

18 Rectus abdominis

19 External oblique

20 Gluteal muscles

21 Posterior thigh muscles

22 Thoracolumbar fascia

23 Antebrachial fascia

24 Iliotibial tract

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Muscles of the upper limb

Posterior view

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The muscles that insert on the scapula and anchor

it to the trunk form an extensive muscular sling.

During development the upper limb annexes these

Scapular Muscles

Muscles of right brachium, shoulder, and chest

Anterior view

muscles from the head and trunk wall. They share the common functional goal of moving the scapula,

stabilizing it, and anchoring it to the axial skeleton. These muscles are some of the larger muscles of the

upper limb, yet produce visibly minor movements of the skeleton. Realize, however, that their major

role is to stabilize and anchor the scapula to the axial skeleton. With the exception of the pectoralis

minor, the nerves that supply these muscles arise from the roots of the brachial plexus.

Scapular Musles

 1 Trapezius

 2 Levator scapulae

 3 Rhomboideus minor

 4 Rhomboideus major

 5 Serratus anterior

 6 Pectoralis minor

 7 Subclavius

Other Muscles and Structures

 8 Sternocleidomastoid

 9 Omohyoid

10 Clavicle

 11 Deltoid

12 Coracobrachialis

13 Pectoralis major (cut)

14 External intercostal

15 Internal intercostal

16 Biceps brachii

17 Brachialis

18 Triceps brachii

19 Latissimus dorsi

20 Supraspinatus

21 Infraspinatus

22 Teres major

23 External oblique

24 Rectus abdominis

25 Brachioradialis

26 Extensor carpi radialis longus

27 Serratus posteror inferior

28 Teres minor

29 External oblique aponeurosis

30 Trachea

31 Spine of scapula

32 Greater tubercle of humerus

33 Rib

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Muscles of neck, shoulder, and back

Posterior view

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Shoulder Muscles - Rotator Cuff

Deep dissection of the right shoulder muscles

Anterior view

The rotator cuff muscles are an important muscle group that play a critical role in stabilizing the

shoulder joint. The four muscles (supraspinatus, infraspinatus, teres minor, and subscapularis)

have thick, fl at tendons of insertion that form a strong musculotendinous cuff around all but the

inferior aspect of the glenohumeral joint. These tendons are intimately applied to the fi brous

membrane of the joint capsule. Individually each muscle contributes little to the total range of

motion of the humerus at the glenohumeral joint. However, they play a prominent role in stabilizing the joint and positioning and stabilizing the head of the humerus in the glenoid cavity. When

the rotator cuff muscles are compromised by injury, the shoulder joint loses stability and

becomes highly susceptible to dislocation.

Rotator Cuff Muscles

 1 Supraspinatus

 2 Infraspinatus

 3 Teres minor

 4 Subscapularis

Other Muscles and Structures

 5 Biceps brachii

 6 Coracobrachialis

 7 Triceps brachii

 8 Teres major

 9 Coracoid process of scapula

10 Superior angle of scapula

 11 Inferior angle of scapula

12 Spine of scapula

13 Medial border of scapula

14 Greater tubercle of humerus

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183

Deep dissection of the right shoulder muscles

Medial view

Deep dissection of the right shoulder muscles

Posterior view

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Shoulder Muscles - Prime Movers

Shoulder Prime Movers

 1 Deltoid

 2 Pectoralis major

 3 Teres major

 4 Latissimus dorsi

Other Muscles and Structures

 5 Levator scapulae

 6 Rhomboideus minor

 7 Rhomboideus major

 8 Supraspinatus

 9 Infraspinatus

10 Teres minor

 11 Triceps brachii

12 Trapezius

13 Spleneus capitis

14 Serratus anterior

15 Pectoralis minor

16 External intercostal

17 Internal intercostal

18 Rectus abdominis

19 Coracobrachialis

20 Biceps brachii

21 Brachialis

22 Posterior scalene

23 Middle scalene

24 Anterior scalene

25 Omohyoid

26 Sternohyoid

27 Sternothyroid

28 Thyrohyoid

29 Sternocleidomastoid

30 External oblique

31 Brachioradialis

32 Clavicle

33 Humerus

34 Spine of scapula

35 Thoracolumbar fascia

36 Linea alba

37 Common carotid artery

The prime movers of the shoulder joint are the muscles that share a common attachment on the

intertubercular groove (pectoralis major, teres major, and latissimus dorsi) and the deltoid muscle.

These large muscles are superfi cial to the muscles of the rotator cuff and form extensive attachments on the pectoral girdle and axial skeleton. Inserting more distally on the humerus then the

muscles of the rotator cuff, they have a better mechanical advantage and produce the major

movements of the shoulder joint. The intertubercular groove muscles also form the anterior and

posterior walls of the axilla. The large pectoralis major forms the anterior wall of the axilla, while

the sheet-like latissimus dorsi and thick, round teres major form the posterior axillary wall.

Muscles of neck, shoulder, brachium, and back

Posterior view

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185

Muscles of neck, shoulder, brachium, and chest

Anteror view

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186

The anterior muscle

compartment of the

brachium consists of

Anterior Brachial Muscles

three muscles — the coracobrachialis, brachialis, and biceps brachii. The coracobrachialis and

brachialis each cross a single joint, the shoulder joint and elbow joint respectively. The biceps

brachii crosses three joints, the shoulder, and the humero-ulnar and radio-ulnar joints of the

elbow. The muscles share in common the actions of fl exion of the shoulder and elbow. All three

muscles are innervated by the musculocutaneous nerve.

Muscles of the right brachium and scapula

Anterior view

Anterior Brachial Muscles

 1 Coracobrachialis

 2 Brachialis

 3 Biceps brachii - long head

 4 Biceps brachii - short head

 5 Triceps brachii

Other Muscles and Structures

 6 Supraspinatus

 7 Subscapularis

 8 Teres major

 9 Brachioradialis

10 Pronator teres

 11 Coracoid process

12 Superior angle

13 Inferior angle

14 Greater tubercle

15 Lesser tubercle

Deep muscles of the right brachium

Anterior view

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187

Muscles of the right brachium and scapula

Posterior view

The three headed triceps

brachii muscle is the sole

muscle of the posterior

Posterior Brachial Muscles

compartment of the brachium. This large muscle extends the shoulder and elbow joints and is innervated

by the radial nerve.

Posterior Brachial Muscles

 1 Triceps brachii - medial head

 2 Triceps brachii - lateral head

 3 Triceps brachii - long head

 4 Biceps brachii - long head

 5 Beceps brachii - short head

 6 Brachialis

Other Muscles and Structures

 7 Supraspinatus

 8 Infraspinatus

 9 Teres minor

10 Teres major

 11 Humerus

12 Greater tubercle

13 Spine of scapula

14 Brachail artery

Transverse section of right midbrachim

Inferior view

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188

The muscles of the

anterior antebrachium form three

Anterior Antebrachial Muscles

distinct muscle layers. The superfi cial group has four superfi cial muscles (pronator teres, fl exor carpi

radialis, palmaris longus, and fl exor carpi ulnaris) covering the intermediate fl exor digitorum superfi cialis.

All fi ve of these muscles share a common attachment on the medial epicondyle of the humerus. The three

deep muscles (fl exor digitorum profundus, fl exor pollicis longus, and pronator quadratus) do not cross

the elbow joint. Other than the two pronators, all the muscles are fl exors of either the wrist or digits. The

median nerve innervates all but the fl exor carpi ulnaris and the ulnar half of the fl exor digitorum profundus,

both of which are supplied by the ulnar nerve.

Superfi cial muscles of the right antebrachium

Anterior view, hand pronated

Anterior Antebrachial Muscles

 1 Pronator teres

 2 Flexor carpi radialis

 3 Palmaris longus

 4 Flexor carpi ulnaris

 5 Flexor digitorum superficialis

 6 Flexor digitorum profundus

 7 Flexor pollicis longus

 8 Pronator quadratus

Other Muscles and Structures

 9 Brachialis

10 Palmar aponeurosis

 11 Brachial artery

12 Radial artery

13 Ulnar artery

14 Anterior interosseous artery

15 Interosseous membrane

16 Abductor pollicis brevis

17 Flexor pollicis brevis

18 Lumbricals

19 Adductor pollicis

20 Flexor digiti minimi brevis

21 Abductor digiti minimi

22 Palmaris brevis

23 Supinator

24 Superficial transverse metacarpal ligament

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Deep muscles of the right antebrachium

Anterior view, superficial muscles removed and hand pronated

Deep muscles of the right antebrachium

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174

Perineal Hypaxial Muscles

trunk. Therefore, the three inner layers of the lateral wall become the major contributors to the pelvic hypaxial wall. The three

muscle layers from each side pass into the bottom of the pelvis where they meet in the midline to surround the urethra,

vagina, and anus. This three-layered muscle fl oor at the bottom of the pelvis is called the pelvic diaphragm (internal layer)

and the perineum (middle and external layers.) The pelvic diaphragm forms a basin-shaped fl oor that supports the pelvic

viscera. The perineal muscles span the diamond-shaped pelvic outlet, and are divided into an anterior urogenital triangle

and a posterior anal triangle. The perineal muscles support the pelvic viscera, form important sphincter muscles that surround the urethral and anal orifi ces, assist in erectile function, and propel the sperm from the male penis during ejaculation.

Additional views of these muscles in both the male and female are depicted in the reproductive system chapter.

The ventral, subvertebral, and lateral supracostal

muscles are either annexed by the lower limb

or terminate above the pelvic region of the

Dissection of male perineal muscles

Inferior view

External perineal muscles

Middle perineal muscles

Internal perineal muscles

Perineal Musculature

 1 Obturator externus muscle

 2 Ischiocavernosus muscle

 3 Bulbospongiosus muscle

 4 Superficial transverse perinei muscle

 5 Superficial external anal sphincter muscle

 6 Deep external anal sphincter muscle

 7 Deep transverse perinei muscle

 8 Levator ani muscle

 9 Ischiococcygeus muscle

Other Muscles and Structures

10 Gluteus maximus muscle

 11 Penis (cut)

12 Obturator nerve

13 Ischial tuberosity

14 Coccyx

15 Perineal body

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Upper Limb Muscles

While the majority of the muscles of the upper

limb arise as true limb muscles from the embryonic somites, some of the upper limb

muscles are annexed from the body wall and head musculature to support and

stabilize the scapula and suspend it from the trunk skeleton. Th e levator

 scapulae, rhomboideus major and minor, serratus anterior, pectoralis minor,

and subclavius muscles are annexed lateral body wall muscles that help

suspend the scapula, while the trapezius is an annexed branchial arch

muscle that is also a part of the scapular group. Unlike these annexed

body wall and head muscles, the true muscles of the limb arise from

mesenchymal migrations of the somites into the developing limb

bud. Th ese migrations form two distinct muscle masses in the limb,

an anterior muscle group and a posterior muscle group. As the

limb develops, the two distinct muscle groups become separated

by connective tissue septa and bones into anterior and posterior

muscle compartments within the diff erent sections of the limb.

As the ventral rami of the associated spinal nerves grow into the

developing upper limb bud, a nerve network, or plexus, develops. From this plexus posterior divisions of the network send

branches into the posterior muscle compartments and anterior

divisions of the network send branches into the anterior muscle

compartments. At the proximal end of the limb, some of the

true limb muscles from the anterior and posterior compartments increase in size and migrate back onto the trunk. As they

spread onto the trunk, they cover the body wall muscles and

 attach to the axial skeleton. Th is muscular expansion of the proximal limb muscles increases their mechanical advantage at the

shoulder joint. Because of this interesting arrangement of body

wall muscles and true limb muscles at the shoulder end of the

 superior limb, a clear compartment organization is not evident. For

this reason, we will group these muscles into groups that share some

common feature, such as a common attachment or function. In the limb

proper we group the muscles into their developmental anterior and posterior muscle compartments. Th is greatly simplifi es the learning process

 because most of the muscles in a compartment share common attachments,

 actions, and nerves. Grouping things in this way can help to simplify the learning

process.

Find more information

about the muscles of the

upper limb in

11

175

REAL ANATOMY

176

outer layer of the trunk wall and head to help suspend it from the axial skeleton. This scapular muscle sling, which has no

homologous counterpart in the lower limb, is the major difference between the muscles of the upper and lower limbs. On the

pages that follow we present the muscles of the upper limb and organize them primarily by developmental groups, with the

exception of the muscles of the shoulder joint (see the outline below). The opposite page and the two pages that follow show

anterior and posterior views of the upper limb muscles and their relationships to the trunk musculature.

This chapter depicts the interesting array of muscles of the

upper limb. Because of its weak ligamentous association with

the axial skeleton, the upper limb annexed muscles from the

Upper Limb Muscles

Pectoral Girdle Muscles

(Annexed from head muscles (trapezius) and outermost layer of

lateral trunk muscles to support and stabilize scapula)

 Trapezius

 Levator scapulae

 Rhomboideus major

 Rhomboiedus minor

 Serratus anterior

 Pectoralis minor

 Subclavius

Shoulder Joint Muscles

 Rotator cuff muscles

(Muscles with a ligamentous role that function as stabilizers of

the weakly ligamentous shoulder joint)

 Supraspinatus

 Infraspinatus

 Teres minor

 Subscapularis

 Intertubercular groove muscles

(Muscles that share an insertion on the intertubercular groove

and are prime movers of the shoulder joint)

 Pectoralis major

 Latissimus dorsi

 Teres major

 Deltoid

Anterior Brachial Muscles

(Nerve supply - musculocutaneous nerve; function as flexors of the

shoulder and elbow)

 Coracobrachialis

 Brachialis

 Biceps brachii

Posterior Brachial Muscles

(Nerve supply - radial nerve, like all posterior compartment muscles;

functions as extensor of shoulder and elbow)

 Triceps brachii

Anterior Antebrachial Muscles

(Nerve supply - median and ulnar nerves; function as flexors of wrist

and digits)

 Superficial muscles

 Pronator teres

 Flexor carpi radialis

 Palmaris longus

 Flexor carpi ulnaris

 Flexor digitorum superficialis

 Deep muscles

 Flexor digitorum profundus

 Flexor pollicis longus

 Pronator quadratus

Posterior Antebrachial Muscles

(Nerve supply - radial nerve; function as extensors of the wrist and

digits)

 Lateral muscles

 Brachioradialis

 Extensor carpi radialis longus

 Extensor carpi radialis brevis

 Extensor digitorum

 Extensor digiti minimi

 Extensor carpi ulnaris

 Anconeus

 Supinator

 Radial muscles

 Abductor pollicis longus

 Extensor pollicis longus

 Extensor pollicis brevis

 Extensor indicis

Hand Muscles

(All intrinsic hand muscles arise from anterior muscles of embryonic limb

and are innervated by the median and ulnar nerve from the anterior

divisions of the plexus)

 Thenar Muscles

 (All supplied by the median nerve except adductor pollicis)

 Abductor pollicis brevis

 Flexor pollicis brevis

 Opponens pollicis

 Adductor pollicis

 Hypothenar Muscles

 (All supplied by the ulnar nerve)

 Palmaris brevis

 Abductor digiti minimi

 Flexor digiti minimi

 Opponens digiti minimi

 Intermetacarpal Muscles

 (All supplied by the ulnar nerve except first two lumbricals)

 Lumbricales

 Palmar interossei

 Dorsal interossei

177

Muscles of the upper limb

Anterior view

 1 Trapezius

 2 Deltoid

 3 Pectoralis major

 4 Biceps brachii

 5 Triceps brachii

 6 Serratus anterior

 7 Anterior antebrachial muscles

 8 Posterior antebrachial muscles

 9 Thenar muscles

10 Hypothenar muscles

 11 Temporalis

12 Masseter

13 Muscles of facial expression

14 Sternocleidomastoid

15 Cervical body wall muscles

16 Rectus abdominis

17 External oblique

18 Anterior thigh muscles

19 Medial thigh muscles

20 Linea alba

21 Tendinous intersection

22 Spermatic cord (cut)

23 Penis (cut)

24 Inguinal ligament

25 Umbilicus

26 Palmar aponeurosis

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170

Dissections of thoracic and abdominal hypaxial muscles

Anterior view

Thoracic and Abdominal Musculature

 1 Rectus abdominis muscle

 2 Serratus anterior muscle

 3 External intercostal muscle

 4 External oblique muscle (superficial lamina)

 5 External oblique muscle (deep lamina)

 6 Internal intercostal muscle

 7 Internal oblique muscle

 8 Innermost intercostal muscle

 9 Transversus abdominis muscle

Other Muscles and Structures

10 Platysma muscle

 11 Sternohyoid muscle

12 Sternothyroid muscle

13 Omohyoid muscle

14 Sternocleidomastoid muscle

15 Trapezius muscle

16 Deltoid muscle

17 Pectoralis major muscle

18 Anterior scalene muscle

19 Middle scalene muscle

20 Posterior scalene muscle

21 Biceps brachii muscle

22 Tensor fasciae latae muscle

23 Gluteus medius muscle

24 Gluteus minimis muscle

25 Iliopsoas muscle

26 Pectineus muscle

27 Adductor longus muscle

28 External lamina of rectus sheath

29 Linea alba

30 Tendinous intersections

31 Internal lamina of rectus sheath

32 Semilunar line

33 Arcuate line

34 Transversalis fascia

35 Inguinal ligament

36 Spermatic cord

37 Inferior epigastric vessels

38 Cutaneous nerves

Thoracic and Abdominal Hypaxial Muscles

The muscles of the thorax and abdomen develop from the hypomere of the thoracic and abdominal somites of the embryo.

Like the neck they clearly demonstrate the muscle pattern of the vertebrate body wall. The thoracic body wall differs from

the abdomen in having well-developed ribs that dominate the wall and limit the movements of the vertebral column. Because

of the well-developed segmental ribs, the muscles of the thoracic wall retain their segmental origins. The uniquely mammalian

diaphragm muscle is a member of this group that plays an important role in respiration. The outermost layer of the lateral

muscle wall is well developed in the thorax. Some portions of this muscle layer remain associated with the ribs, while the

rhomboid muscles (depicted in the upper limb chapter that follows) and large serratus anterior muscle migrate onto the

scapula to become principal stabilizers of the upper limb. The ventral ramus of each of the thoracic and upper lumbar spinal

nerves innervates these muscles.

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171

Dissections of thoracic and abdominal hypaxial muscles

Anteriolateral view

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172

Dissections of lateral muscle layers of thoracic and abdominal wall

Posterior view upper left, Lateral view upper center, Posterolateral view all others

Thoracic and Abdominal Hypaxial Muscles

Again we would have you notice the rarely described deep lamina of the external oblique muscle. Notice its continuity with

the external intercostal muscles, while the superfi cial lamina of the external oblique interdigitates with the serratus anterior

muscle. Also note the similar fi ber orientations of the intercostal muscles and their homologues in the abdominal wall.

The photos of the diaphragm on the opposite page clearly reveal the continuity of this internal layer muscle with its internal

homologue in the abdomen – the transversus abdominis muscle.

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Thoracic and Abdominal Musculature

 1 Rectus abdominis muscle

 2 Serratus anterior muscle

 3 Serratus posterior superior muscle

 4 Serratus posterior inferior muscle

 5 External intercostal muscle

 6 External oblique muscle (superficial lamina)

 7 External oblique muscle (deep lamina)

 8 Internal intercostal muscle

 9 Internal oblique muscle

10 Innermost intercostal muscle

 11 Subcostal muscle

12 Diaphragm

13 Transversus abdominis muscle

14 Quadratus lumborum muscle

15 Psoas major muscle

16 Psoas minor muscle

Other Muscles and Structures

17 Longus capitis muscle

18 Longus colli muscle

19 Splenius capitis muscle

20 Trapezius muscle

21 Deltoid muscle

22 Infraspinatus muscle

23 Teres major muscle

24 Triceps brachii muscle

25 Latissimus dorsi muscle

26 Tensor fasciae latae muscle

27 Gluteus maximus muscle

28 Gluteus medius muscle

29 Gluteus minimis muscle

30 Piriformis muscle

31 Superior gemellus muscle

32 Obturator internus muscle

33 Inferior gemellus muscle

34 Quadratus femoris muscle

35 Iliacus muscle

36 Sacrotuberous ligament

Dissection of hypaxial subvertebral muscles

Anterior view

Dissection revealing diaphragm

Superior view

Dissection revealing diaphragm

Lateral view

37 Sternum

38 Thoracic vertebra

39 Spinal cord

40 Ribs

41 Costal pleura

42 Mediastinal pleura

43 Diaphragmatic pleura

44 Parietal pericardium

45 Fibrous pericardium

46 Inferior vena cava

47 Thoracic aorta

48 Esophagus

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