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Articulations of the upper extremity

This is an excerpt from Kinetic Anatomy 4th Edition With HKPropel Access by Robert S. Behnke & Jennifer L. Plant.

Articulations of the Upper Extremity

Joint	Type	Bones	Ligaments	Movement
Shoulder girdle
Sternoclavicular	Arthrodial (saddle/gliding)	Sternum and clavicle	Sternoclavicular (anterior, superior, and posterior) Costoclavicular Interclavicular Articular disc	Elevation, depression, rotation, protraction, retraction
Acromioclavicular	Arthrodial (plane)	Clavicle and scapula	Acromioclavicular Coracoclavicular (conoid and trapezoid) Coracoacromial (for protection of glenohumeral joint) Articular disc	Elevation, depression, rotation, protraction, retraction, winging (posterior movement to keep scapula close to the thorax during scapular abduction), tipping (rotation to keep scapula close to the thorax during scapular elevation)
Shoulder joint
Glenohumeral	Ball and socket	Humerus and scapula	Glenohumeral (superior, middle, and inferior) Coracohumeral Transverse humeral (keeps long-head biceps tendon in intertubercular groove) Labrum (deepens socket of the glenoid fossa) Capsule	Flexion, extension, hyperextension, abduction, adduction, internal and external rotation
Scapulothoracic	(False joint)	Scapula and thorax	No ligaments (fascia of the serratus anterior muscle and fascia from the thorax)	Elevation, depression, upward rotation and lateral tilt (abduction, protraction) and downward rotation and medial tilt (adduction, retraction) of the scapula on the thorax
Elbow
Humeroulnar	Hinge	Humerus and ulna	Capsule Medial (ulnar) collateral (3 bands: anterior, posterior, and transverse)	Flexion, extension
Radiohumeral	Irregular (gliding)	Humerus and radius	Lateral (radial) collateral Annular	Flexion, extension, rotation (pronation, supination)
Radioulnar (proximal)	Pivot	Radius and ulna	Annular	Pronation, supination
Forearm
Radioulnar (middle)	Syndesmosis	Radius and ulna	Oblique cord Interosseous membrane	Slight (if any)
Radioulnar (distal)	Pivot	Radius and ulna (and articular disc)	Capsule Dorsal radioulnar Volar (palmar) radioulnar	Pronation, supination
Wrist
Radiocarpal	Condyloid (gliding)	Radius, scaphoid, lunate, triquetrum	Capsule Radial collateral Ulnar collateral Dorsal radioulnar Volar (palmar) radioulnar	Flexion, extension, abduction (radial deviation), adduction (ulnar deviation)
Ulnarcarpal (not part of the wrist)	Irregular (gliding)	Ulna, pisiform, triquetrum	Capsule Ulnar collateral Articular disc	Gliding
Wrist: intercarpals
Proximal row	Arthrodial (gliding)	Radius, scaphoid, lunate, triquetrum	Capsule Flexor (volar) retinaculum Extensor (dorsal) retinaculum Radial collateral Ulnar collateral Volar (palmar) intercarpal Dorsal intercarpal	Gliding
Middle	Hinge (gliding)	Proximal and distal rows of carpals	Capsule Volar (palmar) intercarpal Dorsal intercarpal Interosseous intercarpal Radial collateral Ulnar collateral Pisohamate Pisometacarpal	Gliding
Distal row	Irregular (gliding)	Trapezius, trapezoid, capitate, hamate	Capsule Volar (palmar) intercarpal Dorsal intercarpal Interosseous intercarpal	Gliding
Hand and fingers
Carpometacarpal	Modified saddle	Trapezium, trapezoid, capitate, hamate, metacarpals (4)	Capsule Volar carpometacarpal Dorsal carpometacarpal Interosseous carpometacarpal Volar accessory	Flexion, extension, abduction, adduction, slight opposition of fifth
Metacarpophalangeal	Condyloid	Metacarpals (4) and proximal phalanges (4)	Transverse metacarpal Capsule Radial collateral Ulnar collateral Volar accessory	Flexion, extension, abduction, adduction
Proximal interphalangeal	Hinge	Proximal phalanges (4) and middle phalanges (4)	Capsule Radial collateral Ulnar collateral Volar accessory	Flexion, extension
Distal interphalangeal	Hinge	Middle phalanges (4) and distal phalanges (4)	Capsule Radial collateral Ulnar collateral Volar accessory	Flexion, extension
Thumb
Carpometacarpal	Saddle	Trapezium and 1st metacarpal	Capsule	Flexion, extension, abduction, adduction, opposition
Metacarpophalangeal	Hinge	1st metacarpal and proximal phalanx	Capsule Radial collateral Ulnar collateral Dorsal accessory	Flexion, extension
Interphalangeal	Hinge	Proximal phalanx and distal phalanx	Capsule Radial collateral Ulnar collateral Volar accessory	Flexion, extension

Muscles, Nerves, and Blood Supply of the Upper Extremity

Muscle	Origin	Insertion	Action	Nerve	Blood supply
Shoulder girdle, anterior
Pectoralis minor	3rd to 5th ribs	Coracoid process of scapula	Downward rotation of scapula	Medial anterior thoracic	Lateral thoracic and thoracoacromial branches of axillary
Serratus anterior	Upper 9 ribs	Vertebral border of scapula	Upward rotation of scapula	Long thoracic	Lateral thoracic and subscapular branches of axillary, transverse cervical branch of thyrocervical branch of subclavian
Subclavian	1st rib	Subclavian groove of clavicle	Ligamentous action at sternoclavicular joint	Medial anterior thoracic	Clavicular branch of thoracoacromial branch of axillary thoracic
Shoulder girdle, posterior
Levator scapulae	Transverse processes of first 4 cervical vertebrae	Vertical border of scapula	Elevation and downward rotation of scapula	Dorsal scapular	Transverse cervical branch of thyrocervical and intercostals
Rhomboids (major and minor)	Spines of vertebrae C7 to T5	Vertebral border of scapula	Elevation and downward rotation of scapula	Dorsal scapular	Transverse cervical branch of thyrocervical branch of subclavian
Trapezius	External occipital protuberance, all 7 cervical and 12 thoracic spinous processes	Spine of scapula, acromion process, lateral 1/3 of posterior clavicle	Elevation, upward and downward rotation, and adduction of scapula	C2, C3, C4, and spinal accessory (11th cranial)	Transverse cervical branch of thyrocervical branch of subclavian
Shoulder joint, anterior
Pectoralis major	2nd to 6th ribs, sternum, medial 1/2 of clavicle	Inferior to greater tuberosity of humerus in area of surgical neck	Flexion, adduction, and internal rotation of GH joint	Lateral and medial anterior thoracic	Lateral thoracic and thoracoacromial branches of axillary
Coracobrachialis	Coracoid process of scapula	Middle 1/3 of medial surface of humerus	Flexion and adduction of GH joint	Musculocutaneous	Brachial
Biceps brachii (long head)	Supraglenoid tubercle	Radial tuberosity	Abduction and flexion of GH joint, flexion of elbow, supination of forearm	Musculocutaneous	Brachial
Biceps brachii (short head)	Coracoid process of scapula	Radial tuberosity	Adduction and flexion of GH joint, flexion of elbow, supination of forearm	Musculocutaneous	Brachial
Subscapularis	Subscapular fossa	Lesser tuberosity of humerus	Internal rotation and flexion of GH joint, GH joint stability	Subscapular branch from brachial plexus	Subscapular branch of axillary, transverse cervical and transverse scapular branches of thyrocervical
Shoulder joint, superior
Deltoid (clavicular)	Lateral 1/3 of anterior border of clavicle	Deltoid tubercle	Flexion, adduction, and internal rotation of GH joint (above horizontal, abduction)	Axillary	Anterior and posterior humeral circumflex, brachial, thoracoacromial
Deltoid (acromial)	Lateral border of acromion process	Deltoid tubercle	Abduction of GH joint
Deltoid (scapular)	Inferior lip of spine of scapula	Deltoid tubercle	Extension, adduction, and external rotation of GH joint (above horizontal, abduction)
Supraspinatus	Supraspinous fossa of scapula	Proximal facet of greater tuberosity of humerus	Abduction of GH joint, GH joint stability	Suprascapular from C5 through brachial plexus	Transverse cervical and transverse scapular branches of thyrocervical and subscapular
Shoulder joint, posterior
Infraspinatus	Infraspinatus fossa of spine of scapula	Middle facet of greater tuberosity of humerus	External rotation and extension of GH joint, GH joint stability	Suprascapular through brachial plexus	Transverse cervical and transverse scapular branches of thyrocervical
Teres minor	Upper 2/3 of lateral border of scapula	Distal facet of greater tuberosity of humerus	External rotation, extension, and adduction of GH joint; GH joint stability	Axillary through brachial plexus	Posterior humeral circumflex and subscapular
Shoulder joint, inferior
Latissimus dorsi	Spinous processes of lower 6 thoracic and all lumbar vertebrae, ilium, lower 3 ribs, inferior angle of scapula	Intertubercular groove	Internal rotation, extension, and adduction of GH joint	Thoracodorsal nerve and posterior rami of lower 6 thoracic and lumbar spinal nerves	Subscapular branch of axillary, transverse cervical branch of thyrocervical branch of subclavian
Teres major	Inferior 1/3 of lateral border and inferior angle of scapula	Beneath the lesser tuberosity on anterior humerus	Internal rotation, extension, and adduction of GH joint	Subscapular through brachial plexus	Subscapular branch of axillary
Triceps brachii (long head)	Infraglenoid tubercle of scapula	Olecranon process of ulna	Extension and adduction of GH joint	Radial	Posterior humeral circumflex, profundus branch of brachial
Elbow joint, anterior
Brachialis	Distal 1/3 of anterior surface of humerus	Coronoid process and tuberosity of ulna	Flexion of elbow	Musculocutaneous	Brachial
Brachioradialis	Proximal aspect of lateral supracondylar ridge of humerus	Lateral aspect of styloid process of radius	Flexion of elbow, supination of forearm	Radial	Radial
Biceps brachii (long head)	Supraglenoid tubercle	Radial tuberosity	Abduction and flexion of GH joint, flexion of elbow, supination of forearm	Musculocutaneous	Brachial
Biceps brachii (short head)	Coracoid process of scapula	Radial tuberosity	Adduction and flexion of GH joint, flexion of elbow, supination of forearm	Musculocutaneous	Brachial
Elbow joint, posterior
Triceps brachii (lateral head)	Proximal 1/3 of posterolateral aspect of humerus	Olecranon process of ulna	Extension of elbow	Radial	Posterior humeral circumflex, profundus branch of brachial
Triceps brachii (long head)	Infraglenoid tubercle of scapula	Olecranon process of ulna	Extension of elbow, extension and adduction of GH joint	Radial	Posterior humeral circumflex, profundus branch of brachial
Triceps brachii (medial head)	Distal 2/3 of posteromedial aspect of humerus	Olecranon process of ulna	Extension of elbow	Radial	Posterior humeral circumflex, profundus branch of brachial
Anconeus	Lateral epicondyle of humerus	Radial aspect of olecranon process and dorsal surface of proximal 1/4 of ulna	Extension of elbow	Radial	Profundus branch of brachial and dorsal interosseous
Forearm, supinators
Supinator	Lateral epicondyle of humerus and supinator fossa of ulna	Proximal 1/3 of lateral and volar aspect of radius	Supination of forearm	Radial	Dorsal interosseous and radial
Biceps brachii (long head)	Supraglenoid tubercle	Radial tuberosity	Abduction and flexion of GH joint, flexion of elbow, supination of forearm	Musculocutaneous	Brachial
Biceps brachii (short head)	Coracoid process of scapula	Radial tuberosity	Adduction and flexion of GH joint, flexion of elbow, supination of forearm	Musculocutaneous	Brachial
Forearm, pronators
Pronator teres	Common flexor tendon and coronoid process of ulna	Middle of lateral aspect of radius	Pronation of forearm	Median	Radial branch of brachial
Pronator quadratus	Distal part of volar aspect of ulna	Distal part of volar aspect of radius	Pronation of forearm	Median	Ulnar and radial
Wrist and hand, anterior wrist and extrinsic hand
Flexor carpi radialis	Common flexor tendon	Bases of 2nd and 3rd metacarpals	Flexion and radial deviation of wrist, elbow flexion, and forearm pronation	Median	Radial
Flexor carpi ulnaris	Common flexor tendon	Pisiform, hamate, and base of 5th metacarpal	Flexion and ulnar deviation of wrist, elbow flexion, and forearm supination	Ulnar	Ulnar branch of brachial
Flexor digitorum superficialis	Common flexor tendon, coronoid process, and proximal 2/3 of radius	Split tendons on each side of base of middle phalanges of 4 fingers	Flexion of PIP, MP, and wrist joints	Median	Ulnar branch of brachial
Palmaris longus	Common flexor tendon	Palmar aponeurosis	Flexion of wrist	Median	Radial branch of brachial
Flexor digitorum profundus	Proximal 3/4 of coronoid process of ulna and interosseous membrane	4 tendons—passing split superficialis tendons—on bases of distal phalanges of 4 fingers	Flexion of DIP, PIP, MP, and wrist joints	Median and ulnar	Ulnar and volar interosseous
Wrist and hand, posterior wrist and extrinsic hand
Extensor carpi radialis longus	Lateral supracondylar ridge of humerus	Base of 2nd metacarpal	Extension and radial deviation of wrist, supination of forearm	Radial	Radial
Extensor carpi radialis brevis	Common extensor tendon	Base of 3rd metacarpal	Extension and radial deviation of wrist, supination of forearm	Radial	Radial
Extensor carpi ulnaris	Common extensor tendon	Base of 5th metacarpal	Extension and ulnar deviation of wrist	Radial	Ulnar
Extensor digitorum communis	Common extensor tendon	Bases of distal phalanges of 4 fingers	Extension of DIP, PIP, and MP joints of 4 fingers; extension of wrist	Radial	Ulnar
Extensor digiti minimi (proprius)	Common extensor tendon	Base of proximal phalanx of little finger	Extension of 5th MP joint and wrist	Radial	Ulnar
Extensor indicis	Dorsal aspect of distal ulna and interosseous membrane	Base of proximal phalanx of index finger	Extension and radial deviation of 2nd MP joint, extension of wrist	Radial	Ulnar
Wrist and hand, intrinsic hand
Abductor digiti minimi	Pisiform bone	Base of proximal phalanx of little finger	Abduction and flexion of 5th MP joint	Ulnar	Ulnar
Flexor digiti minimi brevis	Hamate bone	Base of proximal phalanx of little finger	Flexion of 5th MP joint	Ulnar	Ulnar
Opponens digiti minimi	Hamate bone	Medial surface of 5th metacarpal	Flexion and adduction of little finger	Ulnar	Ulnar
Dorsal interossei (4)	Adjacent sides of all 4 metacarpals	Bases of 2nd, 3rd, and 4th proximal phalanges and extensor digitorum communis tendon	Abduction of 2nd and 4th MP joints	Ulnar	Metacarpal branches of radial
Palmar interossei (3)	Ulnar side of 2nd metacarpal and radial side of 4th and 5th metacarpals	Radial side of 4th and 5th phalanges and ulnar side of 2nd proximal phalanx	Adduction and flexion of 2nd, 4th, and 5th MP joints	Ulnar	Metacarpal branches of deep volar arch
Lumbricales	Flexor digitorum profundus tendons	Extensor digitorum communis tendons	Flexion of 4 MP joints, extension of 4 PIP and DIP joints	Median and ulnar	Volar metacarpal branch of deep volar
Thumb, extrinsic
Extensor pollicis longus	Middle 1/3 of ulna and interosseous membrane	Base of distal phalanx of thumb	Extension of IP and MP joints of thumb, extension and radial deviation of wrist	Radial	Ulnar through the dorsal interosseous
Extensor pollicis brevis	Middle dorsal aspect of radius and interosseous membrane	Base of proximal phalanx of thumb	Extension of MP joint of thumb, abduction of 1st metacarpal, radial deviation of wrist	Radial	Ulnar through the dorsal interosseous
Abductor pollicis longus	Middle dorsolateral aspect of ulna and interosseous membrane	Base of 1st metacarpal	Abduction of 1st metacarpal, flexion of wrist	Radial	Dorsal interosseous branch of ulnar
Flexor pollicis longus	Middle 1/2 of volar surface of radius	Base of distal phalanx of thumb	Flexion of IP and MP joints, adduction of thumb	Median	Radial, volar interosseous
Abductor pollicis brevis	Trapezius and scaphoid bones	Base of proximal phalanx of thumb	Abduction of MP joint of thumb	Median	Radial
Flexor pollicis brevis	Trapezium	Base of proximal phalanx of thumb	Flexion and adduction of MP joint of thumb	Median	Radial
Opponens pollicis	Trapezium	Lateral surface of 1st metacarpal	Flexion and adduction of MP joint of thumb	Median	Radial
Adductor pollicis	Oblique head: capitate and 2nd and 3rd metacarpal bones; transverse head: 3rd metacarpal	Volar surface of base of proximal phalanx of thumb	Adduction of MP joint of thumb	Median	Deep volar arch

GH = glenohumeral; PIP = proximal interphalangeal; MP = metacarpophalangeal; DIP = distal interphalangeal; IP = interphalangeal.

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