Lab D4: Posterior Triangle

SCM
Scalenius anterior
o Located underneath the Common Carotid Artery
o Nerve roots of brachial plexus can be found here
o Origin: Transverse process of C3-6
o Insertion: 1st rib
o Innervation: C4-C6
o Action: Elevates 1st rib, laterally flexes and rotates cervical part of vertebral column
Scalenius medius
o Behind scalenius anterior
o Origin: Transverse process of C1-6
o Insertion: 1st rib
o Innervation: Anterior rami of cervical nerves
o Action: Elevates 1st rib, laterally flexes and rotates cervical part of vertebral column
Inferior belly of omohyoid
Phrenic nerve
Subclavian artery
o Internal thoracic/mammary
o Thyrocervical trunk
Tranverse cervical
Suprascapular
Inferior thyroid
Subclavian vein
Brachial plexus
o Upper/Middle/Lower trunk
Splenius capitis
o Origin: Ligamentum nuchae, upper 4 thoracic spines
o Insertion: Superior nuchal line of occipital bone, mastoid process of temporal bone
o Innervation: Dorsal primary rami of spinal nerves
o Action: Bends neck laterally, elevates medial border of scapula
Bonus:
o Costocervical trunk
o Deep cervical artery
o Superior intercostal artery
o Right recurrent laryngeal
o Thoracic duct
o Spinal accessory nerve
Can be found in the trapezius muscle

Lab D5: Axilla, Pectoral Region, Mammary Gland

Mammary gland
o Nipple, Areola
 Pectoralis Major
o Origin: Clavicle, sternum, and upper six costal cartilages
o Insertion: Lateral lip of bicipital groove of humerus
o Innervation: Lateral and Medial pectoral nerves (C5,6,7, 8,T1)
o Action: Adducts arm and rotates it medially, flex arm
Pectoralis Minor
o Origin: 3rd, 4th, 5th ribs
o Insertion: Coracoid process of the scapula
o Innervation: Medial pectoral nerve (C6,7,8)
o Action: Depresses point of shoulder, elevates rib of origin if scapula is fixed
Subclavius
o Clinical significance: Protects brachial plexus and subclavian vessels from broken clavicle.
o Underneath is two important vessels: subclavian vein, deeper is subclavian artery
o Origin: 1st costal cartilage
o Insertion: Clavicle
o Innervation: Nerve to subclavius (from the upper trunk) (C5,6) (may give branch to phrenic
nerve aka accessory phrenic nerve)
o Action: Depresses clavicle, steadies this bone during movements of shoulder girdle
Serratus anterior
o Origin: Upper 8 ribs
o Insertion: Medial border and inferior angle of scapula
o Innervation: Long thoracic nerve (C5,6,7)
o Action: Rotates scapula
Brachial plexus
o Lateral cord
Musculocutaneous nerve (terminal branch, pierces coracobrachialis, branch
continues and can be seen underneath biceps brachii)
o Medial cord
Ulnar (terminal branch)
Letter V: Lateral root of lateral cord and medial root of medial cord combine to form
(Median Nerve)
o Posterior cord
Axillary nerve
Radial nerve
Bonus:
o Axillary tail of Spence
o Lateral pectoral nerve
o Medial pectoral nerve
o Thoracodorsal nerve

Lab D6: Arm and Cubital Fossa

Coracobrachialis
o Near axilla
o Pierced by Musculocutanous nerve
 o Origin: Coracoid process of scapula
o Insertion: Medial aspect of shaft of humerus
o Innervation: Musculocutaneous nerve
o Action: Flexes arm, weak adductor

Biceps brachii
o Long head - lateral
o Short head - medial
o Origin: Long head supraglenoid tubercle of scapula, short head coracoid process of
scapula
o Insertion: Tuberosity of radius, bicipital aponeurosis
o Innervation: Musculocutaneous nerve (C5,6)
o Action: Elbox flexion, supinator of forearm, weak flexor of shoulder joint
Brachialis
o Origin: Front lower half of humerus
o Insertion: Coronoid process of ulna
o Innervation: Musculocutaneous (C5,6) and Radial nerve (C,6,7,8)
o Action: Flexor of elbow joint
Brachial artery
o Profunda brachii: Posterior compartment
o Venae comitantes: venous counterpart
o Origin: Axillary artery
o Commencement: Lower border of teres major
o Termination: Opposite the neck of the radius
o Divides into Ulnar and Radial artery
Triceps brachii
o Lateral head - largest
o Long head medially located
o Medial head deep
o Origin: Long head Infraglenoid tubercle of scap, Lateral head Upper half of posterior
surface of shaft of humerus, Medial head Lower half of posterior surface of shaft of
humerus
o Insertion: Olecranon process of the ulna
o Innervation: Radial nerve (C5,6,7,8,T1)
o Action: Elbox extension
Cubital fossa (MTBR)
o Pronator teres (medial border)
o Brachioradialis (lateral border)
o Tendon of biceps brachii
o Brachial artery
o Median nerve
o Contents: medial to lateral
o Median nerve, tendon of biceps, brachial artery, radial nerve
 Basilic vein
o Superficial, medial
o Commencement: Medial border of the wrist
o Termination: Lower border of teres major
o Drainage: Joins Venae comitantes to axillary vein
Cephalic Vein
o Superficial, lateral
o Commencement: Lateral of the wrist
o Termination: Deltopectoral groove
o Drainage: Axillary vein -> Subclavian vein

Lab D7: Back, Shoulder, Scapular Muscles

Trapezius
o Diamond-shaped
o Origin: Occipital bone, ligamentum nuchae, spine of 7th cervical vertebra, spines of all
thoracic vertebrae
o Insertion: Upper fibers into lateral third of clavicle, middle and lower fibers into acromion
and spine of scapula
o Innervation: Spinal part of accessory nerve (motor), C3,4 (sensory), spinal part of XI cranial
nerve
o Action: Upper fibers elevate the scapula; middle fibers pull scapula medially; lower fibers
pull medial border of scapula downward
Latissimus dorsi
o Origin: Iliac crest, lumbar fascia, spines of lower six thoracic vertebrae, lower three or four
ribs, and inferior angle of scapula
o Insertion: Floor of bicipital groove of humerus
o Innervation: Thoracodorsal nerve (C6,7,8)
o Action: Extends, adducts, and medially rotates the arm
Levator scapulae
o Origin: Transverse processes of 1st four cervical vertebrae
o Insertion: Medial border of scapula
o Innervation: C3,4, Dorsal scapular nerve
o Action: Raises medial border of scapula
Rhomboid Minor
o Smaller, above Teres major. Diagonal orientation.
o Origin: Ligamentum nuchae and spine of C7 and T1
o Insertion: Medial border of scapula
o Innervation: Dorsal scapular nerve (C4,5)
o Action: Raises medial border of scapula upward and medially
Rhomboid Major
o Diagonal orientation
o Origin: 2nd to 5th thoracic spines
o Insertion: Medial border of scapula
o Innervation: Dorsal scapular nerve (C4,5)
 o Action: Raises medial border of scapula upward and medially
Lumbodorsal fascia
Erector spinae
o Iliocostalis
o Longissimus
o Spinales
Deltoid
o 3 Fibers
o Origin: Lateral 3rd of the clavicle, acromion, spine of scapula
o Insertion: Middle of lateral surface of shaft of humerus
o Innervation: Axillary nerve (C,5,6)
o Action: Abducts the arm
Supraspinatus
o Origin: Supraspinous fossa of scapula
o Insertion: Greater tuberosity of humerus
o Innervation: Suprascapular nerve (C4,5,6)
o Action: Abducts arm, stabilizes shoulder joint
Infraspinatus
o Origin: Infraspinous fossa of scapula
o Insertion: Greater tuberosity of humerus
o Innervation: Suprascapular nerve (C4,5,6)
o Action: Laterally rotates arm, stabilizes shoulder joint
Teres Minor
o Origin: Upper two thirds of lateral border of scapula
o Insertion: Greater tuberosity of humerus
o Innervation: Axillary nerve (C4, C5,6)
o Action: Laterally rotates arm, stabilizes shoulder joint
Subscapularis
o Origin: Subscapular fossa
o Insertion: Lesser tuberosity of humerus
o Innervation: Upper and lower subscapular nerves (C5,6,7)
o Action: Medially rotates arm, stabilizes shoulder jont
Teres Major
o Origin: Lower third of lateral border of scapula
o Insertion: Medial lip of bicipital groove of humerus
o Innervation: Lower subscapular nerves (C6,7)
o Action: Medially rotates and adducts arm, stabilizes shoulder joint
Axillary nerve
Serratus posterior superior
o Respiration/Inspiration
o Origin: Lower cervical and upper thoracic spines
o Insertion: Upper ribs
o Innervation: Intercostal nerves
o Action: Raises ribs, inspiratory muscle
 Serratus posterior inferior
o Respiration/Expiration
o Origin: Upper lumber and lower thoracic spines
o Insertion: Lower ribs
o Innervation: Intercostal nerves
o Action: Depresses ribs, expiratory muscle

Additional:

3 muscles attached to the coracoid process:

Pec minor, short head of biceps, coracobrachialis

Bones:

clavicle, scapula, humerus

Joints: double planar, planar, synovial ball and socket respectively