Action of Upper Limb’s Muscles

at 3 Main Joints [Shoulder, Elbow & Wrist]

	Shoulder	Elbow	Wrist
Flexion	1. Pectoralis Major (Clavicular Head) 2. Deltoid (Anterior Fiber) 3. Coracobrachialis	1. Biceps Brachii 2. Brachialis 3. Brachioradialis	1. Flexor Carpi Radialis 2. Flexor Carpi Ulnaris 3. Palmaris Longus
Extension	1. Teres Major 2. Deltoid (Posterior Fiber) 3. Latissimus Dorsi	1. Triceps 2. Anconeus	1. Extensor Carpi Radialis Longus 2. Extensor Carpi Radialis Brevis 3. Extensor Carpi Ulnaris
ABduction	1. Supraspinatus [0-18] 2. Deltoid (Mid Fiber) [18-90] 3. Serraatus Anterior [90>]	-	1. Extensor Carpi Radialis Longus 2. Extensor Carpi Radialis Brevis 3. Flexor Carpi Radialis
ADduction	1. Teres Major 2. Pectoralis Major 3. Latissimus Dorsi	-	1. Flexor Carpi Ulnaris 2. Extensor Carpi Ulnaris
Medial Rotation	1. Teres Major 2. Pectoralis Major 3. Latissimus Dorsi 4. Subscapularis 5. Deltoid (Anterior Fiber)	-	-
Lateral Rotation	1. Teres Minor 2. Infraspinatus 3. Deltoid (Posterior Fiber)	-	-

at Superior-Inferior Radioulnar Joint

Pronation	Supination
1. Pronator Teres 2. Pronator Quadratus	1. Supinator 2. Biceps

Others

Protraction		1. Pectoralis Minor 2. Serratus Anterior
Retraction		1. Rhomboidus Minor 2. Rhomboidus Major 3. Trapezius (Middle Fiber)
Rotation	Glenoid cav. faces downwards	1. Rhomboidus Minor 2. Rhomboidus Major
	Glenoid cav. faces upwards	1. Trapezius (Upper & Lower Fibers)
Elavation	Scapula	1. Levator Scapulae
	Shoulder	1. Trapezius
Depression	Shoulder	1. Pectoralis Minor
	Scapula	1. Trapezius
Fix or Steadies		1. Subclavius [Clavicle] 2. Serratus Anterior [Scapula] 3. Palmaris Longus [Tensor of Aponeurosis] 4. Triceps [Shoulder Joint] 5. Biceps [Shoulder Joint]

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Glycoaminoglycan

Glycoaminoglycans (GAGs) aka [Mucopolysaccharides]

GAGs	Structure		Bonds / Linkage	Hydrolytic Products	Distribution
Hyaluronic acid	Glucuronic acid	N-acetyl glucosamine	Intraunit: β 1,3 glycosidic bond Interunit: β 1,4 linkages	1. glucuronic acid 2. glucosamine 3. acetic acid	1. synovial joint – lubricant 2. shock absorbent (vitreous body of eye) 3. cement substances (ECM between skin cells)
Chondroitin sulfate	Glucoronic acid	N-acetyl galactosamine-S [S on C4 or C6]	Intraunit: β 1,3 Interunit: β 1,4	1. glucuronic acid 2. galactosamine 3. acetic acid 4. sulphuric acid	Cartilage, bone, heart valves, tendon (hard CT)
Dermatan sulfate	L- Idurnic acid	N -acetyl galactosamine-S [S on C4]	Intraunit: β 1,3 Interunit: β 1,4	1. iduronic acid 2. galactosamine 3. acetic acid 4. sulphuric acid	Skin, blood vessels, heart valve
Heparin	Glucoronic acid-S or Iduronic acid-S	Glucosamine-S-S [S on C2 & C6]	Intraunit:α 1,4 Interunit: α 1,4	1. glucuronic / iduronic acid 2. glucosamine 3. sulphuric acid	Mast cells’ granules, liver, kidney, lungs (acts as anti-coagulant)
Heparan sulfate	Glucoronic acid-S or Iduronic acid-S	N-acetyl glucosamine-S OR Glucosamine-S-S [S on C2 & C6]	Intraunit: α 1,4 Interunit: α 1,4	1. glucuronic / iduronic acid 2. glucosamine 3. acetic acid 4. sulphuric acid	ECM of all tissues
Keratan sulfate	Galactose	N-acetyl glucosamine-S [ S on C6 of either sugar]	Intraunit: β 1,4 Interunit: β 1,3	1. galactose 2. glucosamine 3. acetic acid 4. sulphuric acid	Cornea of the eye & skin, loose CT

                                                                                                

NB. Glycosidic linkage = glycosidic bond, use interchangeable both in intraunit and interunit.

Hydrolytic Products Comparison

	Glucuronic acid	Iduronic acid	Galactose	Glucosamine	Galactosamine	Acetic acid	Sulphric acid
Hyaluronic acid	/			/		/
Chondroitin sulfate	/				/	/	/
Dermatan sulfate		/			/	/	/
Heparin	/	/		/			/ *
Heparan sulfate	/	/		/		/	/
Keratin sulfate			/	/		/	/

* most rich in sulphate among GAGs

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M.U.S.C.L.E.S [ Pectoral Region & Back Muscles]

M.U.S.C.L.E.S [ Pectoral Region & Back Muscles]

	ORIGIN	INSERTION	NERVE SUPPLY	ACTION
Pectoralis Major	1. Sternocostal head: from the front of sternum & upper 6 costal cartilages 2. Clavicular head: from the front of medial half of the clavicle	1. Lateral lip of bicipital groove of humerus	1. Medial pectoral nerve 2. Lateral pectoral nerve	1. Flexion of arm 2. Adduction of arm 3. Medial rotation 4. Respiratory accessory muscle 5. climbing & swimming
Pectoralis Minor	3rd, 4th & 5th ribs near the costochondral junctions	1. Coracoid processes of scapula (medial aspect)	1. Medial pectoral nerve	1. Protraction of scapula 2. Depression of the shoulder 3. Accessory inspiratory muscle
Subclavius	1st rib and its costal cartilage	1. Clavicle (groove on the inferior surface)	1. nerve to subclavius [C5,C6]	1. Steadies the clavicle 2. Fixes clavicle to 1st rib
Trapezius	1. External occipital protuberance 2. Medial third of the superior nuchal line  of occipital bone 3. ligamentum nuchae + spinous processes of C7 4. Spinous processes of ALL thoracic vertebrae	1. Posterior border of the lateral third of clavicle 2. Medial margin of acromion 3. superior lip of posterior border of the spine of scapula	1. Spinal part of accessory nerve ( CN XI) 2. Ventral rami of C3, C4 – carries proprioception sensation	1. Elevates shoulder (upper fibers) 2. Depress scapula (lower fibers) 3. Rotate scapula so glenoid cavity faces upwards (upper & lower fibers) 4. Retract scapula (middle fibers)
Latissimus Dorsi	1. Spinous processes of T7-T12 & supraspinous ligament 2. thoracolumbar fascia 3. outer lip of iliac crest 4. inferior 3 or 4 ribs 5. inferior angle of scapula	1. floor of bicipital groove of the humerus	1. T (nerve to latissmus dorsi) (C6,C7,C8)	1. Adduction of arm 2. Extension of arm 3. Medial rotation of arm
Levator Scapulae	1. Tranverse processes of C1-C4	1. Medial border of dorsal surface of scapula from the superior angle to the spine	1. Dorsal scapular nerve (C5)	1. Elevation of scapula
Rhomboidus Minor	1. Nuchal ligaments (C5,C6) 2. spinous processes of C7 to T11	1. Small area of medial border of dorsal surface of scapula at level of spine	1. Dorsal scapular nerve (C5)	1. Retraction of scapula 2. Rotation of scapula > glenoid cavity faces downwards
Rhomboidus Major	1. Spinous processes of the T2 – T5	1.Medial border of scapula, inferior to the insertion of rhomboid minor	1. Dorsal scapular nerve (C5)	1. Retraction of scapula 2. Rotation of scapula > glenoid cavity faces downwards

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