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Biceps Brachi
Action Flex the elbow, supinate the forearm,
flex the shoulder
Origin Short head – Coracoid process of
scapula Long head – Supraglenoid tubercle of
scapula
Insertion Tuberosity of the radius andaponeurosis
of the biceps brachii
Innervation Musculocutaneous (C5-6)
Biceps brachii
Supine or seated
Bend the elbow and shake hands with pt
Ask pt to flex his elbow against your resistance
Palpate the ant. surface of the arm and locate the hard, round belly of the biceps
Follow the belly distally to the inner elbow and then follow proximally to where it tucks beneath the ant. fiber of deltoid
Biceps brachii – distal tendon
With elbow flexed, shake hands with pt.
As you locate the biceps’s distal tendon, ask pt to flex his elbow against your resistance
Slide over to the tendon’s medial aspect and explore for the aponeurosis
Biceps brachii- tendon of long head
Locate the intertubercular groove
Laterally rotating the arm may make it easier to pinpoint the tendon
Ask pt. to gently flex his elbow against your resistance
Brachialis
Action Flexion at the elbow joint
Origin Distal half of the anterior surface
of the humerus, also the medial and lateral intermuscular septa
Insertion Ulnar tuberosity
Innervation Musculocutaneous (C5-6) and
radial nerve (C7)
Brachialis Shake hands with pt. and
flex the elbow to 90°
Ask pt to flex his elbow against your resistance
With arm relaxed, slide laterally half an inch off the distal biceps. The edge of the brachialis can be detected
Brachialis
Locate the distal biceps
tenden
Palpate along either side of
the tendon for portions of
the deeper brachialis
Test for biceps brachii and brachialis
• Patient:Patient: Supine or sitting
• Fixation:Fixation: The examiner places one hand under the elbow to cushion it form table pressure
• Test:Test: Elbow flexion slightly less than or at a right angle, with the forearm in supination
• Pressure:Pressure: Against the lower forearm, in the direction of extension
Triceps brachi
Long head
Medial head
Lateral head
Triceps brachiAction
All head: Extend the elbow Long head: Extend and adduct the shoulder
Origin Long head: Infraglenoid tubercle of the scapular Lateral head: Posterior surface of proximal half of the
humerus Medial head: Posterior surface of distal half of the
humerusInsertion
Olecranon process of the ulnaInnervation
Radial (C6-8)
Triceps brachii
Prone
Bring the arm off the side of the table
Locate the olecranon process to outline the distal tendon of the triceps
Ask pt. to extend his elbow as you apply resistance
Slide proximally and onto the broad triceps tendon
Triceps brachii – tendon of long head
Prone
Place one hand on the proximal elbow and ask pt. to extend against your resistance
Locate its belly and follow the muscle proximally
Note how it disappears underneath the post. deltoid toward the infraglenoid tubercle
With the arm relaxed, press through the post. deltoid and strum across its tendon to the infraglenoid tubercle
Test for triceps and anconeus
• Patient:Patient: Prone
• Fixation:Fixation: The shoulder is at 90° abduction, neutral with regard to rotation, and with the arm supported between the shoulder and the elbow by the table.
• Test:Test: Extension of the elbow joint (to slightly less than full extension)
• Pressure:Pressure: Against the forearm, in the direction of flexion.
Corachobrachialis
Action Flex and adduct the shoulder
Origin Coracoid process of the scapula
Insertion Medial surface of mid-humeral
shaft
Innervation Musculocutaneous
Coracobrachialis Supine and laterally rotate and
abduct the shoulder to 45°
Locate the fibers of the pectoralis major
Lay one hand along the medial side of the arm and move your fingerpads into the armpit
Ask pt horizontally adduct gently against your resistance
Isolate the solid edge of the pectoralis major then slide off the fibers posteriorly (into the axilla) and explore the belly of coracobrachialis
Test for coracobrachialis
Test for coracobrachialis
• Patient:Patient: Sitting or supine
• Test:Test: Shoulder flexion in lateral rotation, with the
elbow completely flexed and the forearm supinated.
• Pressure:Pressure: Against the anteromedial surface of the
lower 1/3 of the humerus, in the direction of extension
and slight abduction