lab-manual-muscular-shoulder-arm-atlas

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Antelope Valley College *

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201

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Anatomy

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Jan 9, 2024

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48

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1 Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
2 PRE LAB EXERCISES Before coming to lab, get familiar with a few muscle groups we’ll be exploring during lab. Using Visible Body’s Human Anatomy Atlas, go to the Views section. Under Systems, scroll down to the Muscular System views. Select View 11. Shoulder, and find the following muscles. When you select a muscle, note the book icon in the content box. Selecting this icon allows you to read the muscle’s definition. 1. Pectoralis major 2. Latissimus dorsi Define the following terms: 1. Extension 2. Flexion 3. Abduction 4. Adduction 5. Rotation Straightening a part to where the angle between them increases and the parts move farther apart Bending parts so the angle becomes decresed and the parts become closer moving a part away from the midline moving a part toward the midline Moving a part around in an axis Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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3 IN LAB EXERCISES Use the following modules to guide your exploration of the shoulder and arm regions of the muscular system. As you explore the modules, locate the muscles on any charts, models, or specimen available. These muscles are located in and act on the shoulder and arm regions. Because the glenoid cavity of the scapula is shallow and does not snugly fit the head of the humerus, the tendons of multiple muscles are involved in securing and stabilizing the humerus at the shoulder to prevent dislocation. Other muscles will cross the shoulder (glenohumeral) joint and insert on the arm, causing the arm to move when they contract. Movement of the brachium, or upper arm, depends on the fixators of the shoulder to keep the scapula in place so the arm can move freely. Once we move down into the antebrachium (forearm) and hand, the muscles begin to get smaller and more numerous, which grants us our fine motor skills when we write or play the piano. Pay attention to whether the muscle is on the anterior or posterior side of the arm – muscles on the anterior side will flex, while muscles on the posterior side will extend. The long names of some of these muscles can be daunting, but they are often very descriptive. You can find origins, insertions, actions, and/or locations of these muscles simply in the names. When reviewing the action of a muscle, it will be helpful to think about where the muscle is located and where the insertion is. Muscle physiology requires that a muscle will “pull” instead of “push” during contraction, and the insertion is the part that will move. Imagine that the muscle is “pulling” on the bone or tissue it is attached to at the insertion. Access 3D views and animated muscle actions in Visible Body’s Human Anatomy Atlas, which will be especially helpful to visualize muscle actions. When you select a structure in the Atlas app, you’ll see options to read the definition and hear the pronunciation in the content box. When you select a muscle, be sure to select the blue pin icon in the content box. This will give you the option to view origins and insertions as visible pins on the muscle (select Attachments), view the blood supply, and/or the nerve supply. In each module below, identify the following: • Muscle location • Origin(s) and insertion(s) • Muscle action • Nerve supply Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
4 A. Muscles of the Shoulder Muscles of the Shoulder View the following Muscle Actions: Shoulder flexion Shoulder extension Shoulder horizontal abduction Shoulder horizontal adduction Shoulder abduction Shoulder adduction Shoulder medial rotation Try performing these actions yourself and feel which muscles contract. These muscles primarily act to stabilize the scapula and move the arm. Since the scapula is a moveable bone, it must be stabilized in order for the arm to be able to move. Some of these muscles are prime movers of the arm. They all cross the shoulder joint to insert on the humerus. Remember that muscles pull, and imagine how the muscle will pull on the humerus as it contracts. Shoulder lateral rotation Scapula elevation Scapula depression Scapula abduction Scapula adduction Scapula upward rotation Scapula downward rotation Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
5 View 11. Shoulder Deltoid Pectoralis major Latissimus dorsi Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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6 View 11. Shoulder Deltoid Teres minor Coracobrachialis Latissimus dorsi Supraspinatus Infraspinatus Teres major Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
7 Insertion Shoulder Origin Muscle Pectoralis major Pectoralis minor Deltoid Action Innervation Latissimus dorsi Subscapularis Infraspinatus Coracobrachialis Supraspinatus clavicular head, medial clavicle, lateral lip of intertubercul ar groove of flexion, medial rotation, horizontal adduction of UE lateral pectoral n. (C5,6,7), 3rd-5th ribs coracoid process draws scapula inferiorly and medial pectoral n. (C8,T1) lateral clavicle, acromion Deltoid tuberosity of humerus Abducts arm; flexes, extends, The posterior branch of the axillary nerve indirect to process of lower 6 Intertubercul ar sulcus of humerus Extends, adducts, and medially The thoracodorsal nerve, a branch of the posterior cord of the brachial plexus (C6 to C8 with C7 predominant) Infraspinous Fossa Greater tubercle of humerus Laterally rotates arm, stabilizes The suprascapul ar nerve Supraspinatu s Fossa Greater tubercle of humerus Abducts arm, helps stabilize suprascapul ar nerve origin Attaches to the insertion lesser tubercle of assists in securing the head of the nerve Subscapular nerves C5 tip of coracoid process of scapula middle third of medial surface of helps flex and adduct arm musculocutaneous nerve (C5, C6, C7) Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
8 Insertion Shoulder (continued) Origin Muscle Teres major Teres minor Action Innervation origin Attaches to the posterior surface of the inferior angle of the scapula Attaches into the medial lip of the bicipital groove of the humerus Adducts extends medially rotates the arm supplied by the lower subscapular Lateral border of scapula Greater tubercle of humerus Laterally rotates and adducts arm, innervated by the axillary Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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9 B. Muscles of the Torso that Act on the Scapulae Under the Views section, go to Systems: Muscular System Views and select 20. Muscular System View. • Rotate the model so you see the posterior side. • Select the left side of the trapezius and hide it. • Observe the following deep muscles that act on the scapulae. View 20. Muscular System View Levator scapulae Rhomboideus major Rhomboideus minor Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
10 Insertion Torso Muscles that Act on the Scapulae Origin Muscle Rhomboideus major Rhomboideus minor Levator scapulae Action Innervation Attaches to the spinous processes of Attaches to the lower 2/3 of the medial adducts scapula and elevation of Dorsal Scapular Nerve C4 C5 spinous processes of C7 and T1 upper portion of the medial border of the adducts scapula and elevation of Dorsal Scapular Nerve C4 C5 TPs of C1- C4 Medial border of scapula Elevation of scapula Extension Dorsal Scapular Nerve (C3, C4, C5) Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
11 C. Muscles of the Elbow Under the Views section, go to Systems: Muscular System Views and select 12. Elbow. These muscles are all located on the anterior side of the humerus and cross the elbow to insert on the radius or ulna. When these muscles contract, the arm will flex at the elbow. Biceps brachii is named for its “two heads;” note the two different origins of this muscle. View 12. Elbow Biceps brachii (long head) Brachioradialis Brachialis Biceps brachii (medial head) Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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12 Insertion Forearm: Elbow Flexors Origin Muscle Biceps brachii (long and short heads) Brachialis Brachioradialis Action Innervation long head; superior margin of glenoid fossa of scapula short head; coracoid process of scapula radial tuberosity of radius; fascia flexion and supination of forearm; musculocut aneous nerve (C5- Anterior, distal surface of humerus Ulna Flexes forearm musculocutaneous nerve(C5-T1). Lateral humerus Radius Flexes forearm radial nerve C5-C6 spinal nerve roots Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
13 Muscle Action: Elbow Extension Triceps brachii (long head) Anconeus Triceps brachii (medial head) Triceps brachii (lateral head) These muscles are located on the posterior side of the forearm, and will cross the elbow joint to cause extension of the arm at the elbow when they contract. Note the three different origins of the three heads of the triceps brachii. View Muscle Action: Elbow extension Insertion Forearm: Elbow Extensors Origin Muscle Triceps brachii (medial head) Anconeus Action Innervation Scapula and humerus Ulna extends and adducts arm, extends Radial nerve (C6- C8) dorsal aspect of lateral epicondyle of lateral side of olecranon, proximal 1/4 extension of elbow joint radial nerve (C7-C8) Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
14 These muscles either pronate the forearm (turn the palm down), or supinate it (turn the palm up). View Muscle Actions: Forearm pronation and Forearm supination Muscle Action: Forearm Pronation Pronator teres Pronator quadratus Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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15 Muscle Action: Supination Supinator Insertion Forearm: Pronation and Supination Origin Muscle Pronator teres Pronator quadratus Supinator Action Innervation medial epicondyle of humerus Middle convexity of lateral RUJ pronation, EJ flexion Median nerve distal quarter of anterior surface of distal quarter of anterior surface of RUJ pronation, WJ flexion anterior interosseous nerve Lateral epicondyle of the humerus Lateral surface of the proximal Supination of the forearm Radial nerve (C6) Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
16 These muscles make up the anterior compartment of the forearm, and cross the wrist to insert on the hand. They all function to flex the wrist and/or the fingers when they contract. These muscles have long names, but the names are very descriptive of where the muscle is located and its action. View Muscle Actions: Wrist flexion Wrist abduction Wrist adduction Muscle Action: Wrist Flexion Flexor carpi radialis Flexor digitorum superficialis Flexor carpi ulnaris Palmaris longus Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
17 Muscle Action: Wrist Adduction Flexor carpi ulnaris Extensor carpi ulnaris Muscle Action: Wrist Abduction Flexor carpi radialis Extensor pollicis longus Abductor pollicis longus Extensor carpi radialis longus Extensor carpi radialis brevis Extensor pollicis brevis Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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18 Insertion Hand: Deep Flexors Origin Muscle Flexor carpi ulnaris Flexor pollicis longus Flexor digitorum superficialis Flexor digitorum profundus Action Innervation These muscles also flex the hand, and are located deep to the hand flexors above. Insertion Hand: Superficial Flexors Origin Muscle Flexor carpi radialis Palmaris longus Action Innervation medial epicondyle of the humerus bases of the second and third Flexion of the wrist, abduction of Median nerve (C6, C7) Common flexor tendon from medial flexor retinaculum and palmar Tenses palmar fascia, flex Median nerve (C6, C7) medial epicondyle of humerus, Common Flexor Tendon, ulnar deviation of the hand at hamate, 5th metacarpal. Nerve :media Humeral Head- common flexor tendon from medial epicondyle of humerus, ulnar collatearl ligament of elbow joint, and deep 4 tendosn into sides of middle phalanges 2-5th digits flexion of PIP of 2-5th digits assists in MCP joint flex and wrist fle Median nerve (C7, C8, and T1) Middle anterior surface of the radius and the anterior medial border of the ulna just distal to the coronoid process; occasionally a small Base of the distal phalanx of Flexion of the thumb carpometacarpal, metacarpophalangeal, and interphalangeal joints, Flexion of the wrist, Abduction of the Median nerve, palmar Proximal three-fourths of the Base of the distal phalanxes of Flexion of the four fingers at the Median nerve (C8, T1) to the second and third fingers, Ulnar nerve (C8, T1) to the fourth and fifth fingers Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
19 These muscles are located on the posterior side of the forearm and cross the wrist to insert on the hand. When these muscles contract, the wrist and/or fingers will extend. View Muscle Actions: Wrist extension Wrist abduction Wrist adduction Muscle Action: Wrist Extension Extensor carpi ulnaris Extensor carpi radialis brevis Extensor digitorum Extensor carpi radialis longus Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
20 Insertion Hand: Superficial Extensors Origin Muscle Extensor carpi radialis longus Extensor carpi radialis brevis Extensor digiti minimi Extensor digitorum Extensor carpi ulnaris Action Innervation Lower third of lateral supracondyla Base of the second metacarpal Extension of the wrist, abduction of Radial nerve (C6, C7) lateral epicondyle of humerus base of 3rd metacarpal on dorsal extension of wrist, abduction of deep, superficial radial nerve lateral epicondyle of humerus via 4 tendons contribute to extensor extension of wrist joint with deep radial nerve (C6-C8) Lateral epicondyle of the humerus Base of the middle and distal Extension of the little finger at the Radial nerve (C6-C8) Lateral epicondyle of the humerus, Base of the fifth metacarpal Extension of the wrist, adduction of Radial nerve (C6-C8) Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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21 D. Muscles of the Wrist and Hand Under the Views section, go to Systems: Muscular System Views and select 13. Wrist and Hand. View Muscle Actions: Thumb extension These muscles are also located on the posterior compartment of the forearm, but are located deep to the muscles in the previous section. They will also cross the wrist to insert on the hand, functioning to move the first or second digit when contracted. It will be helpful to remember that “pollicis” is referring to the thumb and “indicis” to the index finger. Muscle Action: Thumb Extension Extensor pollicis longus Extensor pollicis brevis Abductor pollicis longus Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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22 Insertion Hand: Deep Extensors Origin Muscle Abductor pollicis longus Extensor pollicis longus Extensor indicis Extensor pollicis brevis Action Innervation Posterior aspect of the radius and Base of the first metacarpal Abduction of the thumb at the Radial nerve (C6, C7) Posterior lateral surface of Base of the distal phalanx of Extension of the thumb at the Radial nerve (C6-C8) Posterior surface of the lower Base of the proximal phalanx of Extension of the thumb at the Radial nerve (C6, C7) Middle to distal one- third of the Base of the middle and distal Extension of the index finger at the metacarpophalangeal joint, weak wrist extension, weak supination of forearm Radial nerve (C6-C8) Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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23 Muscle Action: Thumb Flexion Flexor pollicis longus Palmaris longus Adductor pollicis Flexor pollicis brevis These muscles move the first digit – the thumb. Earlier sections have included muscles that move the thumb, but are primarily located in the forearm. Thenar muscles are entirely located within the hand and form the thenar eminence – the fleshy protrusion in the hand at the base of the thumb. View Muscle Actions: Thumb flexion and Hand digits opposition Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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24 Muscle Action: Hand Digits Opposition Opponens digiti minimi Abductor pollicis brevis Opponens pollicis Flexor pollicis brevis Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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25 Insertion Finger: Thenar Origin Muscle Abductor pollicis brevis Opponens pollicis Adductor pollicis Flexor pollicis brevis Action Innervation These muscles all function to move digit 5, the little finger. These muscles are also entirely located within the hand. Insertion Finger: Hypothenar Origin Muscle Abductor digiti minimi Flexor digiti minimi brevis Opponens digiti minimi Action Innervation Flexor retinaculum, trapezium Base of proximal phalanx of Abduction of the thumb Recurrent branch of median nerve (C8, T1) trapezium, flexor retinaculum proximal phalanx of thumb abducts thumb spinal levels C8 and T1 Transverse carpal ligament Thumb (base of proximal phalanx) on the radial sesamoid (more lateral of the bumps) CMC joint of thumb: flexion Superficial head: Median n. C8, T1 Deep head: Ulnar n. C8, T1 Transverse head Oblique head Medial base of proximal phalanx 1 (via ulnar sesamoid bone) adducts thumb and contributes to Deep branch of ulnar nerve (C8, T1) Calcaneal tuberosity, plantar aponeurosis Base of proximal phalanx of digit 5, metatarsal bone 5 Metatarsop halangeal joint 5: Toe abduction, toe flexion; Lateral plantar nerve (S1-S3) Hook of hamate, flexor retinaculum Base of proximal phalanx of digit 5 Finger flexion Deep branch of ulnar nerve (C8, T1) Hook of hamate bone, flexor retinaculum Ulnar aspect of metacarpal bone 5 Finger flexion, finger lateral rotation/ opposition Deep branch of ulnar nerve (C8, T1) Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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26 These muscles are located within the hand and are responsible for the fine movements of the fingers. The muscles listed in the chart below are actually groups of muscles. The number of muscles normally found in each group is in parentheses after the name. View Muscle Actions: Hand digits 2-5 flexion and Hand digits 2-5 extension Muscle Action: Hand Digits 2-5 Flexion Lumbricals Palmar interossei Dorsal interossei Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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27 Muscle Action: Hand Digits 2-5 Extension Dorsal interossei Extensor digitorum Palmar interossei Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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28 Insertion Fingers: Midpalmar Origin Muscle Lumbricals (4) Palmar interossei (3) Dorsal interossei (4) Action Innervation Tendons of flexor digitorum profundus muscle Extensor expansion of hand Flex the mcp joint while extending the pip and dip joints Lumbricals 3-4: Ulnar nerve (C8-T1) 5th metacarpal (radial side) 5th metacarpal (radial side) extension and adduction Ulnar n. C8, T1 Adjacent sides of metacarpal bones 1-5 Ulnar bases of proximal phalanges/ Finger abduction, finger flexion Deep branch of ulnar nerve (C8-Th1) Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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29 PUTTING IT ALL TOGETHER 1. Based on what you’ve learned about the muscles in this exercise, what do you think the following terms mean? a. Major b. Minor c. Extensor d. Flexor e. Longus f. Brevis g. Spinatus h. Pollicis i. Carpi it does more than one thing it doesnt have ability that other structures do extending (increasing ) a body part like the limb Flexor (decresing) a body part something that is long something that is short something that is small and slander thunb between the hand and the forearm Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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30 2. Which muscles are part of the rotator cuff that serves to stabilize the shoulder joint? 3. Which muscles are used when performing the following actions? a. Raising your hand high over your head during class b. Rowing a boat c. Reaching behind you, arm extended and pronated d. Reaching in front of you, arm extended and supinated e. Bringing your hand to your heart f. Holding a pencil 4. Carpal tunnel syndrome can result from repetitive motions in the fingers causing inflammation in the carpal tunnel – a space covered by the flexor retinaculum where tendons and nerves pass through the wrist. In this syndrome, the median nerve is compressed, which can lead to tingling, numbness, and muscle weakness. Which muscles are most likely to be affected by carpal tunnel syndrome? subscapularis, teres minor, supraspinatus and infraspinatus abduction scapula shoulder extension shoulder extension medial rotate your shoulder latera quadrupod Flexor pollicis brevis, opponens pollicis, abductor pollicis brevis, 1st and second limbracals Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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31 Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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32 View 11. Shoulder Pectoralis major Deltoid Latissimus dorsi Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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33 View 11. Shoulder Deltoid Teres minor Teres major Supraspinatus Infraspinatus Coracobrachialis Latissium dorsal Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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34 View 20. Muscular System View Levator Scapulae Rhombodeus minor Rhomboideus major Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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35 View 12. Elbow Bicepts brahili (long head) Bicepts brachili (medial head) Brachioradialis Brachialis Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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36 Muscle Action: Elbow Extension Tricepts (long head) Tricepts brachili (lateral head) Tricepts brachili (medial head) Anconeus Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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37 Muscle Action: Forearm Pronation Pronator teres Pronator quadratus Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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38 Muscle Action: Supination Supinatar Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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39 Muscle Action: Wrist Flexion Flexor carpi radialis Flexor digitorum superficialis Flexor carpi ulnaris Palmaris longus Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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40 Muscle Action: Wrist Abduction Extensor carpi radialis longus Flexor carpi radialis Extensor arpi radialis brevis Abductor pollicis longus Extensor pollicis longus Extensor pollicis brevis Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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41 Muscle Action: Wrist Adduction Flexor carpi ulnaris Extensor carpi ulnaris Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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42 Muscle Action: Wrist Extension Extensor carpi radialis longus Extension carpi radialis brevis Extensor carpi ulnaris Extension digitorum Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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43 Muscle Action: Thumb Extension Abductor pollicis longus Extensor pollicis longus Extensor pollicis brevis Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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44 Muscle Action: Thumb Flexion Flexor pollicis brevis Palmaris longus Flexor pollicis longus Abductor pollicis Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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45 Muscle Action: Hand Digits Opposition Flexxor pollis brevis Abductor pollicis brevis Opponens digiti Opponens pollicis Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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46 Muscle Action: Hand Digits 2-5 Flexion Palmar interossei Dorsal interossei Lumbricals Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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47 Muscle Action: Hand Digits 2-5 Extension Dorsal interossei Palmar interssei Extensor Digitorum Downloaded by Larry Parmelo (gb4jrjr5wt@privaterelay.appleid.com) lOMoARcPSD|11715870
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