| Muscle |  |
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| Proximal Attachment | |
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| Distal Attachment | |
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| Innervation | |
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| Actions | |
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| Trigger Point Referral | |
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| Trigger Point Effect | |
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| Subscapularis | subscapular fossa | lesser tubercle of humerus | upper & lower subscapular nerves (C5, C6, C7) | medially rotates & adducts arm; help hold humeral head in glenoid cavity | At rest and activity, post aspect of shoulder , spillover scapula , down post arm to elbow , straplike over referral pain , tenderness around wrist | Frozen shoulder syndrome often develop, restrict abduction and external rotation of the arm,severely restrict ROM, predisposed to TPS in various other shoulder muscles |
| Rectus Femoris | AIIS & ilium superior to acetabulum | base of patella via patellar ligament to tibial tuberosity | femoral nerve (L2, L3, L4) | extend leg @ knee jt; steadies hip jt & helps iliopsoas to flex thigh | Distal to knee and slightly distal half of ant thigh | Quads Strain |
| Lateral Pterygoid | Superior head-> infratemporal surface & infratemporal crest of greater wing of sphenoid bone. Inferior head-> lateral surface of lateral pterygoid plate | neck of mandible (pterygoid fovea), articular disc & capsule of TMJ | mandibular nerve via lateral ptyer. nerve from anterior trunk which enters its deep surface | TOGETHER-> protrudes mandible & depresses chin ALONE-> side to side mvmts of mandible | Pain deep to TMJ, but not in ear | arthritis of TMJ jt |
| Medial Pterygoid | Deep Head-> medial surface of lateral pterygoid plate & pyramidial process of palatine bone. Superficial Head-> tuberosity of maxilla | medial surface of ramus of mandible, inferior to mandibular foramen | mandibular nerve via medial pterygoid nerve | TOGETHER-> help elevate mandible thus closing jaw; help to protrude mandible. ALONE-> protrude side of jaw acting alternately, they produce grinding motion | vague pain to back of mouth and throat | (blank) |
| Gluteus Medius | external surface of ilium <-> anterior & posterior gluteal lines | lateral surface of greater trochanter | superior gluteal nerve (L5, S1) | abducts & medially rotates thigh; keeps pelvis level when opposite leg is raised | pain along crest of ilium & over sacrum, may project downward across buttock to include upper thigh | low back pain |
| Semitendinosis | ischial tuberosity | medial surface of superior part of tibia | tibial division of sciatic nerve (L5, S1, S2) | extends thigh, flex leg & medially rotates when knee flexed; when thigh & leg are flexed, mm extend trunk | sharp pain projecting upwards to glut fold | (blank) |
| Pectoralis Major | CLAVICULAR HEAD-> anterior surface of medial 1/2 of clavicle. STERNAL HEAD-> anterior surface of sternum, superior 6 costal cartilages & aponeurosis of external oblique | lateral lip of intertubercular groove of humerus | lateral & medial pectoral nerves; clavicular head (C5, C6), sternalcostal head (C7, C8, T1) | TOGETHER-> adducts & medially rotates humerus; draws scapula anteriorly & inferiorly. ALONE-> clavicular head flexes humerus & sternocostal head extends it from flexed position | Clav: anterior deltoid area
Sternal: intense pain to anterior chest, down to medial epicondyle, sometimes continuing to 4th &5th digits | sternal division TrP refers pain that closely mimic cardiac ischemia. Lateral fibres refer pain & tenderness to breast making contact with clothing intolerable |
| Serratus Anterior | external surfaces of lateral parts of 1st to 8th ribs | anterior surface of medial border of scapula | long thoracic nerve (C5, C6, C7) | protracts scapula & holds it against thoracic wall; rotates scapula | over side of chest & to lower vertebral border of scapula (not fra from focus of pain characteristic of latissimus dorsi TPs. Extends down arm to hand | shortness of breath |
| Extensor Carpi Ulnaris | lateral epicondyle & posterior border of ulna | base of 5th metacarpal | posterior interosseous nerve (C7, C8), continuation of deep branch of radial nerve | extends & adducts hand @ wrist | pain in ulnar side of back of wrist | (blank) |
| Iliacus | iliac crest, iliac fossa, ala of sacrum & anterior SI ligaments | tendon of psoas major, lesser trochanter & femur distal to it | femoral nerve (L2, L3) | act conjointly in flexing thigh @ hip jt & in stabilizing this jt | groin and upper anterio-medial aspect of thigh on ipsilateral side | (blank) |
| Psoas Minor | sides of T12 to L1 vert. & intervertebral disc (IVD) | pectineal line, iliopectineal eminance via iliopectineal arch | ventral rami of lumbar nerves (L1 & L2) | act conjointly in flexing thigh @ hip jt & stabilizing this jt | pain along lumbar spine and down anterior thigh | (blank) |
| Psoas Major | sides of T12 to L5 vert. & IVDs, TVPs of all lumbar vert. | lesser trochanter of femur | ventral rami of lumbar nerves (L1, L2, L3) | act conjointly in flexing thigh @ hip jt & in stabilizing jt | pain along lumbar vert. & down anterior thigh
distinctive vertical pattern ipsilaterally along lumbar spine | low back pain |
| Quadratus Lumborum | medial 1/2 of inferior border of 12th rib; tips of lumbar TVPs | iliolumbar ligament & internal lip of iliac crest | ventral branches of T12 & L1 to L4 nerves | extends & laterally flexes vert. column; fixes 12th rib during inspiration | superficial trp: along lateral border of iliac crest, into abdomen, outer aspecto of groin or at greater trochanter
Deep: strongly to SI jt, low in buttock, ipsilateral glut area
bilaterally: across upper sacra area | "sciatica" myogenic back pain, short leg & hemi pelvis, myofascial low back pain |
| Sartorius | ASIS & superior part of notch inferior to it | superior part of medial surface of tibia | femoral nerve (L2, L3) | flexes, abducts & laterally rotates thigh @ hip jt; flexes leg @ knee jt | along anteromedial thigh, spillover medial thigh to knee | (blank) |
| Vastus Lateralis | greater trochanter & lateral lip of linea aspera | base of patella via patellar ligament to tibial tuberosity | femoral nerve (L2, L3, L4) | extends leg @ knee | along ldistal ateral thigh, spill over to knee | (blank) |
| Quadratus Femoris | lateral border of ischial tuberosity | quadrate tubercle of intertrochanteric crest of femur & area inferior to it | quadratus femoris nerve (L5, S1) | laterally rotates thigh, steadies femoral head in acetabulum | (blank) | (blank) |
| Gemelli Inferior | ischial tuberosity | medial surface of greater trochanter (trochanteric fossa) of femur | quadratus femoris nerve (L5, S1) | laterally rotate extended thigh of abducted flexed thigh; steady femoral head in acetabulum | (blank) | (blank) |
| Flexor Carpi Ulnaris | humeral head-> medial epicondyle. Ulnar head-> olecranon & posterior border of ulna | pisiform, hook of hammate & 5th metacarpal | ulnar nerve | flexes & adducts hand @ wrist | (blank) | (blank) |
| Peroneus Longus | head & superior 2/3 of lateral surface of fibula | base of 1st metatarsal & medial cuneiform | superficial fibular nerve (L5, S1, S2) | everts foot @ weakly plantarflexes ankle | (blank) | (blank) |
| Splenius Cervicis | sp. processes of T3-T6. | TVP of C1-C3 vert. | dorsal rami of C2-C4 | ALONE-> ipsilateral flexion & rotation of head. TOGETHER-> extends head & neck | straight thru inside of head to behind ipsilateral eye | shooting pain, can cause bluring of vision |
| Extensor Digitorum (superficial mm) | lateral epicondyle | extensor expansions of medial 4 digits | posterior interosseous nerve, continuation of deep branch of radial nerve | extends medial 4 digits @ MCP jts; extends hand @ wrist | (blank) | (blank) |
| Flexor Digitorum Profundus (deep) | prox. 3/4 of medial & anterior surfaces of ulna & interosseous membrane | bases of distal phalanges of medial 4 digits | Medial Part-> ulnar nerve. Lateral Part -> median nerve | flexes distal phalanges @ distal interphalangeal jts of medial 4 digits; assists w/ flexion of hand | (blank) | (blank) |
| Supinator (superficial) | lateral epicondyle, radial collateral & annular lig., supinator fossa & crest of ulna | lateral, posterior & anterior surfaces of prox. 3rd of radius | deep branch of radial nerve | supinates forearm (rotates radius to turn palm anteriorly) | (blank) | (blank) |
| Abductor Pollicis Longus (deep) | posterior surfaces of ulna & interosseous membrane | base of 1st metacarpal | posterior interosseous nerve, continuation of deep branch of radial nerve | abducts thumb & extends it @ MCP jt | (blank) | (blank) |
| Extensor Carpi Radialis Longus (superficial) | lateral supracondylar ridge of humerus | base of 2nd metacarpal | radial nerve | extend & abduct hand @ wrist jt | (blank) | (blank) |
| FlexorPollicis Brevis | flexor retinaculum & tubercles of scaphoid & trapezium | lateral side of base of prox. phalanx of thumb | recurrent branch of medial nerve | flexes thumb | (blank) | (blank) |
| Extensor Carpi Radialis Brevis (superficial) | lateral epicondyle | base of 3rd metacarpal | deep branch of radial nerve | extend & abduct hand @ wrist jt | (blank) | (blank) |
| Platysma | inferior border of mandible, skin & subcutaneous tissues of lower face | fascia covering superior parts of pectoralis major & deltoid mm | cervical branch of facial nerve | draws corners of mouth inferiorly & widens it as in expressions of sadness & fright; draws skin of neck superiorly when teeth are clenched | (blank) | (blank) |
| Tensor Fascia Lata | ASIS & anterior part of iliac crest | iliotibial tract that attaches to lateral condyle of tibia | superior gluteal nerve (L4, L5) | abducts, medially rotates & flexes thigh; steadies trunk on thigh; helps to keep ? extended | (blank) | (blank) |
| Palmaris Longus | medial epicondyle | distal 1/2 of flexor retinaculum & palmar aponeurosis | median nerve | flexes hand @ wrist & tightens palmar aponeurosis | (blank) | (blank) |
| Gemelli Superior | ischial spine | medial surface of greater trochanter (trochanteric fossa) | L5, S1 | laterally rotates extended thigh & abducts flexed thigh; steady femoral head in acetabulum | (blank) | (blank) |
| Vastus Medialis | intertrochanteric line & medial lip of linea aspera | base of patella via patellar lig. to tibial tuberosity | femoral nerve (L2, L3, L4) | extends leg @ knee | (blank) | (blank) |
| Flexor Pollicis Longus (deep) | anterior surface of radius & adjacent interosseous membrane | base of distal phalanx of thumb | anterior interosseous nerve from median | flexes phalanges of 1st digit | (blank) | (blank) |
| Extensor Pollicis Longus (deep) | posterior surface of middle 3rd of ulna & interosseous membrane | base of distal phalanx of thumb | posterior interosseous nerve, continuation of deep branch of radial nerve | extends distal phalanx of thumb @ MCP & IP jts | (blank) | (blank) |
| rhomboid minor | nuchal lig. & sp. processes of C7 & T1 vert. | medial border of scapula from level of spine to inferior angle | dorsal scapular nerve C4, C5 | retract scapula & rotates to depress glenoid cavity; fix scapula to thoracic wall | along medial border of scap, superficial achy pain | movement does not affect pain |
| rhomboid major | sp. process of T2 to T5 vert. | medial border of scapula from level of spine to inferior angle | dorsal scapular nerve | retract scapula & rotates to depress glenoid cavity; fix scapula to thoracic wall | along medial border of scap, superficial achy pain | mvmt does not affect pain |
| Flexor Carpi Radialis (superficial) | medial epicondyle | base of 2nd metacarpal bone | median nerve | flexes & abducts hand @ wrist | (blank) | (blank) |
| Rectus Abdominis | pubic symphysis & pubic crest | xiphoid process & 5th to 7th costal cartilages | thoracoabdominal (ventral rami of inferior 6 thoracis) | flexes trunk (lumbar vert. & compresses abdominal viscera) | (blank) | (blank) |
| Gracilis | body & inferior ramus of pubis | superior part of medial surface of tibia | obturator nerve (L2, L3) | adducts thigh, flexes leg & rotates medially | (blank) | (blank) |
| Extensor Digitorum Longus | prox. 3/4 of medial surface of fibula; lateral condyle of tibia & interosseous membrane | middle & distal phalanges of lateral 4 digits | deep fibular nerve L5, S1 | extends lateral 4 digits & dorsiflexes ankle | (blank) | (blank) |
| Flexor Digitorum Longus | medial part of posterior surface of tibia inferior to soleol line & by broad tendon of fibula | bases of distal phalanges of lateral 4 digits | tibial nerves (s2, S3) | flexes lateral 4 digits & plantarflexes ankle; supports longitudinal arches of foot | (blank) | (blank) |
| Middle Scalene | TVP of C2 & posterior tubercles of TVPs of C3 to C7 | superior surface of 1st rib, posterior to groove for subclavian artery | ventral rami of cerv. spinal nerves | flexes neck laterally; elevates 1st rib during forced inspiration | pec area, back of arm, skip elbow to radial forearm, thumb, index finger | respiratory probs, mistaken for angina |
| Sternocleidomastoid | lateral surface of mastoid process & lateral 1/2 of superior nuchal line | Clavicular Head-> superior surface of medial 3rd of clavicle. Sternal Head-> anterior surface of manubrium of sternum | spinal root of accessory nerve & C2, C3 nerves | tilts head to one side laterally; flexes neck & rotates so face is turned superiorly toward opposite side; TOGETHER-> both mm flexes neck so chin is thrust forward | sternal: vertex, occiput, across cheek, over&around eye
Clavicular: frontal headache, deep earache, cheek or molar ache | sore throat, pain swallowing, tinnitus, nausea, vision changes, runny nose |
| Anterior Scalene | anterior tubercles of TVP of C3-C6 vert. | scalene tubercle of 1st rib, anterior to groove for subclavian artery | cervical spinal nerves C4, C5, C6 | elevates 1st rib; laterally flexes & rotates neck | pec area, back of arm, skip elbow to radial forearm, thumb, index finger | respiratory probs, mistaken for angina |
| Trapezius | medial 3rd of superior nuchal line; external occipital protuberance; nuchal ligament & sp. processes of C7 to T12 vert. | lateral 3rd of clavicle, acromion & spine of scapula | spinal root of accessory nerve & cervical nerves | elevates, retracts & rotates scapula; superior fibres elevate/middle fibres retract/inferior fibres depress scapula/sup. & infer. together rotates scapula | TrP #1: unilateral pain along postolateral neck to mastoid process; can also extend to temporal side of head, & back of eye (question mark) | sometimes mistaken for disc compression, bursitis |
| Pectoralis Minor | 3rd to 5th ribs near their costal cartilages | medial border & superior surface of coracoid process of scapula | medial pectoral nerve (C8 & T1) | stabilizes scapula by drawing it inferiorly & anteriorly against thoracic wall | (blank) | (blank) |
| Piriformis | anterior surface of sacrum & sacrotuberous ligament | superior border of greater trochanter | branches of ventral rami of S1, S2 | laterally rotates extended thigh & abducts flexed thigh; steady femoral head in acetabulum | (blank) | (blank) |
| Splenius Capitis | inf 1/2 of nuchal ligament & sp. processes of T1 to T6 | lateral aspect of mastoid process & lateral 3rd of superior nuchal line | dorsal rami of C2-C4 | ALONE-> laterally flexes & rotates head ipsilateral. TOGETHER-> extends head & neck | vertex of head on ipsilateral side | deep seated headach |
| Gluteus Maximus | ilium posterior to posterior gluteal line, dorsal surface of sacrum, coccyx & sacrotuberous ligament | most fibres end in IT band inserting into lateral condyle of tibia | inferior gluteal nerve (L5, S1, S2) | extends thigh from flexed position; assists in lateral rotation; steadies thigh & assists in rising from seated position | (blank) | (blank) |
| Latissimus Dorsi | sp. processes of T7 to T12 vert.; thoracolumbar fascia, iliac crest & inferior 3 or 4 ribs | floor of intertubercular groove of humerus | thoracodorsal nerve C6, C7, C8 | extends, adducts, medially rotates humerus; raises body toward arms during climbing | inferior angle of scap, may extend to back of shoulder, down medial forearm to ulnar aspect of hand, ring and middle fingers | pain when reaching up, forward
can be mistaken for frozen shoulder |
| Semitendinosis | ischial tuberosity | medial surface of superior part of tibia | tibial division of sciatic nerve (L5, S1, S2) | extends thigh, flexes leg & medially rotates when knee flexed; can extend trunk when thigh & leg are flexed | (blank) | (blank) |
| Adductor Pollicis | OBLIQUE HEAD-> bases of 2nd & 3rd metacarpals, capitate & adjacent carpals. TRANSVERSE HEAD-> anterior surface of body of 3rd metacarpal | medial side of base of prox. phalanx of thumb | deep branch of ulnar nerve (C8, T1) | adducts thumb toward middle digit | (blank) | (blank) |
| Infraspinatus | infraspinous fossa | middle facet of greater tubercle of humerus | suprascapula nerve C5, C6 | laterally rotates arm; help hold humeral head in glenoid cavity | deep intense pain in anterior shoulder, down anterior-lateral arm, forearm, radial half of hand | (blank) |
| Teres Major | dorsal surface of inferior angle of scapula | medial lip of intertubercular groove of humerus | lower subscapular nerve (C6, C7) | adducts & medially rotates arm | deep into posterior deltoid region | pain with motion #1 complaint |
| Supraspinatus | supraspinous fossa | superior facet of greater tubercle of humerus | suprascapular nerve C4, C5, C6 | initiates & assists deltoid in abduction of arm & acts w/ rotator cuff muscles | deep aches, esp medial deltoid, sometimes down arm to lateral epicondyle | mistaken for shoulder bursitis |
| Deltoid | lateral 3rd of clavicle, acromion & spine of scapula | deltoid tuberosity of humerus | axillary nerve C5, C6 | ANTERIOR PART-> flexes & medially rotates arm. MIDDLE PART-> abducts arm. POSTERIOR PART-> extends & laterally rotates arm | (blank) | (blank) |
| Biceps Brachii | Short Head-> tip of coracoid process. Long Head-> supraglenoid tubercle of scapula | radial tuberosity & fascia of forearm via bicipital aponeurosis | musculocutaneous nerve C5, C6 | supinates forearm & when supine, flexes forearm | (blank) | (blank) |
| Brachialis | distal 1/2 of anterior surface of humerus | coronoid process & tuberosity of ulna | musculocutaneous nerve C5, C6 | flexes forearm in all positions | base of thumb and dorsal web space | (blank) |
| Coracobrachialis | tip of coracoid process | middle 3rd of medial surface of humerus | musculocutaneous nerve C5, C6, C7 | helps to flex & adduct arm | (blank) | (blank) |
| Pronator Teres | medial epicondyle of humerus & coronoid process of ulna | middle of lateral surface of radius | median nerve | pronates & flexes forearm | (blank) | (blank) |
| Brachioradialis | prox. 2/3 of supracondylar ridge of humerus | lateral surface of distal ends of radius | radial nerve | flexes forearm | base of thumb and dorsa web space | (blank) |
| Gluteus Minimus | external surface of ilium & anterior & inferior gluteal lines | anterior surface of greater trochanter | superior gluteal nerve L5, S1 | abducts & medially rotates thigh; keeps pelvis level when opposite leg is raised | (blank) | (blank) |
| Temporalis | floor & deep fascia of temporal fossa | tip & medial surface of coronoid process of mand; anterior border of ramus of mand | deep temporal branches of mandibular nerve | elevate mandible; retract mandible | Temporal region, eyebrow, upper teeth | hurts to chew, sensitive teeth, restricted jaw mvmt |
| Masseter | inferior border & medial surface of zygomatic arch | lateral surface of ramus of mandible & coranoid process | mandibular nerve via masseteric nerve | elevates & protrudes mandible, deep fibres retrude | eyebrow, maxilla, anterior mandible, pain deep in ear | hurts to chew, sinus pain, tinnitus, restricted mvmt |
| Levator Scapulae | Posterior tubercles of TVP's of C1-C4 | superior part of medial border of scap (above root of spine) | Dorsal Scapular Nerve C5, cervical nerves C3-C4 | elevate scap, rotate scap to depress glenoid cavity | angle of neck with spillover along medial border of scap, posterior shoulder | often occurs with facet joint irritation, client turns whole body to look behind |
| Teres Minor | superior part of lateral border of scap | inferior facet of greater tubercle of humerus | axillary nerve C5, C6 | laterally rotate arm, hold humeral head in glenoid cavity | sharp deep pain in posterior deltoid prox to deltoid tuberosity (size of tooney) | mistaken for bursitis |
