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Anatomy
Upper Limb
You are asked to review a 45 year old carpenter who presents with weakness and pain in his left arm. You decide to test the strength of his left arm movements. The brachialis muscle acts to perform which of the following movements:
Answer:
The brachialis flexes the forearm at the elbow joint.Anterior Arm Muscles
Anatomy / Upper Limb / Anterior Arm
Last Updated: 8th April 2019
The anterior compartment of the arm consists of three muscles.
Table: Function and Innervation of the Anterior Arm Muscles
| Muscle | Function | Innervation |
|---|---|---|
| Coracobrachialis | Flexion of arm | Musculocutaneous nerve |
| Biceps brachii | Flexion and supination of forearm (primary), flexion of arm (accessory) | Musculocutaneous nerve |
| Brachialis | Flexion of forearm | Musculocutaneous nerve; small contribution by radial nerve to lateral part of muscle |
Coracobrachialis
The coracobrachialis flexes the arm at the glenohumeral joint. It is innervated by the musculocutaneous nerve.
Biceps brachii
The biceps brachii is primarily a powerful flexor of the forearm at the elbow joint and supinator of the forearm. It is also an accessory flexor of the arm at the glenohumeral joint (with the coracobrachialis muscle). It is innervated by the musculocutaneous nerve.
Brachialis
The brachialis flexes the forearm at the elbow joint. It is innervated primarily by the musculocutaneous nerve with a small contribution from the radial nerve.
![Modified by FRCEM Success. Original by Henry Vandyke Carter [Public domain], via Wikimedia Commons](https://primary-cdn.frcemsuccess.com/wp-content/uploads/2016/12/Anterior-Compartment-Arm.jpg)
Anterior Arm Muscles: Coracobrachialis (green), Biceps brachii (red), Brachialis (blue). (Image modified by FRCEM Success. Original by Henry Vandyke Carter [Public domain], via Wikimedia Commons)
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- Biochemistry
- Blood Gases
- Haematology
| Biochemistry | Normal Value |
|---|---|
| Sodium | 135 – 145 mmol/l |
| Potassium | 3.0 – 4.5 mmol/l |
| Urea | 2.5 – 7.5 mmol/l |
| Glucose | 3.5 – 5.0 mmol/l |
| Creatinine | 35 – 135 μmol/l |
| Alanine Aminotransferase (ALT) | 5 – 35 U/l |
| Gamma-glutamyl Transferase (GGT) | < 65 U/l |
| Alkaline Phosphatase (ALP) | 30 – 135 U/l |
| Aspartate Aminotransferase (AST) | < 40 U/l |
| Total Protein | 60 – 80 g/l |
| Albumin | 35 – 50 g/l |
| Globulin | 2.4 – 3.5 g/dl |
| Amylase | < 70 U/l |
| Total Bilirubin | 3 – 17 μmol/l |
| Calcium | 2.1 – 2.5 mmol/l |
| Chloride | 95 – 105 mmol/l |
| Phosphate | 0.8 – 1.4 mmol/l |
| Haematology | Normal Value |
|---|---|
| Haemoglobin | 11.5 – 16.6 g/dl |
| White Blood Cells | 4.0 – 11.0 x 109/l |
| Platelets | 150 – 450 x 109/l |
| MCV | 80 – 96 fl |
| MCHC | 32 – 36 g/dl |
| Neutrophils | 2.0 – 7.5 x 109/l |
| Lymphocytes | 1.5 – 4.0 x 109/l |
| Monocytes | 0.3 – 1.0 x 109/l |
| Eosinophils | 0.1 – 0.5 x 109/l |
| Basophils | < 0.2 x 109/l |
| Reticulocytes | < 2% |
| Haematocrit | 0.35 – 0.49 |
| Red Cell Distribution Width | 11 – 15% |
| Blood Gases | Normal Value |
|---|---|
| pH | 7.35 – 7.45 |
| pO2 | 11 – 14 kPa |
| pCO2 | 4.5 – 6.0 kPa |
| Base Excess | -2 – +2 mmol/l |
| Bicarbonate | 24 – 30 mmol/l |
| Lactate | < 2 mmol/l |
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