Triceps Brachii

OVERVIEW
Muscle Test Group: Triceps brachii and anconeus.

Key Points:

• Muscle group extends the elbow.
• Triceps brachii is composed of three muscle heads: long, medial, lateral.

EXAMINATION
Muscle Function: Extends the elbow. Long head assists in adduction and extension of the shoulder.

Palpation: Long, medial and lateral muscle bellies can be individually palpated on the posterior arm. Palpate just proximal to the olecranon.

Strength Testing:
Gravity-lessened Test: Position ““ patient seated or supine with shoulder and elbow flexed to 90º. Stabilize ““ forearm and hand to eliminate effect of gravity. Resist ““ extension of the elbow (in the direction of elbow flexion).

Alternate Gravity-lessened Test: Position ““ patient seated with shoulder abducted to 90º; elbow flexed to 90º. Stabilize ““ arm on a table close to shoulder height. Patient extends elbow by sliding forearm on the table. Resist ““ extension of the elbow (in the direction of elbow flexion).

Anti-gravity Test:

• Supine Position ““ shoulder flexed at 90º, elbow in full flexion. Stabilize ““ the shoulder and arm. Resist ““ extension of the elbow (in the direction of elbow flexion). Resist up to the unlocked position of slight elbow flexion and not to full extension (locked elbow).

• Prone Position ““ shoulder abducted at 90º, elbow flexed at 90º, forearm in neutral. Stabilize ““ with hand under shoulder and arm. Resist ““ extension of the elbow (in the direction of forearm flexion). Resist up to the unlocked position of slight elbow flexion and not to full extension (locked elbow).

• Seated Position ““ is not technically accurate, but a common alternate position (for ease of examination); shoulder and elbow flexed at 90º. Stabilize ““ the shoulder and arm. Resist – extension of the elbow (in the direction of forearm flexion). Resist up to the unlocked position of slight elbow flexion and not to full extension (locked elbow).

Possible Substitutions: No true substitutions. Careful not to let effect of gravity give illusion of active elbow extension.

Relevant Anatomy:
Triceps Brachii
Innervation:

• Roots: C6, C7, C8, T1.
• Nerve: Radial nerve.
• Innervation Route: C6, C7, C8, T1 â†’ radial nerve â†’ triceps brachii.

Origin of Long Head: Infraglenoid tubercle of the scapula.

Origin of Lateral Head: Lateral and posterior surface of the proximal ½ of the humerus and the lateral intermuscular septum.

Origin of Medial Head: Distal â…” of the medial and posterior surface of the humus below the radial groove and intermuscular septum.

Insertion: Posterior surface of the olecranon process of the ulna and the antebrachial fascia.

Anconeus
Innervation:

• Roots: C7, C8.
• Nerve: Radial nerve, axillary nerve.
• Innervation Route: C7, C8 â†’ axillary nerve â†’ triceps brachii branch â†’ medial triceps brachii branch â†’ anconeus.

Origin: Posterior surface of lateral epicondyle of humerus.

Insertion: Lateral side of olecranon process and superior ¼ of posterior surface of ulna.

Triceps Brachii

OVERVIEW
Muscle Test Group: Triceps brachii and anconeus.

Key Points:

• Muscle group extends the elbow.
• Triceps brachii is composed of three muscle heads: long, medial, lateral.

EXAMINATION
Muscle Function: Extends the elbow. Long head assists in adduction and extension of the shoulder.

Palpation: Long, medial and lateral muscle bellies can be individually palpated on the posterior arm. Palpate just proximal to the olecranon.

Anti-gravity Test:

• Supine Position ““ shoulder flexed at 90º, elbow in full flexion. Stabilize ““ the shoulder and arm. Resist ““ extension of the elbow (in the direction of elbow flexion). Resist up to the unlocked position of slight elbow flexion and not to full extension (locked elbow).

• Prone Position ““ shoulder abducted at 90º, elbow flexed at 90º, forearm in neutral. Stabilize ““ with hand under shoulder and arm. Resist ““ extension of the elbow (in the direction of forearm flexion). Resist up to the unlocked position of slight elbow flexion and not to full extension (locked elbow).

• Seated Position ““ is not technically accurate, but a common alternate position (for ease of examination); shoulder and elbow flexed at 90º. Stabilize ““ the shoulder and arm. Resist – extension of the elbow (in the direction of forearm flexion). Resist up to the unlocked position of slight elbow flexion and not to full extension (locked elbow).

Possible Substitutions: No true substitutions. Careful not to let effect of gravity give illusion of active elbow extension.

Relevant Anatomy:
Triceps Brachii
Innervation:

• Roots: C6, C7, C8, T1.
• Nerve: Radial nerve.
• Innervation Route: C6, C7, C8, T1 â†’ radial nerve â†’ triceps brachii.

Origin of Long Head: Infraglenoid tubercle of the scapula.

Origin of Lateral Head: Lateral and posterior surface of the proximal ½ of the humerus and the lateral intermuscular septum.

Origin of Medial Head: Distal â…” of the medial and posterior surface of the humus below the radial groove and intermuscular septum.

Insertion: Posterior surface of the olecranon process of the ulna and the antebrachial fascia.

Anconeus
Innervation:

• Roots: C7, C8.
• Nerve: Radial nerve, axillary nerve.
• Innervation Route: C7, C8 â†’ axillary nerve â†’ triceps brachii branch â†’ medial triceps brachii branch â†’ anconeus.

Origin: Posterior surface of lateral epicondyle of humerus.

Insertion: Lateral side of olecranon process and superior ¼ of posterior surface of ulna.

Triceps Brachii

Triceps Brachii

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