Acupuncture Anatomy Review - Muscle and Skeletal Landmarks

Our anatomy review section covers the terminology and musculoskeletal landmarks which are commonly used in the finding of acupuncture points. This information is also useful for practitioners of any style of bodywork or energywork.

If you have not had an acupuncture treatment or are looking for more general information, you may want to read our acupuncture basics page as well as our first acupuncture treatment information.

Review of Musculoskeletal Terminology

¤ Terms of Position and Direction

Superior  toward the head or upper part of a structure
Inferior  away from the head or toward the lower part of a structure
Anterior
Ventral
 nearer to or at the front of the body
Posterior
Dorsal
 nearer to or at the back of the body
Superficial  toward or on the surface of the body
Deep  away from the surface of the body
Medial  nearer to the midline of the body or a structure
Lateral  farther from the midline of the body or a structure
Intermediate  between two structures
Proximal  nearer to the attachment of a limb to the trunk
nearer to the point of origin
Distal  farther from the attachment of a limb to the trunk
farther from the point of origin
Ipsilateral  on the same side of the body
Contralateral  on the opposite side of the body

¤ Terms of Movement

Flexion  a decrease in the angle of a joint
Extension  an increase in the angle of a joint
Abduction  movement away from the midline of the body
Adduction  movement towards the midline of the body
Horizontal Abduction  movement away from the midline of the body in a horizontal plane
Horizontal Adduction  movement towards the midline of the body in a horizontal plane
Medial Rotation  movement around a longitudinal axis toward the midline of the body
Lateral Rotation  movement around a longitudinal axis away from the midline of the body
Elevation  upward movement
Depression  downward movement
Protraction  forward movement (mandible and scapula)
Retraction  backward movement (mandible and scapula)
Supination  movement of forearm in which the palm is turned anteriorly
Pronation  movement of forearm in which the palm is turned posteriorly
Inversion  movement of the soles inward so they face eachother
Eversion  movement of the soles outward so they face away from eachother
Dorsiflexion  bending the foot upward
Plantarflexion  bending the foot downward

Muscle Landmarks for CAM Practitioners

 
Origin
Insertion
Action
Innervation
Muscles of the Forearm & Hand
 
thumb = I/1
pinky = V/5
 
Extensor Digitorum
fingers
 lateral epicondyle of humerus via common extensor tendon  base of middle and distal phalanges II-V  extension of digits II-V
 radial nerve from C6, 7 & 8
Flexor Digitorum Superficialis
fingers
 medial epicondyle of humerus, coronoid process of ulna  both sides of the middle phalanges of digits II-V  flexion of digits II-V & wrist
 median nerve from C7, 8 & T1
Flexor Digitorum Profundus
fingers
 anterior surface of proximal 3/4 of ulna  base of the distal phalanges of digits II-V  flexion of fingers II-V & wrist
 median nerve from C8 & T1 for digits II/III and from C8 & T2 for digits IV/V
 
Origin
Insertion
Action
Innervation
Abductor Pollicis Longus
thumb
 posterior radius and ulna  base of metacarpal I  abduction of thumb
 radial nerve from C6 & 7
Adductor Pollicis
thumb
 capitate, metacarpals II & III  base of proximal phalanx of thumb  adduction & flexion of thumb
 ulnar nerve from C8 & T1
Extensor Pollicis Longus
thumb
 posterior radius and ulna  base of distal phalanx of thumb  extension of thumb
 radial nerve from C6, 7 & 8
Extensor Pollicis Brevis
thumb
 posterior radius and ulna  base of proximal phalanx of thumb  extension of thumb
 radial nerve from C6 & 7
Flexor Pollicis Longus
thumb
 anterior radius  base of distal phalanx of thumb  flexion of thumb
 media nerve from C8 & T1
Opponens Pollicis
thumb
 flexor retinaculum and tubercle of trapezium  radial side of metacarpal I  oppose the thumb
 median nerve from C6 & 7
 
Origin
Insertion
Action
Innervation
Extensor Carpi Ulnaris
wrist
 lateral epicondyle of humerus via common extensor tendon, posterior proximal ulna  base of metacarpal V  adduction of wrist, extension
 radial nerve from C6, 7 & 8
Extensor Carpi Radialis Longus
wrist
 lateral epicondyle of humerus, lateral supracondylar ridge  base of metacarpal II  abduction of wrist, extension
 radial nerve from C6 & 7
Extensor Carpi Radialis Brevis
wrist
 lateral epicondyle of humerus  base of metacarpal III  extension of wrist
radial nerve from C6 & 7
Flexor Carpi Radialis
wrist
 medial epicondyle of humerus via common flexor tendon  base of metacarpal II and III  abduction of wrist, flexion
 median nerve from C6 & 7
Flexor Carpi Ulnaris
wrist
 medial epicondyle of humerus via common flexor tendon  pisiform  adduction of wrist, flexion
 ulnar nerve from C8 & T1
Palmaris Longus
wrist
 medial epicondyle of humerus via common flexor tendon  flexor retinaculum and palmar aponeurosis  flexion
 median nerve from C6 & 7
 
Origin
Insertion
Action
Innervation
Muscles of the Shoulder and Arm
     
Pronator Teres
radioulnar
 medial epicondyle of humerus via common flexor tendon, coronoid process of ulna  middle of lateral shaft of radius  pronation of forearm, flexion
 median nerve from C6 & 7
Pronator Quadratus
radioulnar
 distal fourth of anterior ulna  distal fourth of anterior radius  pronation of forearm
 median nerve from C8 & T1
Supinator
radioulnar
 lateral epicondyle of humerus, radial collateral and annular ligaments  lateral surface of proximal shaft of humerus  supination of forearm
 radial nerve from C6
 
Origin
Insertion
Action
Innervation
Brachioradialis
elbow
 lateral supracondylar ridge of humerus  styloid process of radius  flexion of elbow
 radial nerve from C5 & 6
Brachialis
elbow
 distal 1/2 of anterior surface of humerus  ulnar tuberosity  flexion of elbow
 musculocutaneous nerve C5, 6 & 7
Biceps Brachii
elbow
 long head: supraglenoid tubercle of scapula
short head: coracoid process of scapula
 radial tuberosity, aponeurosis of biceps brachii  flexion of elbow, shoulder, supination
 musculocutaneous nerve from C5 & 6
Triceps Brachii
elbow
 long head: infraglenoid tubercle of scapula
lateral head: posterior surface of proximal 1/2 of humerus
medial head: posterior surface of distal 1/2 of humerus
 olecranon process of elbow  extension of elbow, (long head) adduction of shoulder
 radial nerve from C7 & 8
Anconeus
elbow
 lateral epicondyle of humerus  olecranon process and upper posterior surface of ulna  extension of elbow
 radial nerve from C7 & 8
 
Origin
Insertion
Action
Innervation
Coracobrachialis
shoulder
 coracoid process of scapula  medial surface of midshaft of humerus  adduction and flexion of shoulder
 musculocutaneous nerve from C5, 6 & 7
Pectoralis Major
shoulder
 medial half of clavicle, sternum, cartilage of ribs 1-6  greater tubercle of humerus  flexion, adduction, medial rotation, horizonatal adduction of shoulder
 sternal head: medial pectoral nerve from C8 & T1, clavicular head: lateral pectoral nerve from C5, 6 & 7
Deltoid
shoulder
 lateral 1/3 of clavicle, acromion, spine of scapula  deltoid tuberosity  anterior: flexion, medial rotation, horizontal adduction of shoulder; posterior: extension, lateral rotation, horizontal abduction of shoulder; middle, abduction
 axillary nerve from C5 & 6
Latissimus Dorsi
shoulder
 spinous processes of T6-T12, last 3-4 ribs, posterior iliac crest  lesser tubercle  extension, medial rotation, adduction of shoulder
 thoracodorsal nerve from C6, 7 & 8
Teres Major
shoulder
 lower half of lateral border of scapula, inferior angle  less tubercle  extension, medial rotation, adduction of shoulder
 lower subscapular nerve from C5 & 6
 
Origin
Insertion
Action
Innervation
Teres Minor
rotator cuff
 superior half of lateral border of scapula  greater tubercle of humerus  lateral rotation, adduction of shoulder
 axillary nerve from C5 & 6
Infraspinatus
rotator cuff
 infraspinous fossa of scapula  greater tubercle of humerus  lateral rotation, adduction of shoulder
 suprascapular nerve from C5 & 6
Supraspinatus
rotator cuff
 supraspinous fossa of scapula  greater tubercle of humerus  abduction of shoulder
 suprascapular nerve from C5 & 6
Subscapularis
rotator cuff
 subscapular fossa of scapula  lesser tubercle of humerus  medial rotation of shoulder
 upper and lower subscapular nerve from C5 & 6
 
Origin
Insertion
Action
Innervation
Serratus Anterior
scapula
 surfaces of upper 8 or 9 ribs  anterior surface of the medial border of the scapula  abduction of scapula, hold scapula against rib cage
 long thoracic nerve from C5, 6 & 7
Pectoralis Minor
scapula
 ribs 3-5  coracoid process of scapula  depression, abduction, anterior tilt of scapula
 medial pectoral nerve from C8 & T1
Levator Scapula
scapula
 transverse processes of C1-C4  medial border & superior angle of scapula  elevation, medial rotation of scapula
 dorsal scapular nerve from C5 & branches from C3 & 4
Trapezius
scapula
 external occipital protruberance, medial portion of superior nuchal line of occiput, ligamentum nuchae, spinous processes of C7-T12  lateral portion of clavicle, acromion and spine of scapula  upper, elevation & upward rotation of scapula; middle, adduction of scapula; lower, depression & upward rotation of scapula
 accessory nerve (cranial nerve XI) & branches from C3 & 4
Rhomboids Major & Minor
scapula
 major, spinous processes of T2-T5; minor, spinous process of C7-T1  medial border of scapula between spine & inferior angle  elevation, downward rotation, adduction of scapula
 dorsal scapular nerve from C5
 
Origin
Insertion
Action
Innervation
Muscles of the Head, Neck & Face
     
Temporalis
jaw
 temporal fossa and fascia  coronoid process of mandible  elevate, retract mandible
 cranial nerve V (trigeminal)
Masseter
jaw
 zygomatic arch  angle and ramus of mandible  elevate mandible
 cranial nerve V (trigeminal)
Suprahyoids
jaw
 styloid process, underside of mandible  hyoid bone  depress mandible
cranial nerve V (trigeminal)
Digastric
jaw
 mastoid process  inferior border of mandible  hyoid fixed - depress mandible, retract jaw
 cranial nerves V, VII & X11 from C1
 
Origin
Insertion
Action
Innervation
Sternocleidomastoid
neck
 sternal head, top of manubrium; clavicular head, medial 1/3 of clavicle  mastoid process of temporal bone, lateral superior nuchal line of occiput  unilateral, ipsilateral lateral flexion, contralateral rotation; bilateral, flexion of neck, inspiration
 cranial nerve XI (accessory nerve) from C2 & 3
Suboccipital Muscles
neck
 axis (rectus capitis, posterior major & oblique capitis inferior); atlas (rectus capitis posterior minor & oblique capitis superior  atlas except oblique inferior - nuchal line of occiput  extend head except oblique inferior - ipsilateral rotation w/rectus capitis major
Splenius Cervicis
neck
 spinous processes of T3-T6  transverse processes of upper cervical vertebrae  unilateral, ipsilateral lateral flexion, ipsilateral rotation; bilateral, extend head
 dorsal rami of lower cervical nerves
Splenius Capitis
neck
 ligamentus nuchae, spinous proceses of C7-T3  mastoid process, lateral nuchal line  unilateral, ipsilateral lateral flexion, ipsilateral rotation; bilateral, extend head
 dorsal rami of lower cervical nerves
Scalenes
neck
 transverse processes of C1-C7  anterior & middle, 1st rib; posterior, 2nd rib  unilateral, flexion & contralateral rotation of neck; bilateral, flexion of neck, elevate ribs, inspiration
 ventral rami of cranial nerves 3-8
Semispinalis
neck
 transverse processes of T1-T12, articular processes of lower cervical vertebrae  spinous processes of upper thoracic, cervical vertebrae (except C1), superior nucahl line of occiput  extend vertebral column & head
 dorsal rami of spinal nerves
 
Origin
Insertion
Action
Innervation
Muscles of the Spine, Chest & Abdomen
     
Erector Spinae Group (Iliocostalis - lateral, Longissiumus - longest, Spinalis - medial)
spine
 common tendon (thoracolumbar aponeurosis), sacrus, iliac crest, spinous processes of T11-L5  posterior ribs, spinous and transverse processes of cervical and thoracic vertebrae, mastoid process of temporal bone  unilateral, ipsilateral flexion; bilateral, extension of spine
 dorsal rami of spinal nerves
Transversospinalis Group (Multifidi & Rotatores)
spine
 sacrum, transverse processes of lumbar and cervical vertebrae  spinous processes of all vertebrae from lumbar to C2  all transverse to spinous process (multifidi 1+ segment, rotatores 1 segment); extension and contralateral rotation of spine
 dorsal rami of spinal nerves
Quadratus Lumborum
spine
 posterior iliac crest, iliolumbar ligament  last rib, transverse processes of L1-L4  unilateral, elevate hip, lateral flexion, extension of spine
 ventral rami from T12-L4
 
Origin
Insertion
Action
Innervation
Muscles of Respiration
chest
 inspiration, pectoralis minor, sternocleidomastoid, scalenes & serratus anterior  expiration, abdominal muscles  primary, diaphragm
Intercostals
chest
 inferior border of rib above  superior border of rib below  external, increase space between ribs; internal, decrease space
Diaphragm
chest
 sternal head, inner part of xyphoid process; costal head, inner surface of lower 6 ribs; lumbar head, upper 2 or 3 lumbar vertebrae  central tendon  draw central tendon down, increase volume of thoracic cavity
 phrenic nerve from C3, 4 & 5
 
Origin
Insertion
Action
Innervation
Rectus Abdominus
abdomen superficial
 crest of pubis, pubic symphysis  cartilage of ribs 5-7, xyphoid process  flexion of spine
 ventral rami of intercostal nerves from T7-T12
External Oblique
abdomen superficial
 lower 8 ribs  anterior part of iliac crest, abdominal aponeurosis to linea abla  unilateral, ipsilateral lateral flexion, contralateral rotation; bilateral, flexion of thorax, compress abdominal contents
 ventral rami of intercostal nervces from T7-T12 & iliohypogastric & ilioinguinal nerves from L1
Interal Oblique
abdomen deep
 lateral inguinal ligament, iliac crest, thoracolumbar fascia  cartilabe of lower 3 ribs, abdominal aponeurosis to linea alba  unilateral, ipsilateral lateral flexion, ipsilateral rotation; bilateral, flexion of thorax, compress abdominal contents
 ventral rami of intercostal nerves from T8-T12 & iliohypogastric & ilioinguinal nerves from L1
Transverse Abdominus
abdomen deep
 lateral inguinal ligament, iliac crest, thoracolumbar fascia, cartilage of lower 6 ribs  abdominal aponeurosis to linea alba  compress abdominal contents
 ventral rami of intercostal nerves from T7-T12 & iliohypogastric & ilioinguinal nerves from L1
 
Origin
Insertion
Action
Innervation
Muscles of the Pelvis & Thigh
     
Gluteus Maximus
pelvis
 coccyx, posterior sacrum, posterior iliac crest, sacrotuberous and sacroiliac ligaments  gluteal tuberosity and iliotibial tract  extension, lateral rotation, abduction of hip
 inferior gluteal nerve from L5-S2
Gluteus Medius
pelvis
 external surface of the ilium between the iliac crest and the posterior and anterior gluteal line  greater trochanter  abduction, flexion, extension of hip
 superior gluteal nerve from L4-S1
Gluteus Minimus
pelvis
 external surface of the ilium between the anterior and inferior gluteal lines  anterior border of greater trochanter  medial rotation, abduction, flexion of hip
superior gluteal nerve from L4-S1
 
Origin
Insertion
Action
Innervation
Piriformis
hip
 anterior surface of sacrum  greater trochanter  lateral rotation of hip
 sacral plexus (L4-S2) branches
Quadratus Femoris
hip
 lateral border of ischial tuberosity  greater trochanter  lateral rotation of hip
 sacral plexus (L4-S2) branches
Obturator Externus
hip
 superior and inferior ramus of pubis  greater trochanter  lateral rotation of hip
 obturator nerve from L3 & 4
Obturator Internus
hip
 obturator membrane and pelvic surface  greater trochanter  lateral rotation of hip
 sacral plexus (L4-S2) branches
Superior Gemellus
hip
 spine of ischium  greater trochanter  lateral rotation of hip
 sacral plexus (L4-S2) branches
Inferior Gemellus
hip
 ischial tuberosity  greater trochanter  lateral rotation of hip
 sacral plexus (L4-S2) branches
 
Origin
Insertion
Action
Innervation
Tensor Fascia Latae
hip
 iliac crest posterior to the ASIS  iliotibial tract  medial rotation, flexion, abduction of hip
 superior gluteal nerve from L4-S1
Sartorius
hip
 anterior superior iliac spine (ASIS)  proximal, medial shaft of the tibia  lateral rotation, flexion, abduction of hip, flex knee
 femoral nerve from L2-4
 
Origin
Insertion
Action
Innervation
Psoas Major
hip
 bodies and transverse processes of lumbar vertebrae  lesser trochanter of the femur  flexion, lateral rotation, adduction of hip
 nerves from L2 & 3 directly
Iliacus
hip
 iliac fossa  lesser trochanter of the femur  flexion, lateral rotation, adduction of hip
 femoral nerve from L2, 3 & 4
Adductor Magnus
hip
 pubis  linea aspera  adduction of hip
 anterior: obturator nerve from L2-4
posterior: sciatic nerve from L4-S3
Adductor Longus
hip
 pubis  linea aspera  adduction of hip
 obturator nerve from L3 & 4
Adductor Brevis
hip
 pubis  linea aspera  adduction of hip
 obturator nerve from L3 & 4
Pectineus
hip
 pubis  linea aspera  adduction of hip
 femoral nerve from L2-4
Gracilis
hip
 pubis  proximal & medial shaft of tibia at pes anserinus tendon  adduction of hip, assist with flexion
 
Origin
Insertion
Action
Innervation
Semitendinosis
hip
 ischial tuberosity  proximal and medial tibia at pes anserinus tendon  extension, medial rotation of hip, flexion of knee
 tibial division of sciatic nerve from L5-S1
Semimembranosus
hip
 ischial tuberosity  posterior medial condyle of tibia  extension, medial rotation of hip, flexion of knee
 tibial division of sciatic nerve from L5-S1
Biceps Femoris
hip
 long head: ischial tuberosity
short head: linea aspera
 head of the fibula  extension, lateral rotation of hip, flexion of knee
 long head: tibial division of sciatic nerve from S1-3
short head: peroneal division of sciatic nerve from L5-S2
 
Origin
Insertion
Action
Innervation
Rectus Femoris
knee
 anterior inferior iliac spine (ASIS)  tibial tuberosity via patellar ligament  extension of knee, flexion of hip
 femoral nerve from L2-4
Vastus Medialis
knee
 linea aspera  tibial tuberosity via patellar ligament  extension of knee
 femoral nerve from L2-4
Vastus Intermedius
knee
 anterior and lateral shaft of femur  tibial tuberosity via patellar ligament  extension of knee
 femoral nerve from L2-4
Vastus Lateralis
knee
 linea aspera  tibial tuberosity via patellar ligament  extension of knee
 femoral nerve from L2-4
 
Origin
Insertion
Action
Innervation
Muscles of the Leg & Foot
     
Plantaris
foot
 lateral epicondyle of femur  calcaneus via calcaneal tendon  plantar flexion
 tibial nerve from L4-S1
Gastrocnemius
foot
 posterior condyle of femur  calcaneus via calcaneal tendon  plantar flexion, flexion of knee
 tibial nerve from S1-2
Soleus
foot
 posterior tibia, soleal line, proximal posterior fibula  calcaneus via calcaneal tendon  plantar flexion
 tibial nerve from S1-2
 
Origin
Insertion
Action
Innervation
Tibialis Posterior
foot
 posterior tibia, fibula, interosseus membrane  navicular, cuboid & lateral cuneiform bones  plantar flexion, inversion of foot
 tibial nerve from L5-S1
Flexor Digitorum Longus
foot
 posterior tibia  distal phalanges of lateral toes II-V  plantar flexion, inversion of foot, flexion of toes II-V
 tibial nerve from L5 & S1
Flexor Hallicus Longus
foot
 posterior tibia  base & distal phalanges of toe I  plantar flexion, inversion of foot, flexion of toe I
 tibial nerve from L5-S2
 
Origin
Insertion
Action
Innervation
Peroneus Longus
foot
 proximal 2/3 of lateral fibula  base of metatarsal I, medial cuneiform  eversion
 superficial peroneal nerve from L4-S1
Peroneus Brevis
foot
 distal 2/3 of lateral fibula  tuberosity of metatarsal V  eversion
 superficial peroneal nerve from L4-S1
 
Origin
Insertion
Action
Innervation
Tibialis Anterior
foot
 lateral condyle & lateral proximal shaft of tibia, interosseus membrance  base of metatarsal I, medial cuneiform  dorsiflexion
 deep peroneal nerve from L4-S1
Extensor Digitorum Longus
foot
 lateral tibial condyle, proximal shaft of fibula, interosseus membrane  middle & distal phalanges of toes II-V  dorsiflexion, extension of toes II-V
 deep peroneal nerve L4-S1
Extensor Hallicus Longus
foot
 middle, anterior fibula, interosseus membrane  base of distal phalanx of toe I  dorsiflexion, extension of toe I
 deep peroneal nerve L4-S1
 
Origin
Insertion
Action
Innervation

Skeletal Landmarks for CAM Practitioners

  • Carpal Bones of the Hand:
  • On (R)ight palm, radial aspect to ulnar aspect (thumb/I to pinky/V)
  • Proximal Row: Scaphoid, Lunate, Triquetrum, Pisiform
  • Distal Row: Trapezium, Trapezoid, Capitate, Hamate

Sources and More Information

There are many resources which discuss the human anatomy both from a western perspective and how it may apply to the variety of complementary and alternative styles of medicine. Our Anatomy and Physiology Resources section contains a comprehensive list of useful texts and internet resources. The sources that were used for this section are:

  • Anderson, Sandy K.: Desert Institute of Healing Arts, Anatomy and Physiology Lecture Notes
  • Markus, Stephen F.: New England School of Acupuncture, Living Anatomy and Structural Analysis Lecture Notes