Muscle: Abductor
Digiti Minimi
Body Part: Fingers
Action: Abduction, 5th digit
Location: Midpoint of a line drawn between the 5th metocarpophalangeal
joint and the pisiform.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Abductor
Pollicis
Brevis
Body Part: Thumb
Action: Abduction
Location: Midpoint of a line drawn between the volar aspect of the
1st metacarpophalageal joint and the carpometacarpal joint.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Abductor
Pollicus
Longus
Body Part: Thumb
Action: Abduction
Location: Over the shaft of the radius at the mid-forearm deep to the
extensor digitorum communis.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Adductor longus
Body Part: Lower extremity
Action: Thigh Adduction
Location: Proximal 20% of the thigh, one quarter distance from the
medial border to the anterior border of the thigh
BTX-A Dose:
BTX-B Dose:
Image:
Notes: The adductor longus is no longer superficial in the distal
portion.
Deep to this is the adductor magnus, which is innervated by the sciatic
n.
Root: (L2), L3, L4
Nerve: Obturator
Clinical Situation:
------------------------------------------------
Muscle: Adductor Pollicis
Body Part: Thumb
Action: Adduction
Location: At the free edge of the 1st web space directed toward the
proximal end of the first metacarpal bone.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Anconeus
Body Part: Forearm, Elbow
Action: Extension
Location: Place the tip of the little finger on the olecranon and the
ring and middle fingers along with ulna, just beyond tip of middle
finger,
just radial to the ulna.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Biceps Brachii
Body Part: Elbow, Forearm
Action: Flexion, Supination, of the forearm
Location: Into the bulk of the muscle in the mid-arm.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Brachialis
Body Part: Elbow, Forearm
Action: Flexion of forearm in supination
Location: Two fingerbreaths proximal to the elbow crease along and
just lateral to the tendon and the bulk of the biceps.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Brachioradialis
Body Part: Elbow, Forearm
Action: Flexion in neutral position
Location: midway between the biceps tendon and the lateral epiconyle
along the flexor crease.
BTX-A Dose:
BTX-B Dose:
Image:
Notes: 0
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Coracobrachialis
Body Part: Shoulder, Arm
Action: Elevation of the arm with the elbow flex
Location: 4 fingerbreathsdistal to the coracoid process along the volar
aspect of the arm. Insert needle to the bone and withdraw.
BTX-A Dose:
BTX-B Dose:
Image:
Notes: 0
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Deltoid, Anterior
Body Part: Arm, Shoulder
Action: Elevation
Location: 3 fingerbreaths below the anterior margin of the acromion.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Deltoid, middle
Body Part: Arm, Shoulder
Action: Abduction
Location: Halfway between the tip of the acromion and the deltoid
tubercle.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Deltoid, posterior
Body Part: Arm, Shoulder
Action: Extension
Location: 2 fingerbreaths cuadad to the posterior margin of the
acromion.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Extensor
Carpi Radialis, Longus & Brevis
Body Part: Wrist
Action: Extension
Location: 2 fingerbreaths distal to lateral epicondyle.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Extensor Carpi
Ulnaris
Body Part: Wrist
Action: Extension
Location: Just above the shaft of the ulna in the middle of the
forearm.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Extensor
Digiti Minimi Proprius
Body Part: Fingers
Action: Extension at the metacarpophalaneal join
Location: Grasp the forearm at the unction of the upper and middle
3rd with the thumb and middle finger on the radius and ulna. Then
with the index finger bisect these 2 points and insert needle at the
tip
of index finger.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Extensor
Digitorum Communis
Body Part: Fingers
Action: Extension
Location:
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Extensor
Indicis
Proprius
Body Part: Fingers with other fingers flexed
Action: Extension
Location: 2 fingerbreaths proximal to the ulnar styloid just radial
to the ulnar at a depth of 0.5 in.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Extensor
Pollicis
Brevis
Body Part: Thumb
Action: Extension proximal phalanx
Location: Directly on the ulnar side of the radius, 4 fingerbeaths
proximal to the wrist, deep to the extensor digitorum communis.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Extensor
Pollicis
Longus
Body Part: Thumb
Action: Extension distal phalanx
Location: Along the radial border of the ulnar in the mid-forearm,
deep to the exensor carpi ulnaris.
BTX-A Dose:
BTX-B Dose:
Image:
Notes: 0
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Flexor Carpi
Radialis
Body Part: Wrist
Action: Flexion
Location: Four finger-breadths from the midpoint between the biceps
tendon and the medial epicondyle.
BTX-A Dose: 25-50
BTX-B Dose: 1250-2500
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Flexor Carpi Ulnaris
Body Part: Forearm
Action: Flexor
Location: Medial surface of the forearm about midway from the ulna.
BTX-A Dose: 25-50
BTX-B Dose: 1250-2500
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Flexor
Digitorum
Profundus
Body Part: Fingers
Action: Flexion, distal phalanges
Location: Place the tip of the little finger on the olecranon and the
ring, middle and index fingers along the shaft of the ulna.
Insert
the needle just beyond tip of the index finger just ulnar to the shaft.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Flexor
Digitorum Superficialis
Body Part: Fingers
Action: Flexion, proximal interphalangeal jt.
Location: Grasp with your palm to the volar surface of the subject's
wrist. Point the index finger to the bicps tendon and insert the
needle just ulnar to the tip of the index finger, deep to the palmaris
longus.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Flexor Pollicis
Brevis
Body Part: Thumb
Action: Flexion, distal phalanx
Location: Junction between the middle and radial 3rd of a line drawn
between the ulnar aspect of the metacarpophalangeal joint and the
pisifrom.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Flexor Pollicis
Longus
Body Part: Thumb
Action: Flexion of the distal phalanx.
Location: In the mid forearm, from the radial aspect, just volar to
the radius, deep to the flexor carpi radialis and flexor digitorum
superficialis.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Infraspinatus
Body Part: Arm
Action: External rotation
Location: Into infraspinous fossa, 2 fingerbreaths below the medial
portion of the spine of the scapula.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Interossei, Dorsal
Body Part: Fingers
Action: Deviation of the digits.
Location: The common landmark for both the volar and dorsal interossei
is a transmetacarpal line perpendicular to the long axis of the hand at
the level of the first metacarpal joint. Insertions are
made
along this line:
1st dorsal - Just radial to 2nd metacarpal
2nd dorsal - Just radial to 3rd metacarpal
3rd dorsal - Just ulnar to 3rd metacarpal
4th dorsal - Just ulnar to 4th metacarpal
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Interossei, Volar
Body Part: Fingers
Action: deviates the digits
Location: Along a transmetacarpal line perpendicular to the long axis
of the hand at the level of the first metacarpal joint.
Insertions
are made along this line:
1st volar - Just ulnar to 2nd metacarpal
2nd volar - Just radial to 4th metacarpal
3rd volar - Just radial to 5th metacarpal
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Latissimus Dorsi
Body Part: Arm
Action: Internal rotation, Adduction, Extension
Location: 3 fingerbreadths distal to and along the posterior axillary
fold.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation: Spasticity-adducted/internally rotated shoulder
------------------------------------------------
Muscle: Levator scapulae
Body Part: Shoulder
Action: Elevation
Location: Runs deep to the trapezius, bordered medially by the splenius
capitis, and laterally by the scalenus complex. Inject anterior
to
the border of the trapezius.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root: C3, C4
Nerve: Cervical plexus
Clinical Situation: Cervical dystonia
------------------------------------------------
Muscle: Lumbricals
Body Part: Fingers
Action: Flexion of the metacarpophalangeal joint
Location: Just proximal to the joint and radial to the flexion tendon.
BTX-A Dose:
BTX-B Dose:
Image:
Notes: 0
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Opponens Digiti
Minimi
Body Part: Fingers, 5th digit
Action: Oppose
Location: Midpoint between a line drawn between the radial aspect of
the 5th metacarpophalangeal joint and the radial aspect of the
pisiform.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Oppenens Pollicis
Body Part: Thumb
Action: Oppose
Location: Midpoint of a line drawn between the radial aspect
of the carpometacarpal joint and the metacarpophalangeal joints.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Palmaris Longus
Body Part: Hand
Action: Cup
Location: At the junction of the upper and middle thirds of a
line joining the medial epicondyle and the middle of the volar surface
of the wrist.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Pectoralis Major
Body Part: Arm
Action: Adduction
Location: Into the anterior axillary fold.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root: C6, C7, C8
Nerve: Medial pectoral n (medial cord), lateral pectoral n (lateral
cord)
Clinical Situation: Spasticity-adducted/internally rotated shoulder
------------------------------------------------
Muscle: Pectoralis Minor
Body Part: Shoulder
Action: Depression
Location: In the midclavicular line insert needle to anterior surface
of the 3rd rib deep to the pectoralis major.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Pronator Quadratus
Body Part: Forearm
Action: Pronation
Location: 3 fingerbreaths proximal to the midpoint of a line connecting
the radial and the ulnar styloids, depth of 0.75 in.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Pronator Teres
Body Part: Forearm
Action: Pronation
Location: 2 fingerbreaths distal to the midpoint of a line connecting
the medial epicondyl and the biceps tendon.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Rhomboideus Major
Body Part: Back Shoulder Scapula
Action: Retracts scapula. Rotates scapula to rest position
Location: Midway between spine and the inferior angle of the scapula
just medial to the vertebral border, deep to trapezius.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root: C5
Nerve: Dorsal scapular n.
Clinical Situation:
------------------------------------------------
Muscle: Rhomboideus Minor
Body Part: Back Shoulder
Action: Retracts scapula. Rotates lower scapula back to rest position
Location: 1 fingerbreadth medial to vertebral end of the scapular
spine,
deep to trapezius.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root: C5
Nerve: Dorsal Scapular n.
Clinical Situation:
------------------------------------------------
Muscle: Scalenus complex
Body Part: Shoulder
Action: Elevation
Location: Palpate the posterior, middle and anterior muscle belly at
the junction between the neck and the shoulder laterally.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root: C3, C4
Nerve: Cervical plexus
Clinical Situation: Cervical dystonia
------------------------------------------------
Muscle: Serratus Anterior
Body Part: Shoulder Back Scapula
Action: Displacement-Lateral, Laterally rotates and protracts scapula
Location: Just lateral to inferior angle of the scapula.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Subscapularis
Body Part: Arm
Action: Internal rotation
Location:
BTX-A Dose:
BTX-B Dose: 1000-3000 U in 1-2 injections
Image:
Notes:
Root: C6, C7
Nerve: Subscapularis n.
Clinical Situation: Spasticity-adducted/internally rotated shoulder
------------------------------------------------
Muscle: Supinator
Body Part: Forearm
Action: Supination
Location: Just radial to the most distal insertion of the biceps tendon
- deep to the extensor digitorum communnis.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Supraspinatus
Body Part: Arm
Action: External rotation
Location: Supraspinatous fossa just above the middle of the spine of
the scapula, deep to the midtrapezius muscle.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Teres Major
Body Part: Arm
Action: Internal rotation
Location: 3 fingerbreaths above the inferior angle of the scapula along
the lateral border.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Teres Minor
Body Part: Arm
Action: External rotation
Location: Insert 1/3 way between acromion and inferior angle of the
scapula along the lateral border.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Trapezius
Body Part: Shoulder
Action: Elevation
Location:
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation: Cervical dystonia
------------------------------------------------
Muscle: Triceps
Body Part: Arm
Action: Extension
Location:
BTX-A Dose: 100
BTX-B Dose: 5000
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------
Muscle: Triceps,
medial lateral, and long head.
Body Part: Elbow, Forearm
Action: Extension
Location: Lateral head - Immedicate posterior to the insertion of
deltoid
(deltoid tubercule).
Long head - 4 fingerbreaths distal to the posterior axillary fold.
Medial head - 3 fingerbreaths proximal to the medial epiconye of the
humerus.
BTX-A Dose:
BTX-B Dose:
Image:
Notes:
Root:
Nerve:
Clinical Situation:
------------------------------------------------