Lumbar Muscle Energy Flashcards
What muscles make up the erector spinae?
- Iliocostalis
- Longissimus
- Spinalis
What are the functions of the erector spinae?
- bilateral contraction = spinal extension
- unilateral contraction = extension + ipsilateral sidebending
What are the origin and insertion of erector spinae?
sacrum to cervical
What muscle group would antagonize the erector spinae?
psoas muscle and abdominal muscles because they would induce lumbar flexion
What are the origins and insertions of quadratus lumborum?
12th rib and lumbar transverse processes to iliolumbar ligament and iliac crest
what are the actions of QL?
- bilateral contraction: extension
- unilateral contraction: extension with ipsilateral sidebending
What innervates QL?
T12 and L1-4 ventral rami
What is the function of the multifidus and rotatores?
These are postural muscles that control and stabilize individual vertebral motions
Psoas major
O: TP of T12-l5
I: lesser trochanter of femur
A: flexes and internally rotates hip
Innervation: L1-3 ventral rami
Iliacus
O: superior iliac fossa, inner lip of illiac crest, ventral sacroiliac and iliolumbar ligaments, upper lateral sacrum
I: lateral tendon of psoas
A: hip flexion, lumbar sidebending, constant activity in erect posture, important in function and stability
What are the attachments of ALL?
base of occiput –> anterior sacrum
What are the attachments of PLL?
posterior body of axis –> sacrum
Why does the lumbar vertebrae have increased risk of disc herniation?
PLL becomes more narrow as it goes down, so it provides less support to the lumbar vertebrae
What ligament is the first to become tender with lumbar posture changes?
iliolumbar ligament - tender area 1” superior and lateral to PSIS
where does iliolumbar attach?
TPs of L4/L5 and iliac crest
what is the function of the iliolumbar ligament?
increase stability at the lumbosacral junction - it is commonly strained in traumatic postural injuries
Where will the tender area of iliolumbar ligament be?
1” superior and lateral to PSIS
What Dx is due to severe low back pain of sudden onset and without Hx of trauma?
dissecting aortic aneurysm
What is a pain that wakes the pt from sleep?
malignancy until proven otherwise
what leads to rapidly progressing neurological deficits?
epidural abscesses/infection
what gives claudication Sx with back pain?
spinal stenosis
What does FDR stand for?
- Flexion Dysfunction for Type II
- Down (rotation of S.D. down)
- rotation into barrier:multifides and rotatores - Recumbent (lateral recumbent)
- extends the lumbar spine
- erector spinae and QL are bilaterally engaged
*when leg is lifted, sidebend spine into barrier
What does SUE stand for?
- Sims (lateral sims) for Type II
- pt in sims flexes
- psoas and abdominal muscles rotate lumbar spine into the barrier, some multifides and rotatores - Up (SD side up)
- Extension dysfunction
- dropping the legs off the table: sidebends into the barrier by unilaterally engaging erector spinae
What are the steps of a Type I Somatic Dysfunction?
- Pt is convex up, lateral recumbent (sidebent side down)
- Doc faces pt and monitors apex
- Flex knees and hip until motion felt - psoas and ab muscles
- Doc lifts both ankles toward the ceiling until motion at apex - sidebending component
- Pt pushes legs toward floor against doc’s isometric resistance
