LUMBAR OSCE

Question 1

What’s the rectus sheaf

Answer 1

complex and formation differs at levels, antero lateral abdominal wall, anterior layer is external and internal obliques,posterior layer is internal obliques and transversus abdominis layers interlace at mid line which is the linea Alba

Question 2

What’s the thoracolumbar fascia

Answer 2

Thoracolumbar fascia part of the posterior abdominal wall, which also includes psoas major, iliacus, quadratus lumborum, superficial to erector spinae and attaches spinous processes

Question 3

What are the origins and insertions of ligamentum flavum

Answer 3

Ligamentum flavum short but thick ligament connects laminae of adjacent vertebrae from c2-s1, preserves upright posture and assists vertebral column in resuming shape after flexion

Question 4

What are the origins and insertions of anterior longitudinal ligament

Answer 4

Anterior runs down the anterior surface of the spine, all of the vertebral bodies and intervertebral discs on their ventral side

Question 5

What are the origins and insertions of the posterior longitudinal ligament

Answer 5

The posterior longitudinal ligament is located posterior to the vertebral bodies and intervertebral discs, extends from back of sacrum and gradually broadens

Question 6

What muscles to include in the lumbar OSCE

Answer 6

Obliques
Rectus abdominis
Transversus abdominis
Quadratus lumborum

Question 7

What are the origins, insertions of rectus abdominis

Answer 7

Origins: xiphoïde process, 5th-7th ribs
Insertions: pubic symphysis, pubic crest
Anterior rami t6-t12

Question 8

What are the origins and insertions of transversus abdominis

Answer 8

Origins: 7th-12th ribs and their ccs
Insertions: thoracolumbar fascia, iliac crest, lateral 1/3 inguinal ligament
NS:L1 nerve anterior rami T7-t12

Question 9

What are the origins and insertions of quadratus lumborum

Answer 9

Origins: medial border lower 1/2 of 12th rib
Insertions: iliac crest, iliolumbar, transverse processes of lumbar vertebrae
NS: ventral roots t12-l4

Question 10

Origins and insertions of external oblique

Answer 10

Origins:5-12th ribs and their ccs
Insertions: 2/3 iliac crest, linea Alba via rectus sheaf, pubic tubercles to ASIS
Nerve supply: L1 nerve anterior rami T7

Question 11

Origins and insertions of internal oblique

Answer 11

Origins: 10th- 12th ribs, pectin pubis and rectus sheaf via linea Alba
Insertions: inguinal ligament, thoracolumbar fascia
NS: anterior rami T7-t12

Question 12

What is the supraspinous ligament

Answer 12

Originates from c7 and inserts into the sacrum, thicker and broader in lumbar region, limits flexion

Question 13

What is the interspinous ligament

Answer 13

Connect adjoining spinous processes in the vertebrae of the spine
Also limits flexion